COBRA Alternatives in Ohio (2026)

Your options after leaving a job in Ohio

If you lose a job in Ohio, you usually have three ways to keep coverage: federal COBRA, Ohio's state continuation law, or a new Marketplace plan. Federal COBRA generally applies to employers with 20 or more workers and lasts up to 18 months, but you pay the full cost plus a small fee.

Ohio's continuation law (Ohio Revised Code 3923.38) lets you keep group hospital, surgical and major medical coverage for up to 12 months if you were on the plan for at least three months and did not quit or get fired for gross misconduct. The deadline to elect it can be as short as 10 days after your employer's notice, so read any letter from your employer right away. It ends if you become eligible for Medicare or join another group plan.

Losing job-based coverage also opens a special enrollment period, so you can pick a Marketplace plan within 60 days of losing coverage. If your income drops, you may qualify for a premium tax credit, and if it falls to 138% of the poverty level or less, Ohio Medicaid may cover you, and you can apply for Medicaid at any time of year.

A licensed agent can compare what COBRA or state continuation would cost against Marketplace plans for your ZIP code and expected income before your deadlines pass.

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.

Ohio state continuation (Ohio Revised Code 3923.38)

Ohio's continuation law lets you keep your group hospital, surgical and major medical coverage for up to 12 months, paying no more than the group rate. You must elect it in writing and pay the first premium within a short window, which can be as little as 10 days after notice, so act quickly. Unlike federal COBRA (generally employers with 20 or more workers, usually 18 months, and allowed for people who quit), Ohio's law does not apply if you quit voluntarily, does not have to continue dental or vision, and ends if you become eligible for Medicare or join another group plan.

• Who it covers: Employees covered by an employer's group health plan in Ohio for at least three months before their job ended, as long as they did not quit voluntarily and were not fired for gross misconduct. It applies to insured group plans and, unless federal law preempts it, to employer self-funded plans.
• How long: Up to 12 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 Ohio, HealthCare.gov is the federal government’s official marketplace for Ohio. We’re an independent, licensed insurance agency, not part of HealthCare.gov or any government agency, and we can help you compare Marketplace plans and enroll. Ohio uses the federal Marketplace, so you apply and pick a plan through HealthCare.gov. To have coverage start January 1, 2027, choose a plan and pay your first premium by December 15, 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 extra federal premium tax credits that began in 2021 expired at the end of 2025. The U.S. House passed a three-year extension in January 2026, but it did not become law, so 2026 help in Ohio follows the original ACA rules and stops for households above 400% of the federal poverty level. The average Ohio Marketplace enrollee's net premium rose from about $126 a month in 2025 to about $233 a month in 2026, and 2026 sign-ups fell to about 469,600 from more than 583,000.

If your income dropped

Ohio expanded Medicaid in 2014. Adults age 19 to 64, with or without children, can qualify if household income is up to 138% of the federal poverty level, and about 705,000 Ohioans were covered through the expansion in mid-2025. A federal law passed in 2025 requires states to apply work or community engagement rules to most expansion adults starting no later than January 1, 2027, with exemptions such as people who are medically frail and parents or caretakers.

What coverage costs