COBRA vs Marketplace vs Private PPO: What to Do Right After You Lose Employer Coverage

COBRA vs Marketplace vs Private PPO: What to Do Right After You Lose Employer Coverage

Laid off, new job, or between jobs? Here’s the fast, practical guide—costs, networks, deadlines, and how to decide in minutes. We’ll verify your doctors and show clear costs.

COBRA (keep your old plan)

• Same network/benefits you already know.
• Usually most expensive (you pay full premium + 2%).
• Time-limited (18 months); retroactive if elected on time.
• Good when in treatment and changing plans is risky.

Marketplace (Government)

• May be cheapest if your income qualifies for credits.
• Many plans are HMO/EPO; referrals are common.
• Mid-year move allowed due to loss of coverage.
• Credits reconcile at tax time—under-reporting income can create payback.

Private PPO (Licensed Access)

• Nationwide PPO when eligible; keep specialists/hospitals.
• Typically no referrals; fewer hoops.
• Advance premium tax credits do not apply to Private PPOs.
• Pricing = age, ZIP, benefits, and network.
• Great when you travel or want doctor choice.

What tends to cost more—and why

Why COBRA is often pricey

• You pay the entire employer premium + 2% admin fee.
• Large-group plan designs can carry higher OOP maxes.
• No income-based help.

How non-Marketplace Private PPO prices

• Based on age, ZIP, network size, and benefits.
• Good fits: provider choice, travel, specialist access, fewer referrals.
• We verify your doctors before you switch.

How to decide in minutes

Pick COBRA if…

• You’re mid-treatment and can’t risk network changes.
• You can stomach short-term higher premiums.
• You need exactly the same plan and doctors right now.

Pick Private PPO if…

• You want nationwide PPO and typically no referrals.
• You travel, use specialists, or dislike gatekeepers.
• Credits don’t help you—or you prefer not to use them.

We’ll compare all three with your doctors and meds, then show clear side-by-side costs.

Want the best post-employer fit in your ZIP?

We’ll verify your doctors and meds, compare COBRA vs Marketplace vs Private PPO, and show clear costs. No pressure—just answers.

Get Free Quotes Book a Call

FAQ

How long do I have to elect COBRA?

Generally 60 days from the notice. If elected in time, coverage can be retroactive to the loss date (you’d owe premiums).

Can I switch from COBRA to other coverage later?

Yes. Marketplace: during Open Enrollment (or another qualifying event). Private PPO: typically year-round if you’re eligible. We’ll time it so there are no gaps.

Do Private PPOs use ACA tax credits?

No. Private PPOs don’t use ACA advance premium tax credits (APTC). Marketplace plans do, and those credits reconcile at tax time—under-reporting income can create payback.

How do I know if my doctors are covered?

Send your provider list. We check your doctors against the specific plan network you choose so you know before you switch.

How do we start?

Share your doctors, prescriptions, and budget. We’ll map options and enroll you quickly and compliantly.

This overview is educational, not tax or legal advice. Availability varies by state and carrier. Eligibility and enrollment subject to plan terms.

New to Texas? Health Insurance—Fast Guide (Marketplace vs Private PPO)

New to Texas? Health Insurance—Fast Guide (Marketplace vs Private PPO)

Just moved to TX? Here’s how coverage works, what proof you’ll need, and how to keep your doctors. We’ll verify providers and show clear costs—no pressure.

Marketplace (Government)

• Can be cheapest if your income qualifies for credits.
• Many plans are HMO/EPO; referrals are common.
• Options vary by county/ZIP.
• Move = special enrollment (time-limited). Credits reconcile at tax time.

Private PPO (Licensed Access)

• Nationwide PPO access when eligible; keep key doctors/hospitals.
• Typically no referrals; fewer hoops for specialists.
• Pricing isn’t tied to ACA income credits.
• Good for travel, provider choice, and specialist access.

We run both paths side-by-side with your doctors and prescriptions, so you pick based on fit—not guesswork.

What to do first (takes 5 minutes)

1) Gather quick proof

• New TX address (lease, closing docs, utility, USPS change).
• Prior coverage details if switching.

2) List providers & meds

• Doctors, specialists, hospitals you want to keep.
• Current prescriptions (name + dosage).

3) Decide priorities

• Lowest premium vs. broad network.
• Referrals OK or prefer no referrals?
• Travel out of state?

What drives cost in Texas

Marketplace

• Income & household size (for tax credits).
• Plan level & network (HMO/EPO common).
• County—options can change across county lines.

Private PPO

• Age, ZIP, benefit level, and network size.
• No ACA credits; premiums are straightforward.
• Great when keeping providers is the priority.

Simple decision guide

Choose Marketplace if…

• Your income qualifies for strong credits.
• You’re OK with HMO/EPO rules & referrals.
• Lowest premium is the top priority.

Choose Private PPO if…

• You want broad, often nationwide PPO access.
• You prefer no referrals to see specialists.
• Keeping specific doctors/hospitals matters most.

New to Texas? Let’s lock the best fit in your ZIP.

We’ll verify your doctors and meds, compare Marketplace vs Private PPO, and show clear costs. No pressure—just answers.

Get Free Quotes Book a Call

FAQ for recent Texas moves

Do I get a special enrollment window when I move to Texas?

Yes—moves generally create a time-limited window to enroll. We’ll confirm timing and options for your county and situation.

What proof of my move do I need?

