Leaving Employer Coverage in Katy: Your Enrollment Paths
Losing employer coverage opens time-limited enrollment windows, and the right path depends on your age and situation. People 65 or older generally look at Medicare; people under 65 generally look at the ACA Marketplace or COBRA. Deadlines matter, so start early.
Help by phone or video. Please do not send medical records, Medicare numbers or employee health information through website forms.
If you are 65 or older: the Medicare path
When employer coverage ends, a Special Enrollment Period generally lets you enroll in Medicare Part B without a late-enrollment penalty, but the window is limited — generally eight months from when coverage or employment ends. COBRA does not count as employer coverage for this purpose, so electing COBRA can accidentally cost you the window.
If you are under 65: Marketplace or COBRA
Losing job-based coverage qualifies you for a Marketplace Special Enrollment Period, generally 60 days. Premium tax credit eligibility depends on household income and other factors. COBRA keeps your old plan but usually at full cost; compare both before electing, because dropping COBRA mid-year does not reopen Marketplace enrollment.
- Marketplace SEP: generally 60 days from losing coverage
- COBRA: same plan, full premium plus an administrative fee
- Spouse's employer plan: another possible Special Enrollment Period
What to gather before you call
Know your coverage end date, your household's estimated income for the coverage year, and whether anyone in the household is Medicare-eligible. With those three facts, a short phone call can narrow the realistic options quickly.
Common questions
Should I take COBRA or a Marketplace plan?
It depends on cost, your doctors and how far into the plan year you are. COBRA keeps your exact coverage at full price; a Marketplace plan may cost less with a subsidy but uses a different network. Compare both before the COBRA election deadline.
I'm 64 and retiring — what should I do first?
Start Medicare research several months before 65. Your Initial Enrollment Period spans seven months around your 65th birthday, and employer coverage ending interacts with it. A call well before the birthday avoids gaps.
Does losing coverage always create a Special Enrollment Period?
Loss of qualifying coverage generally does, but voluntarily dropping coverage or losing it for non-payment may not. Confirm your specific situation on HealthCare.gov or by phone.
Talk it through with a Texas agent
A short call can narrow the realistic options for your situation. We discuss plans we represent, not every plan on the market.
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Disclaimer
TXInsurance.com is not HealthCare.gov, Medicare.gov or any government agency. Licensed in select but not all states. We do not offer every plan available in Katy. Eligibility, benefits, networks and pricing must be confirmed in the official carrier quote and policy documents.