The sticker shock of a COBRA election notice is almost always the same story. The plan did not get more expensive. You just found out what it always cost.
Federal law lets your former employer’s plan charge you up to 102% of what the coverage actually costs the plan, and for most people that is somewhere between four and seven times the payroll deduction they were used to. This guide works the arithmetic in public, using published national premium averages, so you can estimate your own number before the notice arrives and decide whether to elect at all.
How Much Does COBRA Cost Per Month?
There is no national COBRA price list, because COBRA is not a product. It is your old employer plan at full freight, so the price is whatever your old plan costs. What you can do is anchor to the national average employer premium and apply the statutory 102% cap.
The 2025 KFF Employer Health Benefits Survey, the 27th edition and the most recent one available as of September 2026, put the average annual premium for employer-sponsored coverage at $9,325 for single coverage and $26,993 for family coverage. Those are total premiums, meaning the employer’s share plus the worker’s share combined. That total is the base COBRA is priced from.
The math is simple enough to do on your own plan document:
- Single: $9,325 divided by 12 is $777.08 a month. Multiply by 1.02 for the administrative fee and you get $792.63 a month, or $9,511.50 a year.
- Family: $26,993 divided by 12 is $2,249.42 a month. Multiply by 1.02 and you get $2,294.41 a month, or $27,532.86 a year.
| Coverage tier | Average payroll deduction as an employee | COBRA at 102% | COBRA at 150% (disability extension) | COBRA cost for 18 months at 102% |
|---|---|---|---|---|
| Single | $120/mo | $793/mo | $1,166/mo | $14,267 |
| Family | $571/mo | $2,294/mo | $3,374/mo | $41,299 |
Figures derived from 2025 KFF Employer Health Benefits Survey averages ($9,325 single, $26,993 family) and the premium caps in 26 CFR 54.4980B-8. Your plan’s number will differ.
The payroll-deduction column is the other half of the shock. KFF found the average worker contributed $1,440 a year for single coverage and $6,850 a year for family coverage, which is $120 and $571 a month. Nothing about the coverage changes when you elect COBRA. Only who writes the check changes.
Two caveats before you plan around these numbers. First, they are averages across a survey of more than 1,800 employers, so a generous plan at a large firm can run well above them and a lean high-deductible plan can run below. Second, KFF’s 2026 edition normally publishes in October, and the organization has said employers are bracing for sharper increases, so treat these as a floor for 2026 rather than a forecast.
Why COBRA Costs What It Costs
Your employer’s contribution disappears. This is the whole story, and it is the part nobody explains at the exit interview. KFF found covered workers pay an average of 16% of the single premium and 26% of the family premium. The employer was silently covering the other 84% and 74%. COBRA does not raise the price of your coverage. It just hands you the invoice your employer used to pay.
The 2% administrative fee is a cap, not a fee schedule. The Treasury regulation is explicit: a plan “can require the payment of an amount that does not exceed 102 percent of the applicable premium for that period.” The extra 2 percentage points exist to cover the cost of administering COBRA. On the average family plan that fee is about $45 a month. Plans are allowed to charge less than 102%, and some employers subsidize COBRA for a period as part of a severance package, but the vast majority charge the full cap.
During a disability extension the cap jumps to 150%. If the Social Security Administration determines that a qualified beneficiary was disabled at any time during the first 60 days of COBRA coverage, everyone in that family unit can get an 11-month extension, for 29 months total. The Department of Labor’s own guide states the plan “can charge an increased premium, up to 150 percent of the cost of coverage, during the 11-month disability extension.” On the national averages that is roughly $1,166 a month single and $3,374 a month family, and it applies only to months 19 through 29, not to the original 18.
The price is fixed for a year at a time. Plans must compute and fix the applicable premium before each 12-month determination period begins. Mid-year increases are only allowed in narrow cases, such as when the plan had been charging less than the maximum, when you enter the disability extension, or when you change the coverage you are receiving.
Dental and vision follow the plan, not your wishes. COBRA continues the coverage you actually had the day before the qualifying event. Dental and vision count as medical care under COBRA, so they are continuable, but only if you were enrolled. Whether you can keep medical and drop dental depends on how your employer structured things: if dental and vision are genuinely separate plans under the plan documents, Treasury’s plan-counting rules require the employer to let you elect each one independently. If they were bundled into a single plan, the employer can make it one election for the whole package.
