Your special enrollment window after losing coverage, losing Medicaid, a move, marriage, a baby, or turning 26.
How fast a short-term bridge can start if you only need to cover a gap.
COBRA keeps your old plan at 102% of the full premium for 18 months (36 in some divorce and death cases). Pennsylvania mini-COBRA covers small employers of 2–19 for nine months at up to 105%. It’s right if you’re mid-treatment. It’s usually the most expensive option, and once you elect it you’re on it until it ends or open enrollment.
Tell me the date coverage ends, who’s in the household, roughly what income looks like for the year, and whether anyone is mid-treatment. That decides COBRA vs. marketplace vs. private in about ten minutes.
I’m Nathan Baughman with BIG Benefits in Doylestown. Transitions are most of my week. The good news is the rules are clear, the window is real, and there are usually three ways to cover the gap, not one.
Marketplace (Pennie) special enrollment, within 60 days, with an honest income estimate for the year. Often the cheapest comprehensive option.
Private, underwritten plan if you’re healthy and your income is above the subsidy line, or you simply want a PPO and no enrollment window. Apply any time; coverage the first of next month.
Short-term for a short, known gap of up to four months, such as waiting for new employer benefits to start.
COBRA when continuity of a specific treatment or doctor matters more than price, with an exit plan.
Sixty days. COBRA is a choice, not a default. Check the subsidy with this year’s real income. Keep the kids on CHIP if they qualify. Replace dental, vision and life.
“I had to get temporary health care between jobs. BIG was able to assist and get me covered in no time.” — Google review
Missing the 60 days. Losing coverage is a qualifying life event with a 60-day window before and after. Divorce and turning 26 count when they cause a loss of coverage. The window closes; after that it’s short-term or November.
Not checking the subsidy. Your income for the year matters, and if you just lost a job, it may be lower than you think. A marketplace plan with a credit can be a fraction of COBRA.
Ignoring the kids. Children may qualify for CHIP at any income (free up to about 208% of poverty). Don’t put the whole family on COBRA out of habit.
1. Is there a maximum out-of-pocket? 2. Is it an unlimited contract? 3. Is it guaranteed renewable? If a plan uses words like “deductible” and “PPO network,” that doesn’t automatically make it actual health insurance. These three questions do.
Send me an age and a zip code and I’ll send back a general idea of what’s available in your area. Twenty minutes, no charge, no pressure. Happy to answer any and all questions so you can make the most informed decision for you, your family, or your business.
