There is no specific timeframe for how long an employer must keep your health insurance coverage after a job termination. Instead, the business makes that decision.

Some companies may end health insurance on the day of termination. Another may wait until the end of the month. Still others may give you a few months of coverage to help while you look for a new job. 

There isn’t a law that demands coverage for a minimum period. However, an employer needs to allow you access to its health insurance plan for at least 18 months after termination through COBRA.

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COBRA, which stands for the Consolidated Omnibus Budget Reconciliation Act, requires that private employers with at least 20 employees offer COBRA benefits to former employees. One exception is if the employee is fired for “gross misconduct.”

Former employees get to keep the health insurance coverage through COBRA, but there is a vital caveat -- you’re responsible for all health plan costs. The employer won’t help anymore.

COBRA provides you the peace of mind of keeping the same health coverage, but that comes with a much higher price tag.

How long does COBRA coverage last?

Most employees can keep COBRA coverage for 18 months after termination.

Employees, spouses and dependent children can keep it for 18 months if the employee was terminated and it wasn’t for gross misconduct. Those people are also eligible if the company reduces the employee’s hours and the person is no longer eligible for employer-sponsored health insurance.

COBRA insurance can last longer depending on the situation. Someone with a total disability can keep it for 29 months. Also, other instances can allow people to keep COBRA for 36 months. These situations include covering a spouse after the employee’s death, a divorce or legal separation and a dependent child who loses coverage.

How much does COBRA coverage cost?

Members with COBRA coverage pay up to 102% of the health plan costs with no help from the business.

That can lead to exorbitant costs. The average annual family premiums for an employer-sponsored health plan was more than $20,000 in 2019. The employee often picks up about one-quarter to one-third of those costs. The business picks up the rest.

However, with COBRA insurance, the individual pays for the entire premiums and up to an additional 2% administrative fee.

When must you decide on a COBRA plan?

You’ll receive COBRA benefits information after termination. You then have 60 days to decide whether to take the coverage.

Coverage is retroactive to your termination. You can take all of those 60 days to decide whether to enroll in a COBRA plan. You’ll have to pay the full 60 days of premiums, whether you enroll the first day or the 60th day once you sign up.

You can cancel COBRA at any time within your benefit period, which is usually 18 months. You’ll have access to that coverage as long as you pay your premium and your former employer offers group health insurance. If your previous job drops group health coverage, you won’t be eligible for COBRA any longer.

Also, you may decline COBRA coverage and your spouse or dependent could accept it. That’s allowable.

Other ways to get health coverage after termination

You may be eligible for health plans other than COBRA. For instance, your spouse may have access to health coverage at his or her job. That might be the easiest way to get coverage.

A spouse’s plan isn’t the only other option, though. Here are three different possible options:

  • Individual health insurance -- Individual health plans -- either through the Affordable Care Act exchanges or outside of that marketplace -- offers similar coverage to an employer-sponsored plan. An ACA plan provides comprehensive health benefits, but they can be pricier than an employer plan. However, you can receive subsidies and tax credits if your income is below 400% of the federal poverty level, which reduces an ACA plan’s costs.
  • Medicaid -- Medicaid offers comprehensive benefits at minimum costs for lower-income Americans. Thirty-seven states expanded Medicare eligibility. In those states, people with incomes up to 138% of the federal poverty level are eligible for Medicaid. Premiums are based on your income. Millions of Americans are eligible for Medicaid and can be a low-cost, comprehensive health plan option if you lose your job.
  • Short-term health plan -- Most Americans are eligible for short-term health plans. These low-premium plans aren’t technically considered health insurance under the ACA. They don’t offer the comprehensive benefits found in health insurance plans. Many don’t have prescription drug coverage, mental health and maternity care. These plans can also have high out-of-pocket costs. However, short-term plans can serve as a bridge to future health coverage once. These plans last one year and you can request two extensions. A handful of states don’t allow short-term plans and others have length limitations. Make sure to read the fine print and understand what a specific short-term health plan covers and doesn’t cover.

A job termination is stressful enough, but the added burden of losing your health insurance makes it much worse. You have multiple options if you lose your employer-sponsored health insurance depending on where you live, your income and whether your spouse has access to coverage.