Jeffrey Wade
If you're wondering whether you can keep your medical insurance after starting a new job, the answer is yes, but there are some important factors to consider. Firstly, having job-based insurance may affect your eligibility for savings on a Marketplace plan. Secondly, if you're switching jobs and leaving your current employer, you may be able to keep your existing insurance plan through COBRA (Consolidated Omnibus Budget Reconciliation Act) coverage, which allows you to stay on your former company's group health plan. This option is typically more expensive since you'll have to cover the plan's costs yourself, and it may only be available for a limited period. Alternatively, you can explore individual plans through the Health Insurance Marketplace, which may offer more affordable options, especially if you qualify for premium tax credits or other financial assistance. It's essential to consider your specific circumstances, such as your health, age, and household income, when deciding on the best course of action.
Can I keep medical insurance if I have a job?
| Characteristics | Values |
|---|---|
| Keeping medical insurance when changing jobs | You can keep your job-based coverage for up to 18 months with a COBRA plan, or you can buy an individual plan through the Health Insurance Marketplace. |
| Losing job-based health insurance | You can qualify for a Special Enrollment Period, allowing you to enroll in a marketplace insurance plan within 60 days. |
| Losing job-based health insurance | You may be able to keep your job-based health plan through COBRA continuation coverage. |
| Gaining a job with health insurance | If you have a Marketplace plan and get an offer of health insurance through a job, you may no longer qualify for savings on your Marketplace plan, even if you don't accept the job-based coverage offer. |
| Gaining a job with health insurance | If you enroll in the new job-based insurance, you can keep the Marketplace plan, but you will have to pay full price. |
| Gaining a job without health insurance | If you work for a small business that doesn't offer health benefits, you can get affordable ACA-compliant coverage. |
| Family and Medical Leave | The FMLA requires continuation of group health benefits under the same conditions as if the employee had not taken leave. |
| Family and Medical Leave | Employees must continue to make any normal contributions to the cost of health insurance premiums while on leave. |
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What You'll Learn
Family and medical leave insurance
If you have a job, you will most likely have access to job-based health insurance. This means that you may not qualify for savings on a Marketplace plan, even if you don't accept the job-based coverage offer. However, if you lose your job, you have a few options to maintain health insurance coverage.
One option is to consider the Consolidated Omnibus Budget Reconciliation Act (COBRA), a federal law that allows you to keep yourself, your spouse, an ex-spouse, and your dependents on your former company's group health plan after your job ends. COBRA generally applies to employers that provide health coverage for at least 20 employees, although some states have their own mini-COBRA laws for smaller companies. By choosing COBRA, you can continue with the same health insurance plan and keep your existing medical providers, ensuring that your prescription medications remain covered. However, you will need to cover the plan's costs, including monthly premiums and possibly an additional administrative fee, and the coverage can last between 18 to 36 months.
Another option is to explore the Affordable Care Act (ACA) individual plans through the ACA Marketplace. The ACA is a healthcare reform law that allows Americans to obtain health insurance coverage regardless of pre-existing conditions. It offers a range of essential health benefits that are consistent across different plans, and you can select a health plan from your state's health insurance exchange. While the ACA may offer cheaper monthly premium payments, especially if you qualify for a premium tax credit, it is important to note that the plan details may differ from your previous employer-provided plan.
Additionally, if you lose your job-based health insurance, you may qualify for a Special Enrollment Period (SEP) and enroll in a Marketplace insurance plan within 60 days. This allows you to explore alternative insurance plans to maintain continuous coverage during employment transitions.
Furthermore, specific states like Maryland have implemented their own Family and Medical Leave Insurance programs, such as the MD FAMLI program. This program provides paid family and medical leave, allowing employees to take time off to care for a new child, a family member with a serious health condition, or their own serious health condition impacting their ability to work.
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Job-based insurance options
If you have a job offer that includes health insurance, you may no longer qualify for savings on your Marketplace plan, even if you don't accept the job-based coverage. If you have already accepted the offer, you may want to cancel your Marketplace plan for yourself and anyone else in your household who is eligible for the new job-based coverage.
