Health insurance when you're unemployed: your options for 2027

Losing a job starts two clocks for health coverage. The first is 60 days to pick a Marketplace plan. The second is 60 days to elect COBRA. Both start around the day your job-based coverage ends, and the cheapest choice is often clear only after you estimate your income for the whole year. This page walks through each option in the order most people need it, with every rule linked to HealthCare.gov, the Department of Labor, CMS or KFF.

It is for adults under 65 who are out of work, whether you were laid off, quit, or are between contracts. It is educational, not personalized insurance or tax advice.

Last reviewed: 2026-10-12. Rules change; verify on the linked pages before you act.

The short answer

• You can get Marketplace coverage outside Open Enrollment. If you leave your job "for any reason (even if you quit or get fired)," losing job-based coverage qualifies you for a Special Enrollment Period. Apply "within 60 days of losing your job-based coverage" (HealthCare.gov, if you lose job-based coverage).
• Your price depends on your income for the year, not on having a job. Unemployment pay counts. So does what you earned before you left (same page; HealthCare.gov, what to include as income).
• COBRA keeps your old plan at full price. Up to 102% of the plan's cost (U.S. Department of Labor).
• Medicaid is open all year. Whether you qualify depends on your income and your state.

Your two clocks

Clock one: the Marketplace window. You can pick a plan up to 60 days before and up to 60 days after job-based coverage ends (HealthCare.gov, Special Enrollment Period). Coverage "can start the first day of the month after you lose your job-based coverage" if you enroll in time. HealthCare.gov's example: lose coverage on March 7, enroll by March 31, and coverage can start April 1 (HealthCare.gov). You may be asked for documents that prove the loss.

Clock two: the COBRA election. "You have 60 days to enroll in COBRA, starting from when your coverage ends," or later if the election notice arrives later. After you elect, "you then have 45 days to make your first payment," and coverage "is retroactive to the day you lost your job-based plan" (U.S. Department of Labor, COBRA FAQs).

That retroactive rule is why some people wait: if nothing happens in the first weeks, they let COBRA lapse; if a bill arrives, they elect and pay back to the start. It works only inside the 60 days, and the back premiums are due in full.

Option 1: a Marketplace plan through the Special Enrollment Period

For most people out of work, this is the cheapest route with full protection. Marketplace plans cannot turn you down or charge more for a pre-existing condition, and every plan caps what you pay for covered in-network care in a year: $12,000 for one person in 2027 (HealthCare.gov, out-of-pocket maximum).

How your income is counted. Savings are "based on your estimated income for everyone in your tax household for the full calendar year," and income earned before you left the job counts (HealthCare.gov). Include "all unemployment compensation that you get from your state" (HealthCare.gov, income).

That has a timing effect people miss:

• Late in the year, a household that earned a full salary through September may have too much income for this year to get much credit for October to December.
• For 2027, you estimate 2027 income. If you expect to be out of work for part of the year, that estimate may be much lower, and the credit much larger.

The premium tax credit is described for household income between 100% and 400% of the federal poverty level. If you take more in advance than your final income supports, "you must pay the difference when you file your federal income tax return" (HealthCare.gov, premium tax credit). If you find work mid-year, report the change so the credit adjusts. For 2027, 400% of the poverty level is $63,840 for one person and $132,000 for a family of four, based on the 2026 guidelines (HHS ASPE).

For what plans cost before and after the credit, by state, see how much health insurance costs per month.

Option 2: COBRA

COBRA lets you keep the plan you had. The Department of Labor says you are "initially covered for a maximum of 18 months" after a job ends, and you "may be required to pay the entire premium for coverage up to 102% of the cost to the plan" (U.S. Department of Labor).

What that means in dollars: in 2025 the average employer plan for one person cost $9,325 a year, of which the worker paid $1,440 (KFF). On COBRA you pay the whole $9,325 plus up to 2%, about $793 a month instead of about $120.

When COBRA is worth it:

• You are in the middle of treatment or a pregnancy and cannot risk a network change.
• You have already paid most of this year's deductible, which a new plan would reset.
• You expect to be back on an employer plan within a few months.
• Your income for the year is above the range where a Marketplace credit helps.

The trap. "Choosing to stop paying COBRA premiums on your own doesn't qualify" you for a new Special Enrollment Period (HealthCare.gov, Special Enrollment Period). If you take COBRA and later want out because of the price, you may wait until Open Enrollment. Reaching the end of COBRA does open a new window. Decide within the first 60 days.

Option 3: a spouse's employer plan

If your spouse has job-based coverage, losing your own coverage lets you join their plan, but the window is shorter: "you must request enrollment within 30 days of losing eligibility for other coverage" (U.S. Department of Labor, questions and answers for dislocated workers). Thirty days, not sixty.

One more rule: if a spouse's employer plan counts as affordable for the family, you generally cannot get Marketplace savings even if you decline it. Price both before the 30 days run out.

Option 4: Medicaid, and the coverage gap

You "can apply for Medicaid and CHIP any time of year" (HealthCare.gov). The Marketplace application checks Medicaid at the same time, so you do not need to guess first.

Expansion states. "41 states (including DC) have adopted the Medicaid expansion and 10 states have not" (KFF, status of state Medicaid expansion decisions). In expansion states, adults with income "below 133% of the federal poverty level" qualify (HealthCare.gov, Medicaid expansion and you).

