How much does COBRA cost per month? The 102 percent math, with the deadlines

The same KFF survey found that the average covered worker paid $1,672 a year toward single coverage, about $139.33 a month, and $7,471 a year toward family coverage, about $622.58 a month. Set those beside the COBRA ceilings and the gap is $694.01 a month for single coverage and $1,783.18 for family coverage at the averages. That gap is the employer contribution you stop receiving, plus a 2 percent margin the law allows the plan to add.

Why the COBRA bill starts from the whole premium

Federal law sets the ceiling in two steps. First, 29 USC 1164 defines the "applicable premium" as the cost to the plan for the period of coverage for similarly situated people who have not had a qualifying event, "without regard to whether such cost is paid by the employer or employee." Second, 29 USC 1162(3) says the premium a plan may charge "shall not exceed 102 percent of the applicable premium" and may be paid in monthly installments if you choose. The Treasury regulation at 26 CFR 54.4980B-8 repeats the 102 percent ceiling and adds that a plan must allow monthly payments.

So the number on a COBRA notice is not your old deduction with a fee on top. It is the full price of the coverage, which an employer was mostly paying, plus up to 2 percent. At the single average, the 2 percent margin is $16.34 a month; at the family average it is $47.18. The other $677.67 of the single-coverage gap is the employer share that no longer arrives.

Self-insured plans, where the employer pays claims itself instead of buying an insurance policy, have no insurer premium to point to. For those, section 1164 requires a reasonable actuarial estimate of the cost of coverage, or the prior period's cost adjusted by a federal price index if the administrator elects that method. Either way the result is a full-cost figure, and the 102 percent cap applies to it.

The ceiling is a maximum, not a required price. A plan can charge less, and an employer can pay part of the COBRA premium, for example as part of a separation agreement. The Marketplace rule at 45 CFR 155.420 describes COBRA "for which an employer is paying all or part of the premiums," which matters later when that help stops.

Monthly COBRA amounts at the 2026 KFF averages

The table converts each KFF 2026 average annual premium into monthly figures at three levels: the full premium with no margin, the 102 percent ceiling that applies in most months, and the 150 percent ceiling allowed only in disability-extension months. Group averages show how much plan type and region move the base.

Source: KFF 2026 Employer Health Benefits Survey, published October 22, 2026; survey fielded January to July 2026, 1,937 firms interviewed. Averages for covered workers, employer and worker shares combined. Monthly columns computed by MyCarePrice, October 30, 2026. Averages, not a quote for any plan.

The spread runs from $764.07 a month for single coverage in an HSA-qualified plan to $2,667.13 for family coverage in the Northeast, both at the 102 percent ceiling. Your own plan can sit outside that range in either direction, because an average of thousands of plans hides the plans at each end. The only figure that binds your plan is the one on its election notice.

The family column assumes everyone on the old plan continues. Under 29 USC 1165, an election by the employee or spouse is treated as covering the other qualified beneficiaries unless the election says otherwise, and 54.4980B-6, Q&A-6, gives each qualified beneficiary an independent election. If only some members continue, the plan prices the tier they actually take, such as employee plus spouse or employee plus children. Ask for the monthly amount for each tier you might choose.

Eighteen, 29 and 36 months, added up

The maximum length of COBRA depends on what caused the loss of coverage, and the total cost depends on that length. Under 29 USC 1162(2), a job ending, other than for gross misconduct, or a cut in hours gives 18 months. Death of the employee, divorce or legal separation, the employee's Medicare entitlement, and a child aging out of dependent status give 36 months to the spouse or children. A disability determination by the Social Security Administration stretches the 18 months to 29, and a second qualifying event inside the first 18 months can stretch a spouse's or child's period to 36 months from the original event.

Computed from the KFF 2026 Employer Health Benefits Survey averages and the ceilings in 29 USC 1162 and 26 CFR 54.4980B-8, October 30, 2026. Each total multiplies the rounded monthly figure. Premiums can change at the plan's next 12-month determination period, so a real multi-year total will differ.

The 29-month row is the one people miscount. The 150 percent ceiling applies only to months 19 through 29, and only when the extra months exist because of the disability extension. At the single average, those 11 months cost up to $13,480.50, against $9,166.74 if they had been charged at 102 percent: a difference of $4,313.76. The first 18 months stay at the 102 percent ceiling.

The 36-month row carries no 150 percent months. The regulation is specific: if a person entitled to the disability extension has a second qualifying event within the original 18 months, the plan may not charge more than 102 percent for any month. Only when the second event falls after month 18 may the plan charge up to 150 percent for the disability-extension months.

