What to Do When You Get a COBRA Notice: A Step-by-Step Checklist

You just got a thick envelope from your former employer's benefits administrator, or an email with a multi-page PDF attached. It's overwhelming, it's long, and it comes with a 60-day deadline you cannot extend.

Here's exactly what to do, in what order, so you use those 60 days well.

Day 1 — Find and Read the Important Parts

Don't try to read the whole notice. Most of it is boilerplate that doesn't apply to you. Find these specific things:

• The date the notice was sent or dated. Your 60-day clock starts from here (or from the coverage-end date, whichever is later).
• Your coverage-end date. The last day of your employer-paid coverage.
• Your election deadline. Often printed explicitly on the cover letter or in a highlighted box.
• Your monthly premium. The single number you'd pay if you elected. Look for a table showing medical, dental, vision premiums separately.
• The plan administrator's contact info. Name, phone, email, address. You'll need this later.

Write these five items down on a sticky note. Attach the sticky note to your fridge or your laptop. That's your dashboard.

Day 2 — Calculate Your Real Deadline

Count 60 days forward from the later of (a) your coverage-end date or (b) the date your notice was sent. That's your hard deadline.

If your notice already states the deadline, verify by counting yourself. Administrative errors happen, and if the notice says a deadline earlier than 60 days, that's the deadline the plan will enforce.

Put this date in your calendar with an alert 15 days before and 5 days before. Two alerts, not one.

Day 3–4 — Get a Marketplace Quote

Before you decide on COBRA, you need a real comparison. Go to healthcare.gov (or your state marketplace if applicable) and get a quote.

Key inputs:

• Projected annual income. This is the year you're currently in, with your new (lower) income. Don't use last year's income. Include any unemployment benefits, severance, and part-time income you expect.
• Household size. Include everyone you'd enroll.
• State and ZIP code. Plans and prices vary by county.

Write down the monthly premium for a Silver plan that includes your preferred primary care doctor. Note the out-of-pocket maximum and deductible.

Day 4–5 — Check Spouse/Partner Coverage

If your spouse or partner has employer health coverage, call their HR and ask:

• What's the monthly cost to add me (and dependents) to their plan?
• What's the enrollment window? Usually 30 days from the qualifying event, so this clock is shorter than COBRA's 60.
• Is their network adequate for my current doctors and specialists?

If adding you to a spouse's plan is cheaper than COBRA or the marketplace, that's often the winning option.

Day 5–6 — Check Medicaid Eligibility

Medicaid uses current income for eligibility, not prior-year income. If your household income post-layoff is low enough, you may qualify for free or very low-cost coverage with no waiting period.

Go to your state's Medicaid website (or healthcare.gov will automatically route you if you qualify during the marketplace application). Apply if eligible — it's a parallel option, not a fallback.

Day 7–10 — Compare the Real Numbers

By now you should have three to four data points on a single page:

• COBRA monthly premium and coverage summary
• Marketplace monthly premium (post-subsidy) and coverage summary
• Spouse's plan monthly cost (if applicable) and coverage summary
• Medicaid eligibility (yes/no/pending)

For each, note the monthly premium, deductible, out-of-pocket maximum, and whether your doctors are in network. That's a complete comparison.

Day 10–14 — Make the Decision, Don't Act Yet

Decide which option you're going with, but don't execute immediately if you've chosen the marketplace. Here's why:

• COBRA is retroactive. You can wait and still get coverage back to your coverage-end date if something happens.
• Marketplace Special Enrollment runs 60 days from loss of coverage. No retroactive benefits.
• If you're leaning toward the marketplace but are unsure, you can wait until day 45-55 and still enroll.
• If you're leaning toward COBRA, waiting costs nothing — electing on day 60 has the same effect as electing on day 10, except you pay back premiums.

There are two good reasons to act before the deadline window closes:

• You need medical care right now — don't wait, elect and pay immediately
• You've decided on the marketplace and want coverage to start on the first of the next month — enroll before the 15th of the prior month for that effective date

Day 15–45 — Monitor and Adjust

During this window:

• If something medical comes up and you were planning to skip COBRA, reconsider and elect retroactively
• If your situation changes (new job offer, income change), re-run the comparison
• If you're still holding off on the decision, that's usually fine — just don't forget your calendar alert at day 45

Day 45–60 — Execute

By day 45, you should be locked in on a direction. Execute:

If electing COBRA:

• Complete and sign the election form included with your notice
• Submit it via the method specified (mail, fax, online portal)
• Pay the initial premium within 45 days of submitting the election
• Keep copies of everything — your election form, payment confirmation, and any correspondence
• Confirm with the plan administrator that coverage is active

If electing a marketplace plan:

• Complete the enrollment at healthcare.gov with all household info
• Submit documentation of loss of coverage (typically your COBRA notice or a letter from the employer)
• Pay the first month's premium — coverage won't start until payment is received
• Confirm the effective date in writing

If electing a spouse's plan, work with their HR on enrollment. This often moves faster than COBRA or the marketplace.

Day 60+ — Verify and Keep Records

Whichever option you chose:

• Verify your coverage is active by calling the insurance carrier
• Keep a folder with your election form, payment receipts, and plan ID card
• Set a calendar reminder for any upcoming deadlines — next premium due date, open enrollment, COBRA end date, etc.
• If you're on COBRA, set a reminder 60 days before it ends to start shopping for a replacement plan

Common Mistakes to Avoid

• Electing COBRA on day 1 without comparing. Closes the door on alternatives and often costs thousands more than marketplace coverage with subsidies.
• Waiting too long, then missing the deadline entirely. Set two calendar reminders, not one.
• Assuming "some COBRA" is covered by severance. Severance COBRA subsidies are explicit contract terms — check your agreement in writing, don't assume.
• Ignoring dental and vision notices. If your employer used separate carriers, multiple notices may have arrived. Check all of them.
• Forgetting the 45-day payment window after election. Electing doesn't activate coverage — payment does.

The Bottom Line

The 60-day window isn't about reading 50 pages. It's about a structured two-week decision process followed by monitoring and execution. Use days 1-10 to gather data. Use days 10-45 to decide and observe. Use days 45-60 to execute and confirm.

The worst outcome isn't picking the wrong option — both COBRA and the marketplace work well for the right person. The worst outcome is not deciding at all, letting the deadline pass, and finding yourself uninsured during one of the more vulnerable moments of your life.

Pick a direction. Pick it on purpose.