Almost everyone answers this question with “18 months,” and almost everyone is half right. Eighteen months is the period tied to losing a job or having your hours cut. The other qualifying events, the ones that hit a spouse or a child rather than the employee, run twice as long.
The maximum periods are set in Treasury regulations at 26 CFR 54.4980B-7, which implement the COBRA amendments to the Internal Revenue Code, and the parallel rules run through ERISA and the Public Health Service Act. This guide maps each qualifying event to its maximum period, then covers the part that actually cuts people off, which is almost never the calendar. It is the payment deadlines.
How Long COBRA Coverage Lasts
The type of qualifying event determines both who may elect coverage and how long it must be offered. The clock starts on the date of the qualifying event, not the date you elect and not the date you make your first payment, unless the plan specifically provides for measuring from the date coverage is lost.
| Qualifying event | Who can elect | Maximum coverage period |
|---|---|---|
| Termination of employment (any reason other than gross misconduct) | Employee, spouse, dependent child | 18 months |
| Reduction in hours below the eligibility threshold | Employee, spouse, dependent child | 18 months |
| Either of the above, plus an SSA disability determination covering the first 60 days | Every qualified beneficiary in that family unit | 29 months (an 11-month extension) |
| A second qualifying event during the first 18 months | Spouse, dependent child | 36 months |
| Covered employee becomes entitled to Medicare | Spouse, dependent child | 36 months |
| Divorce or legal separation from the covered employee | Spouse, dependent child | 36 months |
| Death of the covered employee | Spouse, dependent child | 36 months |
| Child loses dependent status under the plan (generally at 26) | Dependent child | 36 months |
Source: the qualifying-event chart in the Department of Labor’s “An Employee’s Guide to Health Benefits Under COBRA,” cross-checked against 26 CFR 54.4980B-7, current as of September 2026.
Three details in that table are worth spelling out.
The disability extension is a family benefit, not an individual one. If SSA determines that any qualified beneficiary was disabled at any time during the first 60 days of COBRA coverage, the regulation applies the 29-month maximum “to each qualified beneficiary who is not disabled as well as to the qualified beneficiary who is disabled.” You must notify the plan of the SSA determination within 60 days of the determination being issued and before the original 18-month period ends. Miss that and the extension is gone. The plan may charge up to 150% of the plan’s cost for months 19 through 29.
A second qualifying event only counts if it would have caused a loss of coverage on its own. A divorce or the employee’s death during the first 18 months can push the spouse and children to 36 months, but only if that event would independently have ended their coverage had the first event never happened. The plan can require notice, and it cannot give you less than 60 days to provide it.
Medicare before a layoff creates a longer, stranger clock. If the covered employee became entitled to Medicare before the termination or reduction in hours, the family’s maximum period ends on the later of 36 months from the Medicare entitlement date or 18 months (29 with a disability extension) from the termination. In practice this often means a spouse gets more than 18 months while the employee gets exactly 18.
Also worth knowing: these are federal minimums. A plan is free to offer longer, and some do as part of a severance package.
The Deadlines That Actually End Your Coverage Early
The regulation lists the events that let a plan cut COBRA short before the maximum period. Most of them are avoidable.
The 60-day election window. Your plan must give you at least 60 days to elect, counted from the later of the date the election notice is provided or the date you would otherwise lose coverage. Every qualified beneficiary elects independently, so a spouse can elect even if the employee declines. You can also waive coverage and then revoke the waiver, as long as you do it before the election period closes.
The 45-day first payment. A plan cannot require payment “earlier than 45 days after the date on which the election of COBRA continuation coverage is made.” That is the most useful deadline in the entire system: coverage is retroactive to the day your old plan ended, so you can elect, wait, and pay only if you need the coverage. But if no payment arrives by day 45, the plan can terminate your COBRA rights and there is no second chance.
The 30-day grace period on every payment after that. Timely payment means payment made within 30 days after the first day of the coverage period. Underpaying slightly is survivable: if the shortfall is no more than the lesser of $50 or 10% of the amount due, the plan must notify you and give you a reasonable period to make it up, with 30 days treated as a safe harbor. Paying nothing is not survivable. A missed premium is the single most common way COBRA ends early.