The coverage gap. In the 10 states that have not expanded, some adults have incomes "too high for their states' Medicaid program but too low to qualify for ACA Marketplace subsidies." KFF estimates about 1.2 million uninsured adults fall in this gap (KFF). Florida, Texas and Georgia are among the states that have not expanded; each state guide says where it stands, starting from the state index. If you are in the gap, apply anyway: children, pregnancy and disability can open other programs, and income often changes during a year out of work.

New for 2027: the Medicaid work requirement. CMS says states must generally start a community engagement requirement "no later than January 1, 2027." It applies to "non-pregnant adults between the ages of 19 and 64" in the Medicaid expansion group, who must show "80 hours per month of qualifying activities" such as work, community service, a work program or half-time school. Exemptions include parents and caregivers of a young child or a disabled person, people who are medically frail, and people in drug or alcohol treatment (CMS fact sheet, June 1, 2026). If you are on Medicaid while job hunting, watch for your state's notices about reporting.

What to be careful with

Short-term plans. They are cheaper because they are not built like ACA plans. Federal rules exempt them from "the prohibitions on discrimination based on health status, pre-existing condition exclusions, and lifetime and annual dollar limits on essential health benefits" (CMS fact sheet). In August 2025, federal agencies said they "do not intend to prioritize enforcement actions" on the 2024 limits to how long these plans can last (U.S. Department of Labor, August 7, 2025 statement). State rules still apply and vary. A short-term plan can be a bridge for a healthy person with a job offer in hand. It is not a safe core plan for someone with a medical history.

Fixed indemnity and "gap" policies. These pay a set amount per day or event, not your bill. They are a supplement, never your only coverage. See hospital indemnity insurance.

Pitches that follow a layoff. Lead lists sell quickly after job losses. Ask any caller for their name and license number and check it with your state's insurance department. Our guide to medical insurance scams lists the red flags.

A simple decision order

1. Write down the date your job-based coverage ends. Both 60-day clocks run from there, and the spouse-plan clock is 30 days.
2. Estimate your household income for the full calendar year, including pay already earned, severance and unemployment compensation.
3. Run a Marketplace application to see your exact credit and whether Medicaid applies. You get exact prices only on an application (HealthCare.gov, lower costs).
4. Price COBRA from your election notice. Compare the monthly cost and what is left of this year's deductible.
5. Check a spouse's plan if there is one, inside 30 days.
6. Pick before the windows close. If you choose COBRA, assume you are keeping it until it ends or until Open Enrollment.

Open Enrollment for 2027

If you missed your 60 days, or want to change plans for next year, Open Enrollment for 2027 coverage on HealthCare.gov runs November 1, 2026 to January 15, 2027. Enroll by December 15 for coverage that starts January 1, 2027 (HealthCare.gov, dates and deadlines). Some states that run their own exchange use other dates. More detail is in when is Open Enrollment for 2027?

Related reading

• Losing employer health coverage: your timeline and your options
• Health insurance for early retirees
• Health insurance for the self-employed, if you are starting your own work
• How to get health coverage without an employer plan

Method / disclaimer

This page summarizes rules published by HealthCare.gov, the U.S. Department of Labor, CMS and HHS, and research from KFF, as read on 2026-10-12. Government pages update; verify before you act. Educational only, not medical, tax, legal or personalized insurance advice. America First Healthcare is an independent licensed insurance agency. Official Marketplace and Medicaid enrollment happens through HealthCare.gov, your state exchange or your state Medicaid agency, not through this page.

Next step

Your Marketplace window is 60 days from the day job-based coverage ends, and it does not wait for the job search. If you want help comparing COBRA, a Marketplace plan at your real income and any other option side by side, start a free healthcare review. Bring your COBRA notice, the date your coverage ends, and a rough estimate of this year's and next year's income.

FAQ

How do I get health insurance if I am unemployed?

Most people use one of four routes: a Marketplace plan through the Special Enrollment Period that opens when job-based coverage ends, COBRA from the former employer, a spouse's employer plan, or Medicaid if household income is low enough. Apply on HealthCare.gov or your state exchange and one application checks Marketplace savings and Medicaid together.

Does quitting my job still let me get Marketplace coverage?

Yes. HealthCare.gov says that if you leave your job for any reason, even if you quit or get fired, losing job-based coverage qualifies you for a Special Enrollment Period. Apply within 60 days of losing the coverage.

Does unemployment pay count as income for health insurance?

Yes. HealthCare.gov tells applicants to include all unemployment compensation from their state. Marketplace savings are based on expected income for the full calendar year, including what you earned before the job ended.

Is COBRA or a Marketplace plan cheaper when I lose my job?

Usually the Marketplace, if your income for the year qualifies for a tax credit, because COBRA can cost up to 102% of the full plan cost with no employer share. COBRA can still win if you are mid-treatment, have already met this year's deductible, or need to keep specific doctors. Compare both before the 60-day windows close.

Can I get Medicaid while unemployed?

Possibly. You can apply for Medicaid any time of year. In the 41 states, including DC, that expanded Medicaid, adults with income below 133% of the poverty level qualify. In the 10 states that did not expand, many adults without children do not qualify on income alone. From January 1, 2027, expansion adults aged 19 to 64 generally must show 80 hours a month of work, community service, a work program or school, unless exempt.

What if I drop COBRA later?

Choosing to stop paying COBRA premiums on your own does not give you a new Special Enrollment Period, so you would wait for Open Enrollment. Reaching the end of your COBRA coverage does open a new 60-day window. Make the COBRA or Marketplace decision during the first 60 days.