Millions of Americans who lose a job get handed the same thick envelope within weeks, and the number inside it has been getting uglier every year.
COBRA lets you keep your employer's health plan for up to 18 months after leaving a job, but you now pay the full premium yourself — the part your boss used to cover included.
The average family plan under COBRA runs roughly $2,100 to $2,400 a month in 2026, according to KFF's annual employer survey data.
Single coverage lands closer to $800 to $900.
That's not a typo, and it's not a worst-case scenario.
Your employer was likely paying 70% to 80% of that premium while you worked.
Losing the job doesn't just cut your income — it can multiply your health insurance bill by three or four times overnight, at the exact moment you can least afford it.
Most people don't realize COBRA is often the most expensive option on the menu.
A marketplace plan through HealthCare.gov frequently costs hundreds less per month, especially if your income drops after a layoff, because subsidies are based on what you earn now, not what you used to earn.
Losing job-based coverage also opens a special enrollment window, typically 60 days, so you don't have to wait for January.
Switching plans mid-treatment can mean new referrals, new prior authorizations, and a fresh deductible you have to meet from zero.
For someone mid-chemo or managing a high-risk pregnancy, paying the COBRA premium can be worth it purely to keep the same doctors and keep the deductible you've already burned through.
Three deadlines matter more than anything else.
You generally have 60 days from the coverage loss notice to elect COBRA, and you can sometimes elect it retroactively if you change your mind after a hospital bill shows up.
You have 60 days to pick a marketplace plan too.
Miss both and you can be locked out of subsidized coverage until the next open enrollment.
There are quieter options worth pricing before you write that first check.
If your spouse has employer coverage, that's usually the cheapest path.
If you're under 26, a parent's plan may still be an option.
Some states run their own subsidies on top of federal ones, and a few expanded Medicaid in ways that catch newly unemployed households.
An ACA broker can run all of these in about 20 minutes for free.
One more trap: COBRA doesn't last forever.
Those 18 months end, and when they do, you get another special enrollment window — but the premium jump from a subsidized marketplace plan to full-price coverage can shock people who never checked the calendar.
If you're staring down that envelope right now, price the marketplace before you assume COBRA is your only lifeline.
Final Thoughts
The gap between the two is often the difference between a tight month and a genuinely brutal one, and the 60-day clock doesn't pause while you decide.