Qualifying Events
COBRA coverage is available after these events:
| Qualifying Event | Who Can Elect | Max Coverage Duration |
|---|---|---|
| Voluntary or involuntary job loss (not gross misconduct) | Employee + dependents | 18 months |
| Reduction in hours below eligibility threshold | Employee + dependents | 18 months |
| Divorce or legal separation | Spouse + dependents | 36 months |
| Employee becomes eligible for Medicare | Spouse + dependents | 36 months |
| Covered employee dies | Surviving spouse + dependents | 36 months |
| Dependent child loses dependent status (e.g., turns 26) | That dependent | 36 months |
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How Much Does COBRA Cost?
You pay 100% of the premium plus a 2% admin fee. The average employer covers ~70% of premiums for employees—so COBRA can feel like a dramatic price jump:
| Coverage Type | Avg Monthly Premium | Your Share While Employed (est.) | COBRA Cost (102%) |
|---|---|---|---|
| Employee only | ~$703 | ~$111 | ~$717 |
| Employee + spouse | ~$1,997 | ~$509 | ~$2,037 |
| Employee + children | ~$1,685 | ~$394 | ~$1,719 |
| Family | ~$2,099 | ~$627 | ~$2,141 |
Averages based on 2023 KFF Employer Health Benefits Survey.
The 60-Day Election Window
After a qualifying event, you have 60 days to elect COBRA. Your employer's plan administrator must notify you within 14 days of the event. Key timing rules:
- Coverage is retroactive to the date of the qualifying event if you elect
- You don't have to pay premiums until you elect—but if you need care before electing, elect immediately and pay retroactively
- Once elected, the first premium payment is due within 45 days
- Coverage terminates if you miss a premium payment (30-day grace period)
Cheaper Alternatives to COBRA
Job loss is a Special Enrollment Period for ACA Marketplace plans. Compare before defaulting to COBRA:
- ACA Marketplace plans — may be significantly cheaper with subsidies based on income; 60 days to enroll after job loss
- Medicaid — free or very low cost if income drops below 138% FPL (~$20,120 single in 2024)
- Spouse's employer plan — job loss qualifies you for a Special Enrollment Period on a spouse's plan
- Short-term health plans — lower cost but limited coverage; don't cover pre-existing conditions
COBRA is best for ongoing treatment
If you or a dependent is mid-treatment (chemotherapy, pregnancy, a specific specialist), COBRA keeps your existing doctors and coverage uninterrupted. For healthy individuals, the Marketplace is usually cheaper.