Every New Mexican deserves access to quality health insurance. Finding the right plan can be overwhelming, especially when it comes to coverage for care associated with gender identity.
At BeWell, we strive to make the process of choosing the right insurance as simple as possible. Here are answers to some common questions we receive from those seeking gender inclusive care.
Is Insurance Coverage Different Depending on Gender?
You have the right to access health insurance regardless of your gender. New Mexico state law protects against health insurance discrimination based on gender identity. However, your health needs – such as reproductive care, mental health support or preventative screenings (such as mammograms or prostate exams) – can be influenced by gender.
You can review the details of your plan and ask your insurance carrier what services are included, and to what extent. Each plan comes with a Summary of Benefits and Coverage (SBC), which breaks down exactly what your plan covers. BeWell certified assisters are always here to help you understand the plan before you enroll.
Health insurance plans through BeWell will not exclude services based on gender identity and will not contain a categorical exclusion of coverage for all health services related to gender transition.
Health insurance plans through BeWell ensure medically necessary services covered will be available to a policyholder regardless of their gender identity. Health insurance companies may not engage in unlawful sex discrimination.
How Much Will Health Insurance Cost?
By law, health insurance cannot cost more based on gender identity. All plans through BeWell cover 10 essential health care services, including free preventative care.
BeWell is also the only place where you can qualify for subsidies to help lower the cost of insurance. In fact, 50% of eligible New Mexicans pay less than $10 a month for coverage.
Plans offered through BeWell are categorized in three metal levels: Bronze, Silver, and Gold. Bronze and Silver plans offer higher out-of-pocket costs and lower premiums, while Gold plans have lower out-of-pocket costs and higher health insurance premiums. Turquoise plans are another option—these plans offer the most out-of-pocket savings for New Mexicans who qualify. Learn more about the metal levels.
BeWell also offers Clear Cost Health Insurance Plans which lower out-of-pocket costs for qualifying New Mexicans and explain benefits and coverage in clear, simple language.
When Can I Enroll in a Health Insurance Plan?
Sometimes, enrolling in health insurance feels like a mess of deadlines. But in reality, there are only a few key dates that you need to pay attention to.
Married same-sex and opposite-sex couples have the same access to coverage through BeWell. They also have the same access to discounts such as Advance Premium Tax Credits (APTC). Health insurance companies must offer same-sex spouses the same coverage it offers to opposite-sex spouses.
Open enrollment begins November 1 and ends January 15. During this time, you can enroll in an insurance plan if you:
- Reside in New Mexico.
- Do not have health insurance through your job or a parent’s job.
- Are not eligible for public coverage, such as Medicaid or Medicare.
- Are not incarcerated.
Enroll by December 15th for coverage to start on January 1st!
Some people will also qualify for a Special Enrollment Period (SEP), which allows you to enroll in a health insurance plan outside of Open Enrollment. You may qualify if you:
- Are Native American: Members of federally recognized Tribes can get low or free access to health insurance and can enroll at any time. These communities are also eligible to change their plans up to once a month and have access to unique health insurance options.
- Have experienced a Qualifying Life Event (QLE): Such as marriage or divorce, having or adopting a child, losing Medicaid or moving.
What Else Should I Know?
When you apply for health insurance, you will need to use the name and gender that appears on your Social Security card. You will have the option to add your preferred name after enrolling.
Be prepared to answer “female” or “male” on the application question. This answer will go to your health insurance company. You should be able to update this information if it changes after you enroll. Optional questions about sex assigned at birth, gender identity and sexual orientation will not be shared with the insurance company. A BeWell certified assister can help you understand what documents to gather and how to answer specific questions on your application.
Your gender identity is a crucial part of who you are, and it should never be a barrier to accessing the health insurance coverage you need. BeWell can help you choose a plan that supports your health and well-being, with respect for your individual needs.
Questions? Call 833-862-3935, chat with us, or schedule a free appointment with a certified assister.