Your former employer stops offering any group health plan. If the employer ceases to provide a group health plan to any employee, including through a successor plan, COBRA ends. This is what happens when a small company folds, and there is no appeal. Your fallback then is the Marketplace or, if the plan was small-employer, whatever your state’s continuation law provides. See mini-COBRA and state continuation coverage.
You become covered under another group health plan. A plan may end COBRA on the date you first become covered under another group plan after the date you elected. Being offered a new job’s plan is not the trigger. Actually being covered is.
You become entitled to Medicare after electing. Same structure, same sequencing trap. If Medicare Part A or B was already effective on or before the date you elected COBRA, the plan cannot drop you for it.
Fraud or conduct that would get an active employee terminated. A plan can terminate COBRA for cause on the same basis it terminates coverage for similarly situated active employees.
When a plan ends COBRA early for any of these reasons, it owes you a notice of early termination stating the date coverage ends, the reason, and any right you have to elect alternative coverage.
What Happens When COBRA Runs Out
Reaching the end of your maximum coverage period is a qualifying life event. HealthCare.gov states that losing COBRA when it “expires after reaching its maximum duration” opens a special enrollment period, and that if you qualify, “you’ll have 60 days to enroll in a Marketplace plan.” The Department of Labor’s guide puts the same window slightly differently for the original job loss, telling qualified beneficiaries they “must select a plan within 60 days before or after losing your job-based coverage,” so you can line up the replacement before the gap opens rather than after.
The distinction that costs people coverage is between COBRA ending and you ending COBRA. Voluntarily cancelling COBRA before it runs out does not open a special enrollment period. Neither does simply deciding it is too expensive. Outside those triggers you wait for Open Enrollment, which runs November 1 through January 15 and lets you switch to a Marketplace plan regardless of why you are leaving COBRA.
Two other doors stay open the whole time. Medicaid and CHIP accept applications year-round with no enrollment window, and coverage starts immediately if you qualify. And if a spouse’s employer plan is available, losing other coverage triggers a HIPAA special enrollment right there, but you generally have to request it within 30 days, which is half the Marketplace window and easy to blow through.
Plan the handoff about 60 days out. Set a reminder for the month before your maximum period ends and price the alternatives then, not the week coverage lapses. Health insurance for the unemployed and COBRA alternatives both walk through what else is on the table, and catastrophic health insurance is worth a look if you are under 30 or qualify for a hardship exemption.
What It Costs While It Lasts
Duration and price are the same decision. Eighteen months of COBRA is not a small commitment at full freight.
Applying the 102% cap federal law permits to the average employer premium in the 2025 KFF Employer Health Benefits Survey ($9,325 a year for single coverage, $26,993 for family), COBRA runs roughly $793 a month for single coverage and $2,294 a month for family coverage. Over a full 18-month period that is about $14,300 and $41,300 respectively. During an 11-month disability extension at the 150% cap, the monthly figures rise to roughly $1,166 and $3,374.
Those are national averages, and your plan’s number is the one that matters. The full arithmetic, including why the price is four to seven times your old payroll deduction and how to shave it down, is in COBRA insurance cost.
If bills land during the gap, the tools do not depend on having a plan. Hospital charity care is tested on your current income, which is exactly what changed, and negotiating a medical bill works on self-pay balances. If you end up uninsured for a stretch, uninsured start here and free and sliding-scale clinics are the first two stops.
The Bottom Line
Eighteen months for a job loss or an hours cut, 29 with a qualifying SSA disability determination, 36 for divorce, death, Medicare entitlement or a child aging off. Count from the qualifying event, not from your election.
Then treat the calendar as the easy part. The deadlines that actually end COBRA are the 60-day election window, the 45-day first payment, and the 30-day grace period on everything after. Put all three in a calendar the day the election notice arrives, and set one more reminder 60 days before your maximum period ends so the special enrollment period does not expire while you are still deciding.