Private PPO vs. COBRA continuation
COBRA has one enormous advantage: nothing changes. Same plan, same network, same doctors, same deductible progress. And one enormous drawback: you now pay the entire premium, including the share your employer was quietly covering, plus an administrative fee.
That is why the sticker shock is so common. A plan that cost $180 a month out of your paycheck can land at $700 or more once the employer contribution disappears.
COBRA
Federal continuation of your former employer's group plan, typically for up to 18 months after your coverage ends.
- Identical coverage, identical network, identical doctors
- Deductible and out-of-pocket amounts already paid this year carry over
- Accepts you regardless of health history — it is the same plan you had
- You pay 100% of the premium plus up to a 2% administrative fee
- Runs out after 18 months, and then you are making this decision anyway
Private PPO
A new underwritten plan chosen for what you actually need now, rather than what your former employer negotiated for a whole workforce.
- Commonly a fraction of the unsubsidised COBRA premium
- Starts any day of the year, including the day after coverage ends
- Nationwide PPO network rather than a regional employer network
- You restart the deductible year, which matters if you are mid-treatment
- Subject to underwriting, so approval is not guaranteed
Where each one actually wins.
- Typical monthly costCOBRAFull group premium, often $650–$1,900Private PPOOften less than halfAdvantage: private PPO
- Keep your current doctorsCOBRAGuaranteed — same networkPrivate PPOUsually, on a broad PPO, but verify firstAdvantage: the alternative
- Health questionsCOBRANonePrivate PPOYes — underwrittenAdvantage: the alternative
- Deductible already paid this yearCOBRACarries overPrivate PPOResetsAdvantage: the alternative
- How long it lastsCOBRAUsually 18 months, then it endsPrivate PPORenewable, not time-boxedAdvantage: private PPO
- Election deadlineCOBRA60 days from your noticePrivate PPONo deadline — apply any dayAdvantage: private PPO
- Mid-treatment continuityCOBRAUninterruptedPrivate PPODepends on the plan and conditionAdvantage: the alternative
- Flexibility to change laterCOBRALocked to the old plan designPrivate PPOChoose the deductible and network you wantAdvantage: private PPO
What people ask us before deciding.
I am in the middle of treatment. Should I just take COBRA?
Probably yes, and we will say so. If you have met a deductible, have surgery scheduled, or are managing an active condition with a specific specialist, continuity is worth real money and underwriting is a risk you do not need. Take COBRA now and call us before the 18 months are up.
Can I take COBRA now and switch later?
Yes. COBRA is not a commitment for the full 18 months — you can drop it when you find something better. A lot of people elect COBRA to cover a gap of a month or two, then move to an underwritten plan once the dust settles. Note that voluntarily dropping COBRA is not itself a marketplace qualifying event, though its natural expiry is.
What about the 60-day election window?
COBRA is retroactive to the day your coverage ended, so the election window doubles as a safety net: if nothing catastrophic happens in those 60 days, you can decline and keep the money. If something does, you elect and it backdates. Your advisor can factor that timing into the plan they recommend.
Does a private plan start fast enough?
Underwritten plans commonly have effective dates on the 1st or 15th, and applications are usually decided in days rather than weeks. If there is a genuine gap, say so on the call — that is a factor in which carrier makes sense.
Best for COBRA
- Anyone mid-treatment or with surgery already scheduled
- Households that have already met a large deductible this year
- People with health history that makes underwriting uncertain
- Short gaps of a month or two between employers
Best for Private PPO
- Healthy households facing a COBRA premium that does not fit the budget
- Anyone who needs coverage for longer than the 18-month COBRA runway
- People who moved out of the old employer network's region
- Self-employment that is now the plan, not a stopgap
The plain-language verdict
COBRA is the right answer when continuity is worth more than the premium — mid-treatment, mid-deductible, or uncertain health history. Outside those cases it is usually the most expensive way to stay covered. Get the actual COBRA number from your HR notice, then let an advisor put a real underwritten alternative next to it.
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