One job ending January 31, 2027: every date in order

The deadlines below follow a single invented case: employment and plan coverage both end on January 31, 2027, the employer tells the plan administrator promptly, and the administrator mails the election notice on February 22, 2027. The person elects COBRA on April 20, 2027. Change any input and the dates move, but the rules that set them do not.

Dates computed by MyCarePrice from the statute and regulations cited, read October 30, 2026. Invented dates; a real plan's will differ. Plans may allow longer periods; the "latest allowed" dates assume the employer and administrator each use their full notice time. Multiemployer plans can have longer notice periods.

Two features of the table deserve a second look. The Marketplace window closes on April 1, 2027, 22 days before the COBRA election period ends on April 23, 2027. Someone who waits for the last day of the COBRA window to decide has, in this case, already let the Marketplace window pass. The two clocks start from different events: the Marketplace clock from the last day of coverage, the COBRA clock from the later of that day or the notice.

The maximum periods are measured from the qualifying event, which in this case is the same day coverage ends. Under 26 CFR 54.4980B-7, when coverage ends later than the event, the period still runs from the event unless the plan's terms measure it from the loss of coverage. If your last day of work and last day of coverage differ, ask which date the plan uses.

The disability extension has its own deadlines. Social Security must determine that the person was disabled at some point in the first 60 days of COBRA (the determination itself can come later), and the qualified beneficiary, not Social Security, must send the plan administrator notice of that determination within 60 days of it and before the 18 months run out, under 29 USC 1166(a)(3) and 1162(2)(A)(viii). In this case that outer limit is July 31, 2028. A notice that arrives after it does not extend anything.

The first payment can cover several months at once

A COBRA election made within the window reaches back to the day coverage ended. The regulation at 54.4980B-6 says that if the election is made during the election period, coverage must be provided from the date coverage would otherwise have been lost. And under 54.4980B-8, Q&A-4, the plan is permitted to apply the first payment to the period starting immediately after that date. So there is no gap in coverage, and there is no gap in the bill either.

In the illustration, the election on April 20, 2027 makes the earliest permitted demand date June 4, 2027. By then the February, March, April and May 2027 periods have all begun, so 4 months are owed together:

Those dollar figures are where the "wait and see" approach meets its cost. People sometimes delay the election because coverage is retroactive anyway, then elect only if a large medical bill arrives. The law allows that sequence, but the payment that follows covers every month back to the loss, not just the month of the bill. Electing earlier does not lower the total; it only spreads it out.

Claims during the waiting period are handled in a specific way. The regulation lets a plan hold claims incurred during the election period until the election and payment are made, and if a doctor, hospital or pharmacy calls to confirm coverage in that window, the plan must give a complete answer, which can be that coverage depends on election and payment. A provider who hears that may ask you to pay at the visit and seek reimbursement later. When the claims do process, the explanation of benefits shows how they were applied; our guide to reading an explanation of benefits line by line covers the columns.

Late, short or mailed: the payment rules after the first month

After the first payment, each month's premium is timely if it is paid within 30 days after the first day of the period it covers, or by a later date if the plan's terms allow one. That rule is in the statute, 29 USC 1162(2)(C), and in 54.4980B-8, Q&A-5. Missing it lets the plan end COBRA as of the first day of the unpaid period, and the statute lists nonpayment among the events that end continuation coverage.

Payment counts as made on the date it is sent to the plan, according to the same Q&A. A check mailed on the 30th day is on time even if it arrives later. Keep the postmark, a certified-mail receipt or the confirmation page from an online payment, because that date is the evidence if the plan says the money was late.

Small underpayments have a defined cushion. A payment that falls short by no more than the lesser of $50 or 10 percent of the amount due is treated as paying in full, unless the plan sends notice of the shortfall and gives a reasonable time to make it up, with 30 days after the notice as the safe harbor. At the averages, 10 percent of a monthly payment is $83.33 for single coverage and $240.58 for family coverage, so in both cases the cushion is $50. That matters most at the start of a new determination period, when the amount can change while an old automatic payment keeps sending the previous figure.

During the grace period, a plan can either keep coverage active or suspend it and reinstate it retroactively when payment arrives. If a provider asks, the plan must say that coverage is in place but subject to retroactive termination if payment is not made. Keep the payment confirmation for any month in its grace period with you at appointments, so a registration desk that sees a pending status can check it against the administrator's record.

When the plan may raise the monthly amount

The amount is not open to change at any time. Under 54.4980B-8, Q&A-2, the applicable premium is computed and fixed before each 12-month determination period, which the plan selects and must use consistently. Inside that period, the amount can rise in only three cases: the plan had been charging less than the maximum and moves up toward it, the disability extension begins and the 150 percent ceiling applies, or the person changes coverage.

