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I am leaving my job and will be without insurance for approximately two weeks. I have access to COBRA health insurance.

From here:

If, in those 45 days, you secure other coverage either through your new employer or somewhere else and you didn't have any health care claims, you simply don't pay your COBRA premium. It means you didn't really have COBRA, but you had the option available.

Does this mean that COBRA basically is a "if you use it you can buy it" insurance? That if I don't sign up initially I can sign up retroactively if I need it?

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My experience with leaving a job and COBRA coverage matches your understanding.

Approximately 3 weeks after my last day I received the paperwork, the deadline for completing the paperwork was 45 days after the end of the insurance coverage.

Therefore I had coverage with the new employer for several weeks before I had to decide if I retroactively needed the COBRA coverage.

Because my family didn't have any major medical issues during that window I never had to purchase the coverage.

I have used the same logic during my lat 3 job changes. Though now with the Affordable care Act if you needed coverage the national or state exchange is another source of insurance that you may have.

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    You actually have 60 days from when the previous insurance ends to decide whether to get COBRA. The quoted statement seems to be saying that you have 45 days after deciding to get COBRA before you need to decide whether you pay for it.
    – user102008
    Commented Jan 14, 2016 at 2:00
  • Confirmed with my HR department!
    – enderland
    Commented Jan 14, 2016 at 21:35
  • And after notifying that you want COBRA you have another 15 (30? 45?) days before you actually have to pay the bill, giving you up to 75+ days to actually decide if you're going to need it.
    – Ed Griebel
    Commented Jan 18, 2016 at 21:14
  • It's 60 days (not 45) from the qualifying event (e.g. job loss) or the date the COBRA notice is provided, whichever is later. As @user102008 said, the 45-day period is the grace period after election before you have to pay. cms.gov/CCIIO/Programs-and-Initiatives/…
    – Matthew Flaschen
    Commented Mar 27, 2018 at 3:46

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