COBRA vs. Your Other Options
You are not obligated to elect. The Department of Labor guide itself tells qualified beneficiaries to “consider all options before you make your decision.”
A Marketplace plan with a premium tax credit. Losing job-based coverage opens a special enrollment period, and HealthCare.gov states you can enroll “within 60 days of losing your job-based coverage.” Subsidies are calculated on your estimated income for the year you need coverage, not on your employment status, so a mid-year job loss often produces a much larger tax credit than you would have qualified for while working. CMS projected that in plan year 2026, tax credits would cover 91% of the lowest-cost plan premium for eligible enrollees, leaving an average of about $50 a month for that plan. Two things to know honestly: the enhanced pandemic-era subsidies expired December 31, 2025, so 2026 premiums after tax credits are higher than they were, and CMS’s own comparison shows a 50-year-old at twice the poverty level getting 81% of the benchmark premium covered in 2026 versus 93% in 2025.
A spouse’s or parent’s plan. Losing coverage triggers a HIPAA special enrollment right in another group plan, but the window is short: you generally must request special enrollment within 30 days of losing the other coverage. This is frequently the cheapest option available and the easiest one to miss.
Medicaid or CHIP. There is no enrollment window. You can apply any time, and if you qualify, coverage begins immediately. Income eligibility is based on current household income, which is exactly the thing that just changed.
State continuation, if your employer was small. COBRA applies to employers with at least 20 employees. Most states run a parallel program for smaller employers, often called mini-COBRA, with its own duration and pricing rules. See mini-COBRA and state continuation coverage.
Short-term plans and going bare. Short-term health insurance is cheaper up front and much thinner, and it is not required to cover pre-existing conditions. If you are considering skipping coverage entirely, read uninsured start here first, and understand that a single hospitalization is what turns this decision into a financial event. A broader comparison lives at COBRA alternatives and health insurance for the unemployed.
How to Pay Less
Use the full election and payment windows before you commit a dollar. Your plan must give you at least 60 days to elect, and the regulation bars a plan from requiring payment “earlier than 45 days after the date on which the election of COBRA continuation coverage is made.” Coverage is retroactive to the date your old plan ended. In practice you can wait, shop the Marketplace, and only elect and pay if you actually incur a claim. Miss the 45-day deadline, though, and the plan can terminate your COBRA rights outright.
Elect for fewer people. Each qualified beneficiary has an independent right to elect. If your spouse can get on their own employer’s plan and only you need bridge coverage, elect single-only COBRA and drop the family tier. On the national averages that is the difference between about $2,294 and about $793 a month.
Drop dental and vision if they are separate plans. Check the plan documents or the election notice. If dental sits in its own plan, declining it is free money, and routine dental and primary care are among the easier things to buy at a cash rate. Price the alternative first: see what a doctor visit costs without insurance before you keep a rider you will not use.
Pay COBRA premiums from an HSA. Health insurance premiums are normally not a qualified medical expense, but IRS Publication 969 lists two exceptions that both apply here: “health care continuation coverage (such as coverage under COBRA)” and health care coverage while receiving unemployment compensation. If you have a balance in an HSA from a prior high-deductible plan, those dollars can pay the premium tax-free. More on that in using an HSA without insurance.
Ask for COBRA in the severance negotiation. Employers routinely agree to cover two to six months of COBRA premiums, and it costs them less than extra severance salary. Ask in writing, and get the end date in the agreement.
Cut the care costs, not just the premium. If you elect a high-deductible version of your old plan, most of what you spend is out of pocket anyway. Prescription assistance programs and free and sliding-scale clinics both work regardless of what plan you are on, and if a hospital bill lands while you are between jobs, hospital charity care is income-tested on your current income, which is exactly the point.
The Bottom Line
Budget roughly $793 a month for single COBRA coverage and $2,294 for family coverage, then replace those averages with the real number on your election notice as soon as it arrives. Add 2% mentally to whatever your plan’s full premium is and you have it.
COBRA is worth the money when continuity is worth the money: mid-treatment, a met deductible, a specific specialist, a drug that is on this formulary and might not be on the next one. It is usually the wrong answer when your income has dropped, because the same drop that makes COBRA unaffordable is what makes a subsidized Marketplace plan or Medicaid cheap. Either way, do not let the clock run out while you decide. Next, see how long COBRA lasts for the deadlines that end coverage early.