Usually a new Texas address document (lease/closing/utility/USPS change). We’ll tell you exactly what’s accepted before you apply.

When will coverage start?

Start dates depend on when you enroll and which route you choose. We’ll show the earliest eligible effective date and time the switch so there’s no gap.

Can I keep my current doctors?

Often, yes. We check your doctors against the exact plan network you choose—before you enroll—so there are no surprises.

What if I’m coming from COBRA?

You can stay on COBRA or switch to Marketplace/Private PPO. We’ll compare costs and timing so you only pay for what you need.

This overview is educational, not tax or legal advice. Availability and rules vary by carrier and county. Eligibility and enrollment subject to plan terms.

New to Florida? Health Insurance—Fast Guide (Marketplace vs Private PPO)

New to Florida? Health Insurance—Fast Guide (Marketplace vs Private PPO)

Just moved to FL? Here’s how coverage works, what proof you’ll need, and how to keep your doctors. We’ll verify providers and show clear costs—no pressure.

Marketplace (Government)

• Can be cheapest if your income qualifies for credits.
• Many plans are HMO/EPO; referrals are common.
• County-based options; networks vary by ZIP.
• Move = special enrollment (time-limited). Credits reconcile at tax time.

Private PPO (Licensed Access)

• Nationwide PPO access when eligible; keep key doctors/hospitals.
• Typically no referrals; fewer hoops for specialists.
• Pricing isn’t tied to ACA income credits.
• Good for travel, provider choice, and specialist access.

We run both paths side-by-side with your doctors and prescriptions, so you pick based on fit—not guesswork.

What to do first (takes 5 minutes)

1) Gather quick proof

• New FL address (lease, closing docs, utility, USPS change).
• Prior coverage details if switching.

2) List providers & meds

• Doctors, specialists, hospitals you want to keep.
• Current prescriptions (name + dosage).

3) Decide priorities

• Lowest premium vs. broad network.
• Referrals OK or prefer no referrals?
• Travel out of state?

What drives cost in Florida

Marketplace

• Income & household size (for tax credits).
• Plan level & network (HMO/EPO common).
• County—options can change across county lines.

Private PPO

• Age, ZIP, benefit level, and network size.
• No ACA credits; premiums are straightforward.
• Great when keeping providers is the priority.

Simple decision guide

Choose Marketplace if…

• Your income qualifies for strong credits.
• You’re OK with HMO/EPO rules & referrals.
• Lowest premium is the top priority.

Choose Private PPO if…

• You want broad, often nationwide PPO access.
• You prefer no referrals to see specialists.
• Keeping specific doctors/hospitals matters most.

New to Florida? Let’s lock the best fit in your ZIP.

We’ll verify your doctors and meds, compare Marketplace vs Private PPO, and show clear costs. No pressure—just answers.

Get Free Quotes Book a Call

FAQ for recent Florida moves

Do I get a special enrollment window when I move to Florida?

Yes—moves generally create a time-limited window to enroll. We’ll confirm timing and options for your county and situation.

What proof of my move do I need?

Usually a new Florida address document (lease/closing/utility/USPS change). We’ll tell you exactly what’s accepted before you apply.

When will coverage start?

Start dates depend on when you enroll and which route you choose. We’ll show the earliest eligible effective date and time the switch so there’s no gap.

Can I keep my current doctors?

Often, yes. We check your doctors against the exact plan network you choose—before you enroll—so there are no surprises.

What if I’m coming from COBRA?

You can stay on COBRA or switch to Marketplace/Private PPO. We’ll compare costs and timing so you only pay for what you need.

This overview is educational, not tax or legal advice. Availability and rules vary by carrier and county. Eligibility and enrollment subject to plan terms.

Marketplace vs Private PPO: Costs, Networks, and When Each Wins

You want the truth without the fluff. Here it is: Marketplace (Government) can be cheapest when your income qualifies for savings. Private PPO (licensed-access) usually wins on keeping doctors, network size, and fewer hoops. We run both—then you choose.

Quick definitions

• Marketplace (Government): Plans on Healthcare.gov or your state exchange. The monthly cost can drop with income-based savings. Networks tend to be HMO/EPO-heavy in many areas.

• Private PPO (licensed-access): Off-exchange, available through licensed agents. Typically, broader PPO networks, out-of-network flexibility, and year-round availability.

👉 No guessing: We verify your doctors and prescriptions on both sides before you enroll.

Cost snapshot (realistic)

• Marketplace: Price depends on income and household. Silver plans can unlock additional savings if you qualify.

• Private PPO: Price isn’t income-based. You’re paying for network flexibility and smoother access.

Network & doctors (what actually matters)

• Marketplace networks can be narrow. Great if your providers are in-network; painful if not.

• Private PPOs typically offer national or near-national networks, along with out-of-network benefits .

• We check your providers first—not after you enroll.

When Marketplace wins

• Your income qualifies for strong savings.

• You’re fine with a narrower network and staying in-network.

• You want the lowest possible premium and rarely use care.

When Private PPO wins

• You want flexibility with doctors and facilities

• You want PPO flexibility for frequent travel

• You’ve been burned by referrals/authorizations, and now you want fewer hoops.

The simple decision tree

1. Share your providers, prescriptions, and budget.

2. We verify both paths (Marketplace vs Private PPO) in your ZIP.

3. You pick the best fit. We enroll you quickly and compliantly.

Get Free Quotes Book a Call