Is COBRA worth it? Sometimes, and it's usually the most expensive door in the hallway. COBRA lets you keep your old employer plan after you leave a job, but you pay the whole premium yourself plus 2%, which at 2025 national averages is about $777 a month for one person and about $2,249 for a family. In New York it can run 36 months. It's the right call if you're mid-treatment, pregnant, or you've already met a big deductible this year. For a healthy person or family, there are two cheaper doors, and one of them almost nobody mentions. I educate, you decide.

I'm Dick Tracy, an independent health insurance broker in Buffalo, licensed in 25 states with 80+ carriers. I came from the healthcare side of this business, so there's no gag clause on me. Here are the tips, the tricks, and the traps for anyone in Western New York who just got a COBRA election notice in the mail.

What COBRA actually is (and isn't)

COBRA isn't an insurance company. It's a 1985 federal law that says when you leave a job, you can keep the exact plan you had, same network, same deductible progress, same everything, as long as you pay for it. The employer's share disappears, so the number on your notice is the real price of your old plan, which most people have never seen. You have 60 days from the notice to elect, and if you do, coverage is retroactive to the day you left, so there's no gap.

How much COBRA costs

Cost math: KFF 2025 Employer Health Benefits Survey average annual premiums of $9,325 single and $26,993 family, divided by 12, times 1.02. Source: KFF. Length: NYS Department of Financial Services.

Your real number is on the election notice, and in Western New York it's often above the national average because our carriers took 14% to 21% increases for 2026. The math doesn't math for most healthy people, and that's before you find out you can't shop it. COBRA is one plan at one price, take it or leave it.

The New York twist: 36 months, and small employers count

Federal COBRA gives you 18 months and only applies to employers with 20 or more employees. New York's continuation law does two things on top of that. It extends fully insured plans to 36 months total, and it covers the small employers federal COBRA skips, so a 6-person shop in Cheektowaga has to offer it too. Same 102% price the whole way. Longer isn't cheaper, though. It just means you can overpay for three years instead of a year and a half.

When COBRA is the right call

I'll say this plainly because a lot of people online won't: sometimes you should take COBRA. If you're in the middle of cancer treatment, pregnant, scheduled for surgery, or your specialist at Roswell Park or Buffalo Medical Group isn't in any other network you can get, the continuity is worth the money. Same if you've already met a $4,000 deductible this year and it's September. Starting a new plan resets that to zero. And if you had a serious diagnosis in the last few years, COBRA or the marketplace is the right door for now, not the private options below. Pack the parachute before the plane goes down, but don't jump if you're already on the ground.

Door two: NY State of Health

Losing job coverage is a qualifying life event, so you get a 60-day special enrollment window on the marketplace, no waiting for November. If your household income for the rest of the year lands under the subsidy line, the credit can make a Silver plan far cheaper than COBRA. Two traps. First, the subsidy is based on your projected income, and severance, unemployment, or a new job in October can push you over the 2026 cliff and trigger a repayment at tax time. Second, marketplace networks in Erie County are mostly HMO-style, so check your doctors before you click. Run your numbers on my free 2026 subsidy cliff calculator, and read NY State of Health vs. a broker for the full picture.

Door three: the one nobody mentions

For a healthy person or family in New York, the option that usually beats both COBRA and the full-price marketplace is merging into a pre-established ERISA group plan. ERISA is a federal law from 1974 that governs employer benefit plans, and federal law overrides New York's community rating. Instead of paying your old employer's group rate alone, I merge you into an ERISA group that already exists: group rates, a true PPO, and a policy you own, so it comes with you to the next job, into self-employment, or all the way to Medicare. No more COBRA notices, ever. It can often start outside open enrollment. Add inexpensive gap or accident coverage and a bad day stays a bad day instead of a bad year.

The 60-day clock, and how to use it

Here's the detective move. You have 60 days to elect COBRA, and coverage is retroactive if you do. That means you can spend the first few weeks pricing the other two doors with zero risk of a gap. If something happens in that window, you elect COBRA and it covers you back to day one. If nothing happens and a better door is cheaper, you never pay the COBRA premium at all. Use the clock; don't let it use you.

Common questions about COBRA in New York