COBRA Alternatives in New York (2026)

Your options after leaving a job in New York

When you leave a job in New York, you usually have three main paths: keep your work plan through COBRA or state continuation, buy a plan through NY State of Health, or apply for Medicaid or the Essential Plan if your income has dropped.

New York gives you more time on your old plan than most states. If your employer's plan was fully insured, you can keep it for up to 36 months in total, whether the company was small or large. Self-funded employer plans only get the federal 18 months. Either way you pay the whole premium yourself, which is often the most expensive option.

Losing job-based coverage opens a special enrollment period, usually 60 days, to pick a NY State of Health plan. Your premium help is based on your expected income for the year, so a lower income after a layoff can mean a bigger tax credit. If you choose to drop COBRA in the middle of the year, that alone usually does not open a new enrollment window, so compare before you sign up.

If your income falls low enough, look at Medicaid (about 138% of the poverty level) or the Essential Plan (up to 200%), which has no premium and no deductible. Both accept applications all year.

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.

New York state continuation (Insurance Law sections 3221(m), 4304(k) and 4305(e), as amended in 2009)

Federal COBRA usually lasts 18 months. If your former employer's plan is fully insured and regulated in New York, state law lets you keep it for up to 36 months in total, either through state continuation alone or by adding 18 more months after federal COBRA runs out. You pay the premium yourself, and the employer does not have to pay for the extra months.

• Who it covers: People leaving insured group health plans, whether the employer is small (state continuation, often called mini-COBRA) or large (federal COBRA plus a state extension). It does not apply to self-funded employer plans or to dental-only, vision-only or drug-only plans.
• How long: Up to 36 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 New York, NY State of Health is New York’s official, state-run health insurance marketplace. We’re an independent, licensed insurance agency, not part of NY State of Health or any government agency, and we can help you compare Marketplace plans and enroll. New York runs its own marketplace and keeps a longer window than HealthCare.gov. For 2026 the state asked people to enroll by December 15 for coverage starting January 1. A federal rule that would have shortened open enrollment starting in fall 2026 was struck down by a federal judge in June 2026.

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. The enhanced federal premium tax credits ended on December 31, 2025, and Congress did not renew them for 2026. The old rules are back: if your household income is above 400% of the federal poverty level, you get no federal premium help, and people below that line get smaller credits. New York health officials estimated marketplace plans cost nearly 40% more without the enhanced credits.

If your income dropped

New York expanded Medicaid, so adults ages 19 to 64 with income up to about 138% of the federal poverty level can generally qualify, with or without children. Starting January 1, 2027, federal work requirements apply to many of these adults. They will have to show 80 hours a month of work, training, school or volunteering (or earnings of at least $580 a month) unless they are exempt, and they will renew every six months.

The Essential Plan is New York's Basic Health Program. It gives premium-free coverage with no deductible to adults 19 to 64 with income up to 200% of the poverty level (about $31,920 a year for one person in 2026) who do not qualify for Medicaid, Medicare or affordable job-based coverage. A waiver had raised the limit to 250% of the poverty level, but after federal funding cuts the state ended that expansion on July 1, 2026, moving about 450,000 people in the 200% to 250% range to regular marketplace plans.

What coverage costs