For millions of Americans between jobs, COBRA continues coverage from a former employer, but the price tag routinely runs $600 to $750 a month for single coverage and north of $2,000 for a family, according to employer benefit surveys and KFF data.
It's the full premium your employer used to split with you, plus a small administrative fee, now landing entirely on your debit card.
Here's the math that catches people off guard.
If your paycheck deduction was $150 a month, your employer was likely covering another $500 or more.
Workers who lose a $60,000 job can suddenly face $9,000 a year in premiums before a single deductible is met.
The 60-day election window is where people get trapped.
You have 60 days from the coverage loss notice to enroll, and if you skip it, you generally can't come back later.
Enrollment can also be retroactive, meaning you might owe two months of premiums at once when you sign up.
Miss a payment by even a few days and coverage can vanish.
The alternative most people don't check: Healthcare.gov.
Losing job-based coverage counts as a qualifying life event, so you can enroll outside open enrollment.
Subsidies are often the difference-maker.
A family earning $70,000 could see marketplace premiums drop to a few hundred dollars a month after credits, far below the COBRA quote.
In the 40-plus states that expanded coverage, adults under roughly $20,000 to $25,000 in income often qualify, and premiums are near zero.
State processing backlogs can run weeks, so applying the day you lose coverage matters.
Short-term health plans look cheap online, sometimes $80 to $150 a month, but they can exclude pre-existing conditions, skip maternity care, and cap payouts.
They are not a substitute for real coverage, and several states restrict or ban them.
One more wrinkle: COBRA can make sense if you've already hit your deductible this year, if you need a specific specialist, or if you're mid-treatment.
Paying the higher premium for a few months to keep continuity can beat starting over with a new deductible.
The practical move is to price all three options in the same afternoon: the COBRA quote from your HR packet, a marketplace plan with subsidies, and Medicaid eligibility.
Most people assume COBRA is the safe default.
Our take: COBRA was designed to prevent gaps, not to be affordable, and treating it as the automatic choice is how families burn through savings in a single quarter.
Final Thoughts
Spend 30 minutes comparing marketplace subsidies before writing that first check, because the difference can easily hit $5,000 a year.