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.


Our Call Center is currently experiencing extremely high volume and longer wait times. For questions related to COVID-19, visit our COVID-19 FAQs