If you have job-based insurance now or get an offer for job-based insurance, you won’t qualify for savings on a Marketplace plan if the job-based plan is considered "affordable". In 2025, a job-based health plan is considered "affordable" if your share of the monthly premium in the lowest-cost plan offered by the employer is less than 9.02% of your household income. Most job-based plans meet these standards. If your employer’s plan meets this standard and is considered “affordable,” you won’t qualify for a premium tax credit if you buy a Marketplace insurance plan instead.
If you are thinking of switching to a Marketplace plan, you should know that you will have to pay the full premium yourself, whereas, with most job-based health insurance plans, your employer pays part of your monthly premium. In addition to your premium, you usually have to pay other costs for your health care, including a deductible, copayments, and coinsurance. If you have a Marketplace health plan, you may be able to lower your costs with a premium tax credit. This tax credit is based on the income estimate and household information you put on your Marketplace application.
If you leave your job for any reason and lose your job-based health insurance, you can enroll in a Marketplace plan. You’ll qualify for a Special Enrollment Period to enroll to get coverage for the rest of the year. For this Special Enrollment Period, you need to apply for Marketplace coverage within 60 days of losing your job-based coverage. Your coverage can start the first day of the month after you lose your job-based coverage.
If you are considering your options after leaving a job, two popular options are COBRA (Consolidated Omnibus Budget Reconciliation Act) and the ACA (Affordable Care Act). COBRA coverage lets you pay to stay on your job-based health insurance for a limited time after your job ends (usually 18 months). You usually pay the full premium yourself, plus a small administrative fee. The ACA, on the other hand, is a health care reform law passed in 2010 that allows Americans to get health insurance coverage regardless of whether they have a pre-existing condition.
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Individual insurance options
If you have a job that offers health insurance, you may not qualify for savings on a Marketplace plan, even if you don't accept the job-based coverage. If you have an offer but haven't accepted it yet, you can update your Marketplace application to see how the offer impacts your savings. If you already have a Marketplace plan and are offered health insurance through a new job, you may want to cancel your Marketplace plan and opt for the job-based insurance.
If you lose your job-based health insurance, you can enrol in a Marketplace plan and may qualify for a Special Enrollment Period to get coverage for the rest of the year. Your coverage can start the first day of the month after your job-based coverage ends. During this transition period, you may qualify for a tax credit to lower your monthly insurance payment, or premium. This tax credit is based on your income estimate and household information.
If you're under 65 and don't qualify for Medicare, two popular options are COBRA (Consolidated Omnibus Budget Reconciliation Act) and the ACA (Affordable Care Act). COBRA allows you to keep yourself, your spouse, an ex-spouse, and your dependents on your former company's group health plan for a limited time (usually 18 months) after your job ends. You will likely have to pay the full premium yourself, plus a 2% administrative fee. With COBRA, you can keep your medical team and all your prescription medications. The ACA, on the other hand, is a health care reform law that allows Americans to get health insurance coverage regardless of pre-existing conditions. You can pick a health plan from your state's health insurance exchange, but the costs can be up to three times higher for older people than for younger ones.
If your employer doesn't offer group health coverage, you may need to create your own 'benefits package'. An employer can use a QSEHRA or ICHRA to help with your individual health insurance premiums. With a reimbursement option, you can choose the level of coverage you want and apply your health reimbursement amount to the cost. Premium subsidies can make your health insurance more affordable, and you can use a subsidy calculator to get an estimate of how much your subsidy could be.
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Continuation of insurance after leaving a job
Losing your job can be stressful, and facing the possibility of losing your health insurance coverage can make it even harder. If you have job-based insurance and are leaving your job, it's important to understand your options for continuing your insurance coverage. Here are some key things to know about maintaining your insurance after leaving a job:
Continuation Options:
- COBRA Continuation Coverage: The Consolidated Omnibus Budget Reconciliation Act (COBRA) allows you to keep yourself, your spouse, an ex-spouse, and your dependents on your former company's group health plan when your job ends. This applies to employers with 20 or more employees, and coverage can last 18 to 36 months. You must pay the full premium, possibly with an additional 2% administrative fee, and you have 60 days to decide if you want to opt for COBRA.
