Keeping health insurance after you lose your job

This page is about health coverage after a job ends. It is general information, not legal or tax advice. If you still have the job and want to know whether your employer must offer insurance, see Does my employer have to give me health insurance?. For income help after a layoff, see Can I get unemployment after being fired or quitting?.

What are my choices?

We know a layoff hits everything at once. Start by seeing which doors are open to your family. Each person in a family can qualify for something different.

Sources: DOL COBRA FAQ, DMHC, Health and Safety Code 1366.26, Covered California for immigrants, and the DHCS Medi-Cal changes page.

How does COBRA work?

COBRA lets you keep the same health plan you had at work, with the same doctors and benefits. The difference is that you now pay the whole premium yourself.

• Who: The U.S. Department of Labor says COBRA generally covers group health plans at employers with 20 or more employees. Losing your job for any reason except gross misconduct counts. So does a cut in your hours. Your spouse and children on the plan may be able to keep it too.
• How long: for a job loss or cut in hours, the maximum is usually 18 months (DOL COBRA FAQ).
• Deadlines: you have 60 days to enroll, counted from when your coverage ends or when the election notice is given or mailed, whichever is later. Then you have 45 days to make your first payment.
• Cost: generally the full cost of the plan plus 2 percent. That is often much more than you paid from your paycheck, because your employer was paying part of it.

Watch your mail for the election notice. Do not throw away anything from your old plan or your former employer's benefits office.

How does Cal-COBRA work?

Cal-COBRA is California's version for small employers. The Department of Managed Health Care says:

• It applies to employers and group plans covering 2 to 19 employees.
• It can last up to 36 months.
• If your federal COBRA lasted 18 months, you may be able to buy 18 more months through Cal-COBRA when it ends.
• You have 60 days after being notified to sign up, and 45 days after you send the enrollment form to pay your first premium.

Under Health and Safety Code 1366.26, the plan may charge no more than 110 percent of the rate for a covered employee. For someone found disabled by Social Security, the cap can rise to 150 percent after the first 18 months.

DMHC does not run COBRA, but its Help Center at (888) 466-2219 answers questions and takes complaints about health plans.

Should I pick COBRA or Covered California?

Compare before you choose. Ask yourself:

1. Am I in the middle of treatment? If you are pregnant, getting cancer care or seeing a specialist, COBRA keeps the same plan and doctors. Covered California may mean a new network.
2. What will each one cost per month? Get the COBRA price from your notice. Get a Covered California quote. For many families with lower income after a layoff, Covered California with financial help, or Medi-Cal, costs far less.
3. Who in my family can use each one? Covered California is only for people who are lawfully present. Medi-Cal rules depend on age and status. See the sections below.

Covered California timing: Covered California says losing health insurance through your job is a qualifying life event. You can apply 60 days before or after your coverage ends. Apply before it ends to avoid a gap. "COBRA coverage ended" is also listed as a qualifying event.

The Department of Labor's COBRA FAQ says choosing COBRA does not stop you from enrolling in the Marketplace later, but you must pick a Marketplace plan within 60 days of losing job based coverage to use that window. If you want to switch later outside open enrollment, ask Covered California first whether you would qualify.

Can my children get Medi-Cal?

Yes, if they meet the income rules. Children under 19 can get full Medi-Cal whatever their immigration status. The 2026 enrollment freeze for adults does not apply to children (DHCS Medi-Cal changes, Covered California for immigrants). Pregnant people can also get full Medi-Cal during pregnancy and for one year after, whatever their status.

After a layoff your income may now be low enough. Apply right away. Each family member's eligibility is checked on its own, so a citizen child can qualify even if a parent cannot (Covered California). You can apply online through BenefitsCal or Covered California, by phone, by mail, or at your county office (DHCS, Apply for Medi-Cal).

What if I am undocumented?

The rules changed in 2026. Here is where things stand (checked October 21, 2026):

• Full Medi-Cal for new adult applicants: since January 1, 2026, adults 19 and older without satisfactory immigration status cannot newly enroll in full scope Medi-Cal. DHCS calls this the Adult Expansion Freeze (DHCS letter I 26-02).
• Already enrolled? Adults who had full Medi-Cal before January 1, 2026 can keep it if they renew on time (DHCS changes page). Do your renewal. Do not let it lapse.
• Emergency (restricted scope) Medi-Cal is still open to people who qualify by income, whatever their status. It covers emergency care, pregnancy care and nursing home care.
• More changes are coming in 2027 for people DHCS lists with unsatisfactory immigration status. An adult premium is planned from July 1, 2027, between $30 and $50 a month, with the exact amount set by the governor in May 2027 (LAO). See Medi-Cal for adults in 2026 for the details. More: Medi-Cal changes in 2027.
• Covered California is not open to people who are not lawfully present.
• COBRA: if you were on your employer's plan, the COBRA and Cal-COBRA rules we read do not ask about immigration status. If you can afford the premium, it may be the only way to keep the same plan.

