What benefits are covered under COBRA?

Asked by: Prof. Liam Sauer  |  Last update: October 19, 2025
Score: 5/5 (67 votes)

Inpatient and outpatient hospital care, • Physician care, • Surgery and other major medical benefits, • Prescription drugs, and • Dental and vision care. COBRA requires most of these plans to provide a temporary continuation of health coverage that would otherwise end due to certain events.

What are COBRA eligible benefits?

The Consolidated Omnibus Budget Reconciliation Act (COBRA) gives workers and their families who lose their health benefits the right to choose to continue group health benefits provided by their group health plan for limited periods of time under certain circumstances such as voluntary or involuntary job loss, ...

What are the disadvantages of COBRA coverage?

COBRA cons
  • COBRA can be expensive, especially compared to the premiums you were paying before your qualifying event. ...
  • COBRA does not apply to all employer-sponsored health plans—in particular, those organizations with fewer than 20 employees may have no requirements. ...
  • Even if you get an extension, COBRA is only temporary.

What are the 7 COBRA qualifying events?

The seven COBRA qualifying events that allow individuals to maintain their employer-sponsored health insurance include termination of employment for reasons other than gross misconduct, reduction in the number of work hours, divorce or legal separation from the covered employee, the covered employee becoming entitled ...

How does COBRA work after leaving a job?

COBRA health insurance provides for the continuation of group health coverage when you quit, retire or are fired from a job that offered a qualifying plan. It can also be applied if your hours are reduced so that you no longer meet your employer's criteria for plan eligibility. The only exception is dismissal for gross.

Everything you need to know about COBRA

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What is the COBRA loophole?

If you decide to enroll in COBRA health insurance, your coverage will be retroactive, meaning it will apply to any medical bills incurred during the 60-day decision period. This loophole can save you money by avoiding premium payments unless you actually need care during this time.

How long is COBRA offered after termination?

A plan, however, may provide longer periods of coverage beyond the maximum period required by law. When the qualifying event is the covered employee's termination of employment or reduction in hours of employment, qualified beneficiaries are entitled to 18 months of continuation coverage.

Who is not eligible for COBRA?

Why would an employee not qualify to enroll in Cal-COBRA? The employee is enrolled in or eligible for Medicare. The employee does not enroll within 60 days of receiving the notice of eligibility from the employer. The employee is covered by another health plan.

How expensive is cobra insurance?

The average monthly cost of COBRA Insurance premiums ranges from $400 to $700 per individual.

Does COBRA coverage begin immediately?

Assuming one pays all required premiums, COBRA coverage starts on the date of the qualifying event, and the length of the period of COBRA coverage will depend on the type of qualifying event which caused the qualified beneficiary to lose group health plan coverage.

What is the largest disadvantage of COBRA?

COBRA coverage is not cheap. Why? Because you're now responsible for paying your portion of your health insurance: The cost your employer contributed to your premium, in addition to the 2% service fee on the cost of your insurance.

Is COBRA even worth it?

While it may seem like a lot of money, COBRA may actually cost you less than what you'll pay on the open market. That's because you may still get your former company's group discount. You can also use a health savings account (HSA) to pay for your COBRA premiums. They're considered a qualified medical expense.

Does COBRA affect your taxes?

There isn't necessarily a “COBRA Tax Deduction”. You can only deduct the amount of COBRA medical expenses on your federal income tax in excess of 7.5% of your Adjusted Gross Income and then only if you itemize deductions.

Is it better to use COBRA or obamacare?

ACA plans may offer significant cost savings through subsidies that aren't available under COBRA. By transitioning to an ACA plan, you can often find more affordable coverage without waiting until COBRA expires, giving you flexibility in managing your healthcare costs.

Does COBRA cover surgery?

“Medical care” includes: Inpatient and outpatient hospital care, • Physician care, • Surgery and other major medical benefits, • Prescription drugs, and • Dental and vision care. COBRA requires most of these plans to provide a temporary continuation of health coverage that would otherwise end due to certain events.

What plans are not subject to COBRA?

Indemnity policies, PPOs, HMOs, and self-insured plans are all eligible for COBRA extension; however, federal government employee plans and church plans are exempt from COBRA. Individual health insurance is also exempt from COBRA extension.

Is there cheaper insurance than COBRA?

Marketplace insurance, available through the Affordable Care Act (ACA), is a popular alternative. It often provides more affordable options compared to COBRA, with a range of plans to suit different needs and budgets.

How do I calculate my COBRA payment?

Using the information provided in Box 12 of your most recent W-2 form, labeled Code DD, you will find the total annual cost of your employer-sponsored health coverage. To determine your monthly COBRA premium, divide this annual amount by 12 and include any applicable administrative fees, which may be up to 2%.

How does the COBRA coverage work?

COBRA stands for the Consolidated Omnibus Budget Reconciliation Act. COBRA allows former employees, retirees, and their dependents to temporarily keep their health coverage. If you get COBRA, you must pay for the entire premium, including any portion that your employer may have paid in the past.

What are the qualifying reasons for COBRA?

Qualifying Events for Dependent Children
  • Loss of dependent child status under the plan rules.
  • Voluntary or involuntary termination of the covered employee's employment for any reason other than gross misconduct.
  • Reduction in the hours worked by the covered employee below plan eligibility requirements.

How long does a COBRA take to process?

Coverage under COBRA will be retroactive from your last day of coverage as an active benefits participant. This reinstatement normally takes between 5 and 10 business days from when your first full month of COBRA payment is processed.

How long can I get COBRA if I quit my job?

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.

Does COBRA work immediately?

You have 60 days to enroll in COBRA once your employer-sponsored benefits end. Even if your enrollment is delayed, you will be covered by COBRA starting the day your prior coverage ended.

Does health insurance end immediately after termination?

Employers aren't required to continue providing health insurance coverage after termination, so most workers lose coverage immediately or at the end of their last month of employment. However, most companies must allow you to stay on your plan through COBRA continuation coverage.

Can I go to the doctor while waiting for a COBRA?

You will be reimbursed for any medical bills that you pay out-of-pocket during this period. Contact the plan administrator for more information on filing a claim for benefits. Complete plan rules are available from the employer's benefits offices.