Health Insurance Special Circumstances

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Health Insurance Special Circumstances

Everyone’s life is unique and sometimes important life changes can change your health coverage needs.


You may be eligible to apply for a new health plan, or change the coverage you already purchased on the NY State of Health marketplace if (or when) you experience one of the following events:

  • Loss of minimum essential health coverage*
  • Change in marriage or domestic partnership status, birth, adoption, or placement in foster care
  • Becoming a citizen, national or lawfully present individual
  • Enrollment errors by the federal government or the marketplace
  • A health plan you bought on the marketplace doesn’t meet the terms of its contract
  • Change in eligibility for financial help (tax credits or subsidies)
  • Permanent move to NY, or permanent move from one county to another within NY
  • Native Americans can enroll or change plans one time per month throughout the year
  • You enrolled in employer coverage that does not meet standards for affordable, adequate coverage


If you feel that your situation may qualify for a special enrollment, EmblemHealth can help you find a plan that fits your needs. To learn more, give us a call at 1-866-838-9144, TTY 711 or visit


*10 categories of essential health benefits, including doctor visits, hospital care and prescription drugs.



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