County programs for adults (check with the county):

• San Mateo County residents: ACE (Access to Care for Everyone) gives health benefits to uninsured low income residents 19 and older. The county lists a $360 yearly enrollment fee and a $15 copay for most services, both waivable based on income (San Mateo County Health).
• Santa Clara County residents: the Primary Care Access Program (PCAP) offers low cost primary care for adults 19 and older with household income at or below 650% of the federal poverty level and no other coverage. Call (888) 363-3394, option 1 (Santa Clara County PCAP, checked October 18, 2026).
• Other counties: ask your county health department or a community clinic. See Health care, whatever your status.

What if I have DACA or another status?

• DACA: Covered California says that as of August 2025 DACA recipients can no longer enroll through Covered California because of a federal rule. Adults with DACA can newly apply for full scope Medi-Cal based on income, per the DHCS freeze chart.
• Green card holders: can use Covered California, and from 2027 are one of the few immigrant groups that keep financial help.
• Asylees, refugees, T visa holders, TPS holders and people on work or student visas: may still enroll in Covered California, but starting in 2027 they will no longer get financial help to lower premiums. Current enrollees keep their help through 2026, and costs will likely rise in 2027. Medi-Cal rules for some of these groups are also changing: the DHCS freeze chart lists people with TPS, granted or pending, as restricted scope if they newly apply at 21 or older. Check Medi-Cal for adults in 2026.

Will using coverage hurt my immigration case?

COBRA is coverage you pay for yourself. It is not a public benefit.

For Covered California and Medi-Cal, Covered California says applying will not affect your immigration status, but it also notes that a new federal public charge rule starting in September 2026 may affect some green card applications where financial help is involved. A family member's benefits are never counted as yours, though an officer may look at a child's means tested benefits as a sign of low household income. Social Security, Medicare and unemployment are not counted. If anyone in your home is applying for a green card, read What benefits can I use without hurting my immigration case? and talk to a free legal helper first.

What mistakes should I avoid?

• Waiting for the last day. Covered California says to apply before coverage ends to avoid a gap.
• Missing the first COBRA payment. You have 45 days after you elect. Mark it on your calendar.
• Letting a child go uninsured because a parent cannot qualify. Apply for the child separately.
• Skipping a Medi-Cal renewal if you already have full Medi-Cal. Under the freeze, adults who lose it may not be able to get back in. DHCS gives a short window, 3 months, to re-enroll after losing coverage.
• Paying for a "discount card" sold as insurance. Ask whether it is a real health plan before you pay.

Questions people ask

My employer said I was fired for misconduct. Can I still get COBRA? Federal COBRA covers losing a job for any reason except gross misconduct. Ordinary firing usually still qualifies. If the plan says no, call the DMHC Help Center at (888) 466-2219 or a free legal clinic.

Can just my children keep COBRA? DMHC says spouses and dependents may qualify. Ask the plan administrator what each family member can choose before you sign.

Will unemployment pay count as income for Medi-Cal or Covered California? Report all income when you apply. A counselor can explain how it is counted for your case.

Where can I get help picking? Call Covered California's service center, or ask a community clinic. In Santa Clara County, PCAP enrolls people through Enrollment Counselors at participating clinics.

Who can help?

Contact them to confirm hours, languages and openings. Being listed here is not a referral or a promise of service.

• DMHC Help Center (statewide): (888) 466-2219, questions and complaints about health plans and COBRA (DMHC)
• Covered California (statewide): (800) 300-1506, TTY (888) 889-4500, Monday to Friday 8 a.m. to 6 p.m.
• Medi-Cal Help Line (statewide): 1-800-541-5555 (DHCS)
• San Mateo County: ACE and other programs at San Mateo Medical Center clinics, Ravenswood Family Health Center (East Palo Alto) and North East Medical Services (Daly City) (San Mateo County Health)
• Santa Clara County: PCAP, (888) 363-3394, option 1
• Legal Aid at Work (statewide): free clinic for job loss questions, East Palo Alto line (415) 404-9093 (Workers' Rights Clinic)

Is there a checklist I can print?