The practical result is that most COBRA bills change once a year, usually at the employer's plan renewal. If your COBRA starts two months before the plan year turns over, expect a new figure two months in. Ask the administrator for the determination period dates and, once it is set, the coming period's amount, so the 18-month total in the table above can be redone with real numbers.

Coverage changes run both ways. Under 54.4980B-5, a COBRA participant must get the same open enrollment rights as active employees in the same position, so you can move to a different benefit package the employer offers at open enrollment, or drop family members, and the amount follows the tier you choose. Outside open enrollment, the rule only requires the plan to continue the coverage you had the day before the qualifying event, with a narrow exception for region-specific plans such as an HMO when you move out of its area.

What you already paid toward the deductible stays credited

COBRA is the same plan, not a new one, and the deductible rules follow from that. Under 54.4980B-5, Q&A-2, a person whose COBRA begins partway through a deductible period keeps credit for expenses already counted toward the deductible, as though the qualifying event had not happened. For a family deductible, only the expenses of family members who elect COBRA need to be counted.

Take an invented plan with a $3,000 individual deductible, where the person had met $2,400 of it before the job ended. Under COBRA, $600 remains for the rest of that deductible period. A new policy bought elsewhere starts its own deductible and out-of-pocket counters under its own terms, and nothing in the COBRA rules makes another insurer credit what was paid to the old plan. Late in a plan year, after heavy spending, that difference can outweigh a gap in monthly premiums. Our explainer on the deductible and the out-of-pocket maximum shows how both counters build through a year.

The same logic covers a plan year reset. COBRA counters return to zero when the employer plan's year turns over, exactly as they would for an active employee. If you are near the out-of-pocket maximum in November, a planned procedure in December and one in February sit under two different counters even on unbroken COBRA.

COBRA and a Marketplace plan: the rules that decide the timing

The comparison itself is premium plus expected out-of-pocket costs, and the Marketplace half of it depends on income-based premium tax credits. That arithmetic is laid out, with 2027 figures, in our guide to 2027 Marketplace plan costs and premium tax credits; it is not repeated here. What follows are the timing and eligibility rules that sit underneath it.

• The window around job loss. 45 CFR 155.420(c)(2) gives a person losing minimum essential coverage 60 days before and 60 days after the loss to pick a plan. HealthCare.gov puts it as enrolling "within 60 days of losing your job-based coverage." If the plan is chosen on or before the last day of the old coverage, the rule at 155.420(b)(2)(iv) has coverage start on the first day of the next month.
• Dropping COBRA early is not a qualifying loss. Under 155.420(e), loss of coverage does not include voluntary termination or failure to pay premiums, "including COBRA continuation coverage premiums prior to expiration of COBRA continuation coverage." HealthCare.gov says the same: ending COBRA early by choice means waiting for open enrollment unless another life event occurs.
• Exceptions that do open a window. COBRA running out at the end of its maximum period, an employer that completely stops contributing to COBRA premiums, and the end of a government COBRA subsidy each count, under 155.420(d)(15) and (e)(1).
• Open enrollment works for any reason. During the annual open enrollment period, a person on COBRA can enroll in a Marketplace plan regardless of why COBRA is ending. The 2027 dates are listed in the Marketplace costs guide linked above.
• Enrolling in COBRA affects the tax credit for those months. IRS Publication 974 says that if you are offered coverage by a former employer, such as COBRA, you are treated as eligible for that employer coverage for premium tax credit purposes only for the months you are enrolled in it. Declining COBRA does not by itself block the credit; enrolling does, for each month enrolled.
• Medicaid and CHIP have no window. HealthCare.gov notes that a person eligible for Medicaid or CHIP can enroll at any time, and advises waiting for a final eligibility decision before ending COBRA. Medicaid can also reach back to some months before the application; see Medicaid retroactive coverage and the 2027 change.

None of this ranks one route over the other. It sets the dates by which each route stays open, and the illustration table shows how the Marketplace window can close first.

Paying the premium from an HSA, and what an FSA cannot do

An HSA generally cannot pay insurance premiums, but IRS Publication 969 lists exceptions, and two of them fit job loss directly: "health care continuation coverage (such as coverage under COBRA)" and "health care coverage while receiving unemployment compensation under federal or state law." An HSA balance built up while employed can therefore pay COBRA premiums tax-free, because Publication 969 describes an HSA as portable: it stays with you if you change employers or leave the work force.

At the single average, an HSA balance of $3,333.36 would cover the four-month first payment in the illustration, and $15,000.12 would cover the full 18 months. Health FSAs work differently: Publication 969 lists health insurance premiums among the expenses a health FSA cannot reimburse. The account rules side by side, including leftovers and carryover, are in our guide to paying for care from an HSA or FSA.

