COBRA Alternatives in Maryland for 2027
Leaving a job in Maryland gives you three paths: keep your old plan through COBRA or Maryland's continuation law, switch to a Marketplace plan during a special enrollment period, or apply for a private plan that can start on the first of next month if approved. The cheapest path depends on your health, your income for the year and how much of your deductible you have already met. Maryland individual premiums are also rising 14.6% on average for 2027.
Private health insurance in Maryland
Most people I help in Maryland end up on a private plan, not a Marketplace plan. Private, medically underwritten health insurance is priced on your age, zip code and health instead of your income, so a strong year never raises your premium and there is no tax credit to pay back in April.
Why people leave the Marketplace
- Premiums keep climbing. Maryland Marketplace premiums are rising 14.6% on average for 2027.
- The subsidy cliff. Above 400 percent of the poverty level ($63,840 for one person, $132,000 for a family of four) you pay full price.
- Surprise tax bills. Underestimate your income and you repay the tax credit in April.
- Narrow networks. Many plans are local HMOs or EPOs that need referrals and cover little outside the area.
- High out-of-pocket costs. 2027 out-of-pocket maximums reach $12,000 per person and $24,000 per family.
- One window a year. Outside open enrollment you need a qualifying life event to enroll or switch.
What a private plan does differently
- Start any month. If approved, coverage can begin the first of next month, with no wait for open enrollment.
- Networks that travel. Many private plans use national PPO networks, which can give you in-network doctors outside Maryland too. Networks vary by plan.
- Can cost less than full-price Marketplace plans for some healthy applicants above the subsidy line.
- Accident coverage the Marketplace does not offer. A private plan can be paired with accident coverage, a separate policy. What it includes varies by plan.
- Approval is based on health. You answer health questions, and acceptance is not guaranteed.
With a significant health condition, or income low enough for a large tax credit, a Marketplace plan can be the better fit, and I will tell you if it is. Either way you see both side by side.
Private plans are not ACA Marketplace plans. Benefits, exclusions and pre-existing condition rules differ by plan and by state, so review the plan details before you enroll.
Get a private plan quoteLearn more: coverage not based on income · how underwriting works · private vs Obamacare · PPO plans for individuals · switching from the Marketplace
Maryland continuation law
Maryland has three continuation laws. Section 15-409 covers job loss for Maryland residents with three months of coverage. Section 15-407 gives a surviving spouse up to 18 months after an employee's death, with 45 days to elect. Section 15-408 lets a former spouse and children continue after a divorce, generally while the employee stays covered under the group. All three apply only to insured group contracts issued to Maryland employers, including those with fewer than 20 workers, and you pay the full premium plus up to 2 percent. Larger employers, with 20 or more workers, fall under federal COBRA.
Switching off COBRA in Maryland
Marylanders switch through Maryland Health Connection, the state exchange, which generally allows 60 days after losing other coverage to enroll. If both Maryland continuation and federal COBRA could apply, the Maryland Insurance Administration's position is that you can claim both and any differences are resolved in your favor. Before you stop paying, line up the new plan's start date so there is no gap, and remember that a new plan restarts the deductible. For help with a continuation or enrollment problem, call the Insurance Administration at 1-800-492-6116.
The Maryland individual market you would switch into
Maryland Health Connection, the state's own exchange, sets its own open enrollment dates; check its site for 2027 deadlines. Maryland offers more state help than most states: its State Reinsurance Program, approved through 2028, helps hold down premiums, and the Maryland Premium Assistance Program adds state help on top of federal tax credits for eligible enrollees based on household income. Maryland's continuation law reaches the small employers that federal COBRA skips, so leaving a small shop usually means you can keep the group plan for up to 18 months if you elect within 45 days. Short-term plans are tightly limited to less than three months with no renewals, which makes them a narrow bridge rather than a long-term option. Because the state subsidy runs through Maryland Health Connection, buying through the exchange matters if you want the full amount of help.
Other Maryland rules to know
- Short-term plans: Maryland law limits short-term plans to less than three months with no renewals, which is stricter than the federal rule, so the federal enforcement pause does not change anything in Maryland.
- Where to enroll: Maryland runs its own exchange, Maryland Health Connection. Maryland Health Connection sets its own open enrollment dates; check its site for 2027 deadlines. Private, medically underwritten plans can start the first of any month if approved.
- 2027 rates: individual plans 14.6% on average, small-group plans about 10.2%. See the Maryland 2027 rate page.
What COBRA really costs
Under federal COBRA, which covers employers with 20 or more employees, you can keep your group plan for up to 18 months but pay up to 102 percent of the full premium, including the share your employer used to pay. That is often the most expensive option available. You have 60 days to elect it, and coverage is retroactive, so some people wait and elect only if they need care.
When COBRA is still worth keeping
Keep COBRA when you have met most of your deductible this year, are in the middle of treatment, or need a specific doctor who is not in other networks. Otherwise compare it against a Marketplace plan, which may come with a tax credit, and a private plan.
Do not miss the 60-day window
Losing job-based coverage opens a 60-day Marketplace special enrollment period. Voluntarily dropping COBRA later does not open a new one outside open enrollment, so decide while the window is open.
For 2027 the Marketplace credit stops at 400 percent of the poverty level: $63,840 for one person, $86,560 for two and $132,000 for a family of four. The out-of-pocket maximum for 2027 Marketplace plans is $12,000 for one person and $24,000 for a family. The full guide covers the rest.
Compare Maryland plans
Licensed in Maryland. Private plans priced first, Marketplace alongside when it fits. No fee.
Maryland questions
Where do Maryland residents enroll in 2027 coverage?
Maryland runs its own exchange, Maryland Health Connection. Maryland Health Connection sets its own open enrollment dates; check its site for 2027 deadlines.
What continuation rights does Maryland give after leaving a small employer?
Maryland requires insured group plans, including those of employers with fewer than 20 workers, to offer up to 18 months of continuation to Maryland residents who leave a job voluntarily or are let go for reasons other than cause after three months of coverage. You have 45 days to elect it and pay the full premium plus up to a 2 percent fee.
How much are Maryland premiums rising for 2027?
Individual-market premiums are set to rise 14.6% on average, and small-group plans about 10.2%.
Is a Marketplace plan cheaper than COBRA?
Often, especially if your income qualifies for a tax credit. Above the subsidy line, a private plan may cost less than both for a healthy buyer.
Can I drop COBRA and get a Marketplace plan later?
Only during open enrollment, unless you have another qualifying event. Your special enrollment window after losing job coverage lasts 60 days.
Sources: insurance.maryland.gov, www.marylandhealthconnection.gov, insurance.maryland.gov. Facts checked October 2026. See all Maryland health insurance rules.
COBRA alternatives in other states
Written by Frank Caballero, licensed health insurance agent in Maryland and 30 other states, NPN 21032307.