COBRA vs Marketplace vs Private PPO: What to Do Right After You Lose Employer Coverage
Quick guide to COBRA vs Marketplace vs Private PPO—costs, networks, and when each wins. We’ll verify your doctors and show clear prices.
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.
- 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.
- 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.
- 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.
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.
FAQ
How long do I have to elect COBRA?
Can I switch from COBRA to other coverage later?
Do Private PPOs use ACA tax credits?
How do I know if my doctors are covered?
How do we start?
This overview is educational, not tax or legal advice. Availability varies by state and carrier. Eligibility and enrollment subject to plan terms.
Marketplace vs Private PPO: Costs, Networks, and When Each Wins
Fast guide to non-Marketplace Private PPOs—how they bill, who they fit, and what to verify first. We’ll confirm your doctors, compare options, and show clear costs
Coverage Options • Open Enrollment
Marketplace vs. Private PPO: Costs, Networks, and When Each Wins
Fast take: Marketplace (government exchange) plans can be cheapest if your income qualifies for subsidies. Private PPOs usually win on doctor access, nationwide networks, and fewer hoops. At RKA Insurance Advisors, we compare both—then you decide.
Quick Definitions
- Marketplace (Government): Plans sold on Healthcare.gov or your state exchange. Prices drop with income-based subsidies. Networks are often HMO/EPO-heavy.
- Private PPO (licensed access): Off-exchange, available through licensed advisors. Broader PPO networks, out-of-network flexibility, and year-round enrollment.
👉 No guessing: We verify your doctors and prescriptions on both sides before you enroll.
Cost Snapshot
Marketplace
Price depends on income and household size. Silver-tier plans can unlock extra savings if you qualify.
Private PPO
Price is not income-based. You’re paying for broader networks and fewer restrictions.
Networks & Doctors (What Matters Most)
Marketplace networks can be narrow. Great if your providers are in-network; painful if they’re not. Private PPOs typically offer national or near-national PPO networks, plus out-of-network benefits.
We always check your providers first—not after you enroll.
When Marketplace Wins
- Your income qualifies for strong subsidies.
- You’re fine with a narrower network.
- You want the lowest possible premium and rarely use care.
When Private PPO Wins
- You want flexibility with doctors and facilities.
- You travel often and need PPO access nationwide.
- You’ve been frustrated with referrals and authorizations before.
The Simple Decision Tree
- Share your providers, prescriptions, and budget.
- We verify both Marketplace and PPO paths in your ZIP code.
- You pick the best fit. We enroll you quickly and compliantly.
Quick FAQs
Does Marketplace always cost less?
Can RKA check my doctors in both networks?
Is Private PPO available year-round?
Educational use only; eligibility and benefits vary by state and carrier. Always review official plan documents.
Extended Open Enrollment Information
Open Enrollment has been extended through January 15, 2026. Don't miss your last chance to enroll in Marketplace or Private PPO health insurance for 2026. Get free quotes from licensed advisors today.Extended Open Enrollment: Don't Miss the January 15th Deadline
Good news! You still have time to get health insurance for 2026. Open Enrollment has been extended through January 15, 2026, giving you 30 extra days to compare plans and enroll with confidence.
⚠️ Important: If you missed the December 15th deadline for January 1st coverage, you can still enroll by January 15th for coverage starting February 1, 2026.
Key Enrollment Dates
The federal Open Enrollment period for 2026 began November 1, 2025 and closes January 15, 2026. This extended timeline gives you more time to:
- Compare Marketplace and Private PPO plan options
- Verify your doctors and prescriptions are covered
- Calculate your subsidy eligibility
- Enroll with a licensed advisor at no cost to you
What's Available for 2026?
There are several health coverage options available during Open Enrollment:
- Marketplace Plans (Healthcare.gov): ACA-compliant plans with potential income-based subsidies
- Private PPO Plans: Off-exchange underwritten options with broader networks, available only through licensed agents
- Ancillary Coverage: Vision, dental, accident, critical illness, and short-term disability
Why Work With a Licensed Advisor?
Health coverage is too important to navigate alone. Working with a licensed health insurance advisor ensures you:
- See all available options — both on and off the marketplace
- Get accurate subsidy calculations based on your income
- Have your doctors and prescriptions verified before enrollment
- Receive year-round support for claims, renewals, and coverage changes
Best of all, there's no cost to you. Licensed agents are compensated by insurance carriers, not by clients.
Ready to Compare Your Options?
Don't wait until the last day — get your free quote today
What Happens After January 15th?
After Open Enrollment closes, you'll need a Qualifying Life Event to enroll in Marketplace plans. Common qualifying events include:
- Loss of employer-sponsored coverage
- Marriage or divorce
- Birth or adoption of a child
- Permanent move to a new state or county
- Loss of Medicaid or CHIP coverage
Important note: Private PPO plans may be available year-round depending on your health status and location. Contact us to explore your options even after the Open Enrollment deadline.
Need help before the deadline? Call us at 561-806-9913 or get your free quote online. We're licensed in 32 states and ready to help you find the right coverage.