If the plan you continue is a high-deductible plan, the deductible arithmetic for the months ahead is the same as it was while employed; the high-deductible plan cost math walks through premium plus deductible across a year with stated inputs.

Employers under 20 workers and state continuation: a Texas example

Federal COBRA does not reach every job. Under 29 USC 1161(b), it does not apply to a group health plan for a calendar year if all employers maintaining the plan normally employed fewer than 20 employees on a typical business day during the preceding year. Some states add continuation rules of their own for insured plans, and your state's insurance department is the place to ask whether one applies.

Texas is one state whose regulator spells its rules out in plain terms. The Texas Department of Insurance, Health care coverage guide, updated March 31, 2026, says:

Source: Texas Department of Insurance, Health care coverage guide, page updated March 31, 2026, read October 30, 2026.

The same TDI guide adds the conditions: the plan must be subject to Texas insurance law, so self-funded plans are outside state continuation; the person must have had coverage for the 3 months before the job ended; and a person fired from the job usually cannot get it. The guide does not state a premium ceiling for the state months, so ask the insurer what those months will cost before counting on them. Other states have different lengths and conditions, and none of the Texas figures carry over.

What can end COBRA before the maximum

The 18, 29 and 36 months are maximums. Section 1162(2) lists the events that end coverage sooner, and each one stops the premium as well:

• The employer stops offering any group health plan to any employee.
• A premium is not paid within the grace period.
• After electing COBRA, the person becomes covered under another group health plan that has no preexisting-condition exclusion or limitation affecting that person.
• After electing COBRA, the person becomes entitled to Medicare. The reverse order is different: Medicare entitlement that comes before the COBRA election does not end COBRA under this provision.
• For disability-extended coverage, Social Security makes a final determination that the person is no longer disabled. Coverage can end with the month that begins more than 30 days after that determination, and the person must tell the plan within 30 days of it.

A separate Medicare rule can lengthen coverage for family members. If the employee became entitled to Medicare less than 18 months before the job ended, the spouse and children get COBRA until at least 36 months after the Medicare entitlement date, under 1162(2)(A)(vii). Medicare has its own enrollment periods, so a person near 65 should confirm those dates with Medicare directly instead of assuming COBRA settles them.

Reading the election notice: a fill-in table

The election notice and the first premium invoice contain every input needed to redo the 102 percent arithmetic with your plan's own numbers. Copy these lines out before the window closes:

Write every phone confirmation down with the date and the name of the department. If the notice is missing a line from this table, the administrator is the one to ask, and the answer is worth getting in writing, since the deadlines it sets run whether or not the paperwork is clear.

Common COBRA premium questions

The survey and the law behind the numbers

• KFF, 2026 Employer Health Benefits Survey, summary of findings, published October 22, 2026: average annual premiums for single and family coverage, worker contributions, and averages by plan type, firm size and region. Checked October 30, 2026.
• US Code, 29 USC 1162 (premium ceilings of 102 and 150 percent, maximum periods, 30-day timely payment, events ending coverage), 1161 (fewer than 20 employees exception), 1163 (qualifying events), 1164 (applicable premium), 1165 (60-day election period), 1166 (30-day and 14-day notices, disability notice). Checked October 30, 2026.
• eCFR, 26 CFR 54.4980B-5 (deductible credit, open enrollment rights), 54.4980B-6 (election period, coverage from the date of loss), 54.4980B-7 (measuring the maximum period), 54.4980B-8 (102 and 150 percent, determination period, 45-day first payment, timely payment, shortfall safe harbor). Checked October 30, 2026.
• eCFR, 45 CFR 155.420, Marketplace special enrollment periods: 60 days before and after a loss of coverage, coverage effective dates, and the COBRA exclusions in paragraph (e). Checked October 30, 2026.
• HealthCare.gov, COBRA coverage when you're unemployed: 60-day enrollment after losing job-based coverage, switching from COBRA, Medicaid and CHIP at any time. Checked October 30, 2026.
• IRS, Publication 969 (2025), insurance premiums an HSA can pay, and premiums a health FSA cannot reimburse. IRS, Publication 974 (2025), COBRA and premium tax credit eligibility by month enrolled. Checked October 30, 2026.
• Texas Department of Insurance, Health care coverage guide, state continuation lengths and conditions, page updated March 31, 2026. Checked October 30, 2026.

General cost information, not legal, tax or insurance advice, and not a recommendation of any coverage. KFF figures are survey averages of total premiums, not a quote for any plan. Your plan's election notice, plan documents and administrator set the amounts and dates that apply to you.