Qualifying Life Events

A qualifying event is a life change that opens a door to health coverage you could not otherwise get at that moment. Two separate systems use the term, and they do not mean the same thing.

COBRA qualifying events are the specific events that give you the right to stay on an employer plan. Marketplace qualifying life events are the changes that open a Special Enrollment Period to buy an individual plan outside of Open Enrollment. Losing a job triggers both. Getting married triggers only the second. This page covers each in turn.

Reviewed by Prodest Insurance Group, a licensed insurance agency (NPN 19515569) · Updated 28 October 2026 against current federal guidance.

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COBRA Qualifying Events

The event determines two things: who is entitled to continue coverage, and for how long. An event only counts if it actually causes a loss of coverage under the plan.

Qualifying event	Who may continue	Maximum period
Job loss, for any reason other than gross misconduct	Employee, spouse, dependent children	18 months
Reduction in the employee’s hours	Employee, spouse, dependent children	18 months
Divorce or legal separation	Spouse, dependent children	36 months
Death of the covered employee	Spouse, dependent children	36 months
A child loses dependent status under the plan	That dependent child	36 months
The employee enrolls in Medicare	Spouse, dependent children	36 months

Job loss counts whether you quit, were laid off, or were let go. Gross misconduct is the single exception.

A Note on Medicare

Medicare is the most misunderstood item on that list. An employee enrolling in Medicare while still working does not usually lose group coverage, so there is usually no qualifying event at all. Where it matters is for the family: if the employee’s Medicare enrollment causes a spouse or child to lose coverage, those dependents may continue for up to 36 months.

Becoming eligible for Medicare is also not the same as being entitled to it. The rules turn on actual entitlement, and how they apply depends on the timing relative to the job ending.

Who Has to Tell the Plan, and By When

This is where people most often lose rights they were entitled to. For some events the employer notifies the plan. For others the responsibility is yours, and the deadline is short.

Event	Who notifies the plan	Deadline
Job loss or reduction in hours	Your employer	30 days
Death of the covered employee	Your employer	30 days
Employer bankruptcy	Your employer	30 days
Divorce or legal separation	You	60 days
A child losing dependent status	You	60 days

If you are divorcing, this deadline is yours to meet

Nobody else will report a divorce or legal separation to the health plan. If the 60-day window passes without notice, the right to continue coverage can be lost. A court decree of divorce or legal separation is required. Filing paperwork or beginning the process is not enough on its own.

Once the plan knows, it must send an election notice within 44 days of the qualifying event, or within 14 days of being notified by you.

When 18 Months Can Become More

Disability extension. If the Social Security Administration determines that a qualified beneficiary is disabled before the 60th day of COBRA coverage, and the disability continues through the initial 18-month period, all qualified beneficiaries may receive an additional 11 months, for up to 29 months in total. The plan may charge up to 150 percent of the premium during the extension.

Second qualifying event. If a second event happens during the initial 18 months, such as a divorce or the death of the covered employee, coverage may extend by a further 18 months, up to 36 months in total. The same 60-day notice rule applies for divorce, legal separation, or a child losing dependent status.

What Does Not Qualify

• Taking FMLA leave. Your employer must maintain your coverage during the leave, so nothing is lost. If you do not return afterwards and coverage ends then, that can be a qualifying event.

• Losing coverage because premiums went unpaid. Voluntary or non-payment loss does not open a Marketplace Special Enrollment Period.

• Dropping coverage by choice. Choosing to end coverage you could have kept is not the same as losing it.

• A divorce that does not cost anyone their coverage. For Marketplace purposes, divorce alone is generally not enough. The loss of coverage is what counts.

• Working for an employer COBRA does not cover. Federal government employees are covered by a separate law, and church plans are generally exempt.

Marketplace Qualifying Life Events

These open a Special Enrollment Period to buy an individual or family plan. The window is generally 60 days, and for some events you can enroll in the 60 days before the change as well as after.

Life event	Window to enroll	Notes
Losing job-based, individual, or student coverage	60 days	Includes COBRA running out. Losing coverage for non-payment does not count
Losing Medicaid or CHIP	90 days	A longer window than other coverage losses
An employer or government COBRA subsidy ending	60 days	You may move to a Marketplace plan when the subsidy stops
Turning 26 and aging off a parent’s plan	60 days	Coverage may run to the end of the month or plan year
Getting married	60 days	Coverage can begin the first day of the following month
Having a baby, adopting, or fostering	60 days	Coverage can be backdated to the date of the event
Moving to a new area with different plans	60 days	You generally must have had coverage before the move
Divorce or legal separation that costs you coverage	60 days	The loss of coverage is what triggers it, not the divorce itself

You may be asked to send documents proving the event before coverage can begin.

