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.

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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.

Losing employer coverage creates options most people don't know about. Our licensed advisors compare COBRA, marketplace plans, and private PPO alternatives to find the best fit for your situation. Compare your options now.

Open Enrollment & Your Plan Options

Open Enrollment • Basics

Open Enrollment & Your Plan Options, Explained

📅 Looking for this year's exact dates? See our 2027 Open Enrollment Dates guide →

Fast take: Open enrollment is the once-a-year window to sign up for or change health coverage. It opens November 1 and runs into mid-January in most states — enroll by December 15 for a January 1 start. But the Marketplace isn't your only option: the right plan depends on your income, health, lifestyle, and work. Here's how the choices actually compare.

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Open enrollment is the period each year when you can sign up for health insurance or change your current coverage. In most states it opens November 1 and runs through mid-January for individual and family plans. Enroll by December 15 and coverage typically starts January 1; enroll after that (through the deadline) and coverage usually starts February 1. Some states run their own window on different dates — check with one of our benefit specialists for your state, or see the current-year guide linked above.

Marketplace metal tiers

• Bronze — lowest monthly cost, but higher deductibles and more out-of-pocket expense.
• Silver — middle-of-the-road; balances coverage and cost (and unlocks extra savings if you qualify).
• Gold — higher premium, stronger cost-sharing, lower deductibles and out-of-pocket exposure.
• Platinum — rare and only in a few counties; highest premium, lowest deductibles.

Networks: why the type matters

Most Marketplace options are HMO or EPO networks — limited to a local service area, covering you outside it only for emergencies. PPO networks are available in select areas and offer nationwide access to providers without referrals. If you travel, split time between states, or want freedom to see specialists directly, network type matters as much as price.

Subsidies (premium tax credits)

If your income falls between 100% and 400% of the federal poverty level, you may qualify for a premium tax credit that lowers your Marketplace cost — sometimes dramatically. The exact income cutoffs change each year, and earning over the top of the range means you pay full price (the "subsidy cliff"). We calculate your current-year subsidy and show your true net cost. More on the subsidy cliff →

Options beyond the Marketplace

Our specialty — private nationwide PPO. If subsidies aren't available to you (or you want a broader network), a private, medically-underwritten PPO often delivers lower out-of-pocket costs and lower deductibles than the Marketplace, with coast-to-coast provider access and no referrals. Some options are guaranteed renewable to age 65. It's the option only a limited number of agents offer — and where we shine. (Underwriting required — you'll need to be relatively healthy to qualify.)

Other options we can compare

• Short-term medical — often the most affordable; coverage for roughly 30 days up to (with some insurers) 12 months. More limited than major medical.
• Fixed indemnity — supplemental coverage that pays set cash benefits toward specific costs; a layer of protection on top of a plan, not a replacement.
• Healthcare sharing — members share medical costs via a monthly share amount; not insurance, with its own rules and limits.

Don't assume your current plan is still the best

Before you renew, talk to a benefits specialist — we'll compare Marketplace and private options, verify your doctors, and make sure you're not overpaying.

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Frequently asked questions

When exactly can I enroll?

Open enrollment opens November 1 and runs into mid-January in most states; some state marketplaces differ. See the current-year guide for exact dates, or ask us about your state.

Is the Marketplace my only choice?

No. Depending on your income and health, a private nationwide PPO or a supplemental option may be a better fit. We compare all of them for you.

How do I know I'm not overpaying?

We price your real annual cost — premium, deductible, copays, and out-of-pocket max — across every option and verify your doctors before you enroll.

For education only; eligibility, benefits, and availability vary by carrier and state. Always review official plan documents. Private plans are medically underwritten — not all applicants qualify. RKA Insurance Advisors is an independent, licensed health insurance brokerage (NPN 19540130). We do not offer Medicare. Call (561) 806-9913.