COBRA Alternatives: Affordable Care Act, Private Short-Term Medical and Medicaid

• ACA marketplace plans cover preexisting conditions and essential benefits. You may qualify for premium subsidies and cost-sharing reductions based on income. Similar to work health insurance.
• Short-term health plans can be a lower-cost option for temporary needs. These plans usually do not cover preexisting conditions and may have benefit limits. Find affordable term health plans.
• Medicaid provides free or low-cost coverage for eligible people with low incomes, families, some seniors, and people with disabilities. Learn more about Medicaid.
• Spouse or partner’s employer plan may allow you to enroll after you lose coverage, which can be less expensive than COBRA.
• Medicare may be an option if you are eligible due to age or disability. Check enrollment windows to avoid penalties.
• Children’s Health Insurance Program (CHIP) offers low-cost coverage for eligible children and teens.

• How to Apply for ACA in Your State
• Understanding Special Enrollment Periods
• Apply for COBRA
• Cancel COBRA

Marketplace insurance under the Affordable Care Act is a common alternative to COBRA. It often costs less and offers a range of plans for different needs and budgets. You can compare plans by benefits, monthly premium, deductibles, and provider network to find the right fit. Enroll during Open Enrollment or after a qualifying life event such as losing job-based coverage.

• Premiums are often lower than COBRA for similar coverage.
• Most people qualify for financial help that lowers monthly premiums and out-of-pocket costs.
• Outside Open Enrollment, you can enroll within 60 days of qualifying events, including loss of employer coverage.
• Plans must cover preexisting conditions and can’t charge more because of health; premiums may vary by age, location, and tobacco use within limits.
• Coverage continues as long as you pay your premiums and remain eligible.
• You can choose among multiple plan types and provider networks; network size varies by plan.

Learn about savings by enrolling in an Affordable Care Act marketplace plan.

Short-term health insurance can provide temporary coverage while you are between jobs or waiting for new coverage to start. Premiums are often lower than COBRA, and coverage can begin quickly.

• Designed for brief gaps in coverage; term lengths and availability vary by state and insurer.
• Uses medical underwriting; applicants can be denied, and preexisting conditions are usually not covered.
• Benefits are limited and may exclude services such as maternity care, mental health care, and prescription drugs.
• Not ACA-compliant coverage and not eligible for marketplace subsidies.
• Renewals are not guaranteed; coverage generally ends when the term ends.

Find temporary plans to cover your insurance gap.

In some states, buying short-term health insurance requires membership in a professional or affinity association. When required, certain plans will auto-enroll you in the appropriate organization based on your location and disclose any dues or fees during enrollment.

Medicaid offers free or low-cost health coverage for people with limited income. Eligibility is set by each state and usually depends on income, household size, and other factors. The Children’s Health Insurance Program provides low-cost coverage for eligible children and teens, and some states also cover pregnant people. You can apply at any time of year.

• Income limits and rules vary by state; documentation is required.
• Little to no monthly premium; copays are low or not required.
• Covers core services such as doctor visits, hospital care, and prescriptions, though exact benefits vary by state.
• CHIP may be available when a child does not qualify for Medicaid.
• If your income increases, you may qualify for marketplace coverage with subsidies.

Check your state of residency for links to Medicaid and CHIP options.