COBRA Alternatives in Maryland (2026)

Your options after leaving a job in Maryland

If you lose or leave a job in Maryland, you usually have three paths: federal COBRA, Maryland state continuation, or a new individual plan. Losing job-based coverage opens a special enrollment period, so you do not have to wait for open enrollment.

Federal COBRA covers employers with 20 or more workers. Maryland's own continuation law covers insured group plans and lets you keep coverage for up to 18 months if you were covered for at least 3 months and were not fired for cause. Either way, you usually pay the full premium plus a fee, which can be a shock.

Compare that cost with Marketplace plans. If your income dropped, federal tax credits plus Maryland Premium Assistance may bring a new plan well below your COBRA bill. Maryland also lets you start the process by checking a box on your unemployment insurance application.

If your income has fallen close to zero, check Maryland Medicaid. Adults can qualify with income up to 138% of the poverty level, and you can apply any time.

How federal COBRA works

Federal COBRA lets you keep your former employer’s group plan if the employer had 20 or more employees. Coverage usually lasts up to 18 months, and you can be charged the full premium plus a 2% administrative fee, because your employer stops paying its share.

You generally have 60 days from your election notice to choose COBRA. Coverage is retroactive, so some people wait and only elect it if they need care during that window. Talk to an agent before relying on that, because missing the deadline ends the option.

Maryland state continuation (Maryland Insurance Article, Section 15-409)

Maryland law lets you keep your group coverage for up to 18 months after leaving a job, as long as you were not fired for cause. You can be charged the full premium (your share plus the employer's share) plus an approved administrative fee, and you get at least 45 days to elect it. It applies to insured group contracts, which matters most at small employers that federal COBRA does not reach.

• Who it covers: Maryland residents who were covered for at least 3 months under an employer's insured group health contract and whose job ended for any reason other than cause, including quitting. A covered spouse and dependent children can continue too.
• How long: Up to 18 months

Marketplace plans and your special enrollment period

Losing job-based coverage opens a 60-day special enrollment period, so you don’t have to wait for open enrollment. In Maryland, Maryland Health Connection is Maryland’s official, state-run health insurance marketplace. We’re an independent, licensed insurance agency, not part of Maryland Health Connection or any government agency, and we can help you compare Marketplace plans and enroll. Maryland runs its own exchange, and it adds state money on top of federal tax credits, including a young adult subsidy for ages 18 to 37. For 2027 coverage, plans picked by December 31, 2026 generally start January 1, and January picks start February 1.

Marketplace premiums are based on your expected income for the year, not last year’s. If you’re between jobs, a lower income estimate can mean a much larger premium tax credit. Congress did not extend the enhanced federal premium tax credits, so they ended after 2025. For 2026, federal help again stops at 400% of the federal poverty level, and Maryland's individual market rates rose an average of 13.4%. Maryland stepped in with its own premium assistance for households under 400% of poverty, but people above that line get no state or federal help.

If your income dropped

Maryland expanded Medicaid starting January 1, 2014. Adults age 19 to 64, with or without children, can qualify with household income up to 138% of the federal poverty level. You can apply any time of year, not only during open enrollment.

What coverage costs