What Is COBRA and Who Qualifies?
- COBRA Basics: A federal law that lets you keep your group health insurance after job-based coverage ends.
- Eligibility: You qualify if your employer had 20 or more employees and you experienced a qualifying event (e.g., termination, reduced hours, divorce).
- Duration: Generally up to 18 months, with extensions to 29 or 36 months under specific circumstances.
Why Florida Residents Turn to COBRA
- Continuity of Care: Keep your current doctors, prescriptions, and network—critical if you’re mid-treatment.
- No New Waiting Periods: Avoid delays or exclusions for pre-existing conditions, which some Marketplace plans may impose.
- State Assistance: Florida’s SHIP (State Health Insurance Assistance Program) can guide you through enrollment and billing questions.
Cost Considerations: What Hits Your Wallet
- Premiums
- Up to 102% of the Plan Cost: Under COBRA, you pay the entire premium (both employee and employer shares), plus up to a 2% administrative fee.
- Average Range: As of 2025, typical individual premiums run between $600–$1,000 per month; family plans can exceed $2,000.
- Out-of-Pocket Maximums & Deductibles
- Plan-Defined Limits: All the same deductibles, copays, and coinsurance apply, which can add hundreds or thousands more if you need significant care.
- Payment Deadlines
- 60-Day Election Window: You have 60 days from losing coverage to elect COBRA.
- 45-Day Premium Deadline: From election, you have 45 days to submit your first payment. Missing deadlines means losing COBRA entirely.
Other Factors Affecting Your Budget
- Marketplace Subsidies: If your household income falls below 150% of the Federal Poverty Level, you may qualify for premium tax credits on Healthcare.gov—sometimes cheaper than COBRA.
- Medicaid Eligibility: Low-income Floridians may find Medicaid a no-cost option, but availability depends on income and asset limits.
- Short-Term Plans: These can be a stopgap at lower premiums, but beware limited coverage and potential pre-existing condition exclusions.
Tips to Manage and Reduce Costs
- Compare Plans First: Always run a quick quote on the ACA Marketplace during your 60-day window.
- Negotiate Payment Plans: Some insurers offer installment options to spread out COBRA payments.
- Consider a Health Savings Account (HSA): If you switch to a high-deductible plan, you can stash pre-tax dollars for medical expenses.
- Shop Your Prescriptions: Use mail-order pharmacies or discount programs to lower drug costs, especially if your deductible is high.
COBRA Can Help But it is Expensive
COBRA can be a crucial bridge for Florida residents facing gaps in health insurance—but it comes at a premium. By understanding key costs, deadlines, and alternatives like Marketplace subsidies or Medicaid, you can make an informed choice that safeguards both your health and your wallet.
