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 in our marketplace.
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—can be influenced by gender.
So, it’s important to understand what your plan covers, especially if you have specific health needs, such as fertility treatments, mental health support, gender-affirming care, or routine screenings such as mammograms or prostate exams.
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. And BeWell’s Certified Assisters are always here to help you understand the plan before you enroll.
How Much Will Health Insurance Cost?
By law, health insurance cannot cost more based on gender identity. All plans through BeWell cover 10 essential healthcare services, including no-cost preventative care.
BeWell is also the only marketplace in New Mexico where people can get subsidies to help lower the cost of insurance. In fact, approximately 50% of eligible New Mexicans pay less than $10. The New Mexico Premium Assistance Program can further lower costs for families with household incomes of less than 400% of the federal poverty level.
Plans on BeWell are categorized in three tiers: bronze, silver, and gold. Bronze and silver plans offer higher out-of-pocket costs and lower premiums, while the gold plans offer lower out-of-pocket costs and higher premiums. Turquoise plans are another option—these plans offer the most out-of-pocket savings for New Mexicans who qualify.
BeWell also offers Clear Cost Health Insurance Plans in its marketplace. These plans help 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.
Open enrollment begins November 1st and ends January 15th. During this time, you can enroll in an insurance plan if you meet these criteria:
- Must 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.
Sign up by December 31 for coverage to start on January 1! Some people will also qualify for a Special Enrollment Period, 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 no-cost 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 a low household income: People with a household income below 200% of the federal poverty level who aren’t eligible for Medicaid or the Children’s Health Insurance Program.
- Have experienced a qualifying life event: Such as a marriage or divorce, having or adopting a child, losing Medicaid, moving, or more.
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? Ready to talk with a Certified Assister? Contact the BeWell team today.
