Are COBRA Benefits The Same As My Insurance? | Costs Vs Plan

COBRA usually keeps the same employer health plan and network, while you take over the full premium and follow strict election and payment rules.

When job-based coverage ends, the first question is usually simple: “Do I get to keep what I had?” COBRA is often described as keeping your insurance, so it’s easy to assume nothing changes.

Most of the care rules do stay the same because COBRA is continuation coverage under the same group health plan. The parts that feel different are cost, deadlines, and paperwork. This guide shows what matches, what can shift, and how to check your own plan fast.

What COBRA Is And What It Is Not

COBRA continuation coverage is a federal rule that can let you stay on a former employer’s group health plan after certain events. You’re not shopping for a new policy. You’re keeping the existing plan, just without the employer payroll system and employer premium share.

When COBRA Applies

In many cases, COBRA applies when an employer has 20 or more employees and offers a group health plan. Qualifying events often include job loss (other than for gross misconduct), a reduction in hours, divorce or legal separation, death of the covered employee, and a dependent child losing eligibility.

If you want a straight reference for the baseline rules and notices, start with the U.S. Department of Labor’s COBRA page. COBRA Continuation Coverage (EBSA).

What “Same Plan” Means

“Same plan” usually means the same insurer, the same network, and the same benefit design you used as an employee. If active employees can switch during open enrollment, COBRA participants typically get the same chance, since the plan is still the employer’s plan.

What Usually Stays The Same Under COBRA Coverage

For many people, the main payoff is continuity. If you’re mid-treatment or your clinicians are hard to replace, staying in the same plan can save time and avoid rerunning approvals.

Network And Provider Rules

Because it’s the same plan, the in-network list and referral rules often stay the same. If your doctor was in-network last month, they’re usually in-network next month under COBRA, as long as you elect coverage and pay on time.

Covered Services And Cost Sharing

Copays, coinsurance, deductibles, and covered services usually match what you had. If you already paid toward your deductible in the current plan year, that progress often carries over because you’re staying in the same plan year and the same plan.

Prescription Coverage

Formularies, pharmacy networks, and prior authorization rules usually stay tied to the plan. If a medication is working for you, confirm refill rules early so you don’t get stuck during the transition week.

Where COBRA Can Feel Different From “My Insurance”

Even when benefits match, COBRA can feel like a different product because the employer is no longer subsidizing the premium and payroll is no longer collecting it for you.

You Pay The Full Premium Plus A Fee

Under COBRA, you typically pay the full premium that was previously split between you and your employer, plus a small administrative fee. That’s why the monthly bill can jump sharply even though the plan name stays the same.

The Department of Labor’s employee guide explains elections, premiums, and time limits in plain language. An Employee’s Guide To Health Benefits Under COBRA.

The Employer Can Still Change The Plan

COBRA follows the employer’s group plan. If the employer switches insurers, changes networks, or tweaks cost sharing for active employees, COBRA participants are usually moved along with the plan change.

COBRA Ends After A Set Period

COBRA is time-limited. Many events trigger up to 18 months of continuation coverage, with longer periods available in certain situations. Your election notice should state your end date.

Deadlines And Late Payments Matter

With job-based coverage, payroll deductions can hide how tight timing is. With COBRA, missing election or payment rules can end coverage. Keep copies of notices and proof of payment.

How To Check If Your COBRA Benefits Match Your Old Plan

You don’t need an insurance degree to verify what you’re keeping. You just need the right documents.

1. Match the plan option. Confirm the exact plan you had, not just the insurer name.
2. Compare the SBC. Review deductible, out-of-pocket maximum, office visit copays, and hospital coverage.
3. Verify clinician network status. Use the insurer’s directory, then save a screenshot.
4. Read the election notice. Write down election and payment due dates and set reminders.

COBRA Benefits Vs Your Insurance Plan: What Matches And What Can Shift

This checklist-style table is a quick way to see where “same coverage” is true and where surprises come from.