One event, two doors, one clock

Losing job-based coverage opens both options at once, and both run on roughly the same 60-day timeline. That is the moment to compare them, because electing COBRA and then dropping it voluntarily does not reopen the Marketplace window. Letting COBRA run out completely does.

Compare COBRA and Marketplace coverage →

Is losing COBRA a qualifying event? →

How long does COBRA last? →

What to do when you lose coverage →

Read the full COBRA explainer →

How much COBRA costs in every state →
COBRA rules in your state →
Quitting your job? How COBRA works →

Common Questions About Qualifying Events

Is losing COBRA coverage a qualifying event?

Yes, for the Marketplace. COBRA running out counts as losing job-based coverage and opens a 60-day Special Enrollment Period to buy an individual or family plan. It does not count if coverage was lost because premiums went unpaid.

Is voluntarily dropping COBRA a qualifying event?

No. Choosing to end coverage you could have kept is not the same as losing it, and it does not open a Marketplace Special Enrollment Period. Letting COBRA run out completely does. That is why the moment you lose job-based coverage is the time to compare both options.

What should I do when COBRA runs out?

COBRA ending opens a 60-day Special Enrollment Period on the Marketplace. If you are losing Medicaid or CHIP instead, the window is 90 days. You may be asked to send documents proving the event before coverage can begin. A licensed agent can confirm which window is open and how long you have.

What counts as a COBRA qualifying event?

Job loss for any reason other than gross misconduct, a reduction in hours, divorce or legal separation, death of the covered employee, a child losing dependent status under the plan, or the employee enrolling in Medicare in a way that costs a spouse or child their coverage. An event only counts if it actually causes a loss of coverage under the plan.

How long does COBRA last?

18 months after job loss or a reduction in hours. 36 months for divorce or legal separation, death of the covered employee, a child losing dependent status, or the employee's Medicare enrollment. Two situations can extend the 18-month period: a disability determination or a second qualifying event.

Can COBRA be extended past 18 months?

Yes, in two ways. If Social Security determines that a qualified beneficiary is disabled before the 60th day of COBRA coverage, all qualified beneficiaries may receive an additional 11 months, up to 29 in total, and the plan may charge up to 150 percent during the extension. If a second qualifying event such as a divorce or death occurs during the initial 18 months, coverage may extend to 36 months in total.

Do I qualify for COBRA if I quit my job?

Yes. Job loss counts whether you quit, were laid off, or were let go. Gross misconduct is the single exception.

Who has to notify the plan, and by when?

For job loss, reduced hours, death of the employee, or employer bankruptcy, your employer notifies the plan within 30 days. For divorce, legal separation, or a child losing dependent status, the responsibility is yours, and the deadline is 60 days. Once the plan knows, it must send an election notice within 44 days of the event, or within 14 days of being notified by you.

Sources

The information on this page is drawn from the following federal sources. Your own plan documents govern your specific situation.

U.S. Department of Labor, FAQs on COBRA Continuation Health Coverage for Workers
U.S. Department of Labor, An Employee’s Guide to Health Benefits Under COBRA (PDF)
U.S. Department of Labor, COBRA Health Continuation Coverage
HealthCare.gov, Special Enrollment Period (glossary)
HealthCare.gov, Qualifying life event (glossary)

Not sure which event applies to you?

A licensed agent can confirm which door is open, how long you have, and what each option would cost. No charge, no obligation.

This page is general information, not advice about your specific situation. Your plan documents and the Marketplace determine what applies to you. A licensed agent can review your circumstances with you.

Prefer to talk? Call (888) 918-4516 · Monday to Friday, 10:00 a.m. to 5:30 p.m. Eastern

This website provides educational information about health insurance and is a solicitation for insurance. It is a non-government website operated by Prodest Insurance Group, a health insurance agency that presents health plans, which may include Affordable Care Act (ACA) plans, private health insurance, short-term medical insurance, or supplemental insurance based on the consumer's selection. Qualified ACA plans must meet or exceed the essential benefit requirements of the Affordable Care Act; non-ACA plans are not required to provide all of the essential benefit requirements contained in the Affordable Care Act. Pre-existing condition provisions, benefit availability, limitations and exclusions vary by plan type and state. You should review all plan details and product brochures before purchase. To qualify for ACA health insurance coverage outside of the open enrollment period, you must meet special enrollment requirements.

*Eligibility for Affordable Care Act (ACA) Advance Premium Tax Credit (APTC) and cost-sharing reductions is based on annual federal income thresholds, household size, and plan availability within the applicable service area. Premium rates, plan availability, and subsidy amounts vary by state and marketplace. Final eligibility and premium obligations are determined by the Health Insurance Marketplace under Internal Revenue Code Section 36B and applicable federal regulations.

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