Health coverage after a job loss checklist
A printable from Health coverage after a job loss. Fill it in by hand. Nothing you write is collected by this website.
Printable checklist
Health coverage after my job ends
Date my work coverage ends: __________ Date COBRA notice arrived: __________
COBRA sign up deadline (60 days): __________ First payment deadline (45 days after I sign up): __________
Covered California window (60 days before or after coverage ends): __________ to __________
For each person in my home
| Name | Age | Possible options (COBRA, Covered California, Medi-Cal, county program) | Monthly cost | Applied on |
|---|---|---|---|---|
Questions to ask
- Is anyone in the middle of treatment who needs to keep the same doctors?
- What is the COBRA price per month for my family?
- What is the Covered California quote with financial help?
- Do my children qualify for Medi-Cal now that my income dropped?
- Is anyone in my home applying for a green card? (Check public charge first.)
- If I have full Medi-Cal already, when is my renewal due?
From Health coverage after a job loss. Facts checked October 21, 2026. Free information, not legal or medical advice.