What should I do about health insurance during a career change?

Updated October 2026 · How we answer

Know your options

If you leave a job, you can usually keep your employer's plan for up to 18 months through COBRA, but you pay the full premium plus a small admin fee—often $500–$700 per month for individuals, more for families. That's expensive but preserves your current doctors and coverage.

The Affordable Care Act (ACA) marketplace offers subsidized plans based on income. Losing job-based coverage qualifies you for a special enrollment period (usually 60 days). You may also qualify for Medicaid if your income drops. If you have a spouse or partner with employer coverage, joining their plan is often the cheapest option.

• COBRA: keep your old plan, but pay full premium
• ACA marketplace: subsidies if income is low to moderate
• Spouse's plan: often the most affordable
• Medicaid: if income falls below state threshold
• Short-term plans: limited coverage, not ACA-compliant

Time your transition

Health insurance is month-to-month. If you can, leave your job at the end of a month so your coverage lasts through that month. Then start new coverage on the first of the next month to avoid a gap.

If you're going back to school, check if your school offers a student health plan. If you're starting a new job, ask when benefits begin—some employers have a waiting period of 30–90 days.

Avoid gaps in coverage

A gap in coverage can be risky if you have an accident or illness. Even a short gap can leave you with large medical bills. If you can't afford a full plan, look into a high-deductible catastrophic plan or a short-term plan for a few months.

Also, note that some states have their own marketplaces with different rules. Check your state's insurance department website for details.

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