- Temporary Continuation of Coverage (TCC): If you leave Federal Service, you may be eligible for TCC under the Federal Employees Health Benefits (FEHB) Program. TCC allows you to temporarily continue your FEHB coverage for up to 18 months, but you must pay the full premium plus a 2% administrative charge.
- Marketplace Plans: You can purchase a private insurance plan through the Health Insurance Marketplace, which is a federal exchange established under the Affordable Care Act (ACA). Depending on your income, you may qualify for subsidies, lower costs, or free coverage through Medicaid. You can buy a Marketplace plan to bridge the gap until your new job-based insurance starts.
- Special Enrollment Period (SEP): After losing job-based coverage, you may qualify for an SEP, allowing you to enroll in a Marketplace plan within 60 days. You can explore different plans and preview estimated prices based on your income.
Important Considerations:
- Cost: COBRA continuation coverage can be expensive since you have to pay the full premium without any previous subsidies. Marketplace plans may offer more affordable options, and you may qualify for savings or tax credits based on your income.
- Medical Providers and Prescription Drugs: If you choose COBRA, you can keep your existing medical team and prescription medications. With a Marketplace plan, you'll need to ensure that your medical providers are in-network and that your prescription drugs are covered to avoid unexpected out-of-pocket costs.
- Age: If you're older, premiums for an individual ACA plan can be significantly higher than a job-based plan.
- Timing: Your Marketplace coverage can start the first day of the month after your job-based coverage ends, so it's important to act quickly.
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Insurance options for small businesses
If you have a job that offers health insurance, you may no longer qualify for savings on a Marketplace plan, even if you don't accept the job-based coverage offer. If you lose your job-based health insurance, you can start a new health insurance plan the first day of the month after your job-based coverage ends. You can also qualify for a Special Enrollment Period, which means you can enroll in a Marketplace plan within 60 days. You may also be able to keep your job-based health plan through COBRA continuation coverage, which allows you to keep yourself, your spouse, an ex-spouse, and your dependents on your former company's group health plan when your job ends.
Now, here are some insurance options for small businesses:
Health Insurance for Small Businesses
- The Affordable Care Act (ACA) may help small businesses and small tax-exempt organizations afford the cost of covering their employees. Businesses with fewer than 25 employees that provide health insurance may qualify for a small business tax credit of up to 35% (up to 25% for non-profits) to offset the cost of health insurance.
- The Colorado Option Small Group Plans are available to small employers with less than 100 employees. These plans are affordable and provide rich benefits at a lower cost than many other options. Small businesses can purchase these plans through a broker.
- HealthCare.gov offers resources to learn more about health insurance products and services for your employees, such as Health Reimbursement Arrangements (HRAs) and group health plans.
Other Types of Insurance for Small Businesses
- Small businesses may also want to consider other types of insurance to protect against risks. A licensed insurance agent or broker can help design a policy tailored to the business's specific needs.
- Replacement insurance can protect against physical property losses. This can include the cost of replacing or repairing lost or damaged property.
- Unemployment Insurance is required for all businesses with employees in Colorado. This provides benefits to unemployed workers to maintain their economic purchasing power.
- In Colorado, any vehicles used by a company must be properly insured according to the law.
- Workers' compensation coverage is mandated by Colorado state law for all employees. This insurance provides wage replacement and covers medical expenses for workers injured on the job.
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Frequently asked questions
If you lose your job, you can keep your job-based health plan through COBRA continuation coverage for up to 18 months. COBRA is a federal law that allows you to keep yourself, your spouse, an ex-spouse, and your dependents on your former company's group health plan. Alternatively, you can buy an individual plan through the Health Insurance Marketplace.
If you work for a small business with fewer than 50 employees that doesn't offer health benefits, you'll need to create your own "benefits package". You can purchase an individual plan through the Health Insurance Marketplace. Depending on your household income and where you live, you may be eligible for Medicaid or CHIP.
Yes, the Family and Medical Leave Act (FMLA) requires that employees on leave continue to receive benefit coverage for medical care, surgical care, hospital care, dental care, eye care, mental health counseling, substance abuse treatment, etc., on the same terms as before leave.