Coverage Piece	Often The Same Under COBRA	Where Differences Show Up
Plan design	Same benefit rules and covered services	Changes at renewal follow the employer plan
Provider network	Same in-network list and referral rules	Network contracts can change during the year
Deductible and OOP tracking	Often carries within the same plan year	Resets at the new plan year, same as employees
Prescription coverage	Same formulary and pharmacy rules	Formulary changes follow plan updates
Premium amount paid	Same total premium for the plan option	You usually pay the full premium plus a fee
Claims handling	Same insurer processes claims	Coverage can end after missed payments
Coverage duration	Continuation for a fixed maximum period	Ends at maximum period or if other rules end it
Dental and vision	May continue if part of the group plan	Some employers offer separate options or none

Cost Reality Check Before You Elect

If your COBRA premium looks shocking, you’re not alone. Many employees never see the full cost because the employer pays a large share.

To decide with clarity, run a quick two-number test:

• Monthly COBRA premium versus the cheapest plan you’d accept elsewhere.
• Total expected care costs for the next few months based on your current deductible status, prescriptions, and planned visits.

If you expect expensive care soon and you’ve already paid toward your deductible, COBRA can preserve that progress. If your care is light, a lower-premium option can win even with a new deductible.

COBRA And Marketplace Coverage: Rules That Change The Decision

After losing job-based coverage, you may qualify for a Marketplace special enrollment period. HealthCare.gov explains when COBRA makes sense and how it interacts with Marketplace timing. COBRA Coverage When You’re Unemployed.

A common mistake is assuming you can start COBRA now and switch later on any day you choose. Outside open enrollment, switching usually requires a qualifying event. If you think a Marketplace plan is your likely destination, check the timing rules before you lock in months of COBRA premiums.

Medicare Timing After 65

If you’re eligible for Medicare, COBRA gets trickier. Medicare.gov notes that COBRA may not pay as primary coverage once you’re eligible for Medicare, which can leave larger out-of-pocket costs if you rely on COBRA alone. COBRA Coverage (Medicare.gov).

If you or a spouse is near 65, treat Medicare enrollment timing as part of the decision, not an afterthought.

Decision Table: When COBRA Often Fits Versus Other Options

This table helps you weigh continuity against cost in a few common scenarios.

Your Situation	COBRA Often Fits	Another Option Often Fits
Ongoing treatment with specific clinicians	Same network and approvals usually stay in place	If the new plan keeps the same clinicians in-network
High spending already this plan year	Can keep deductible and OOP tracking consistent	If premiums are too high and care slows down
Short gap before a new job’s coverage starts	Can bridge without changing doctors or meds	If you can use a lower-cost plan for a short window
COBRA premium is unaffordable	Only if you must keep the same plan for care	Marketplace plans may cost less based on income
You want to keep dependents on the same plan	Can keep family coverage under the same group plan	If another plan offers better family pricing or networks
You’re eligible for Medicare soon	May help dependents in some setups	Medicare planning may be the core move

Checklist To Avoid Costly Mistakes

• Don’t guess at deadlines. Put election and payment due dates on a calendar the same day you get the notice.
• Confirm the premium in writing. Include dental and vision if you plan to keep them.
• Verify network status. If a clinician left the network, ask about cash-pay rates and out-of-network coverage.
• Track prescriptions. Refill early when possible, and confirm prior authorization rules for the next fill.
• Price a backup plan. Even if COBRA looks right, compare at least one Marketplace option.

Clear Takeaway

Most of the time, COBRA benefits are the same as your employer insurance because it’s the same group plan. What changes is who pays, how strict the timing is, and the fact that plan changes made by the employer can still flow through.

If you want the same clinicians and the same plan rules for a short stretch, COBRA can be a clean bridge. If the premium is too steep, a Marketplace plan may fit better. The right answer comes from your documents, your budget, and your care needs over the next few months.