When Life Changes, Your Health Coverage Should Too
Life doesn’t follow a neat schedule. Sometimes, big events—both happy and difficult—can change your health insurance needs overnight. The good news is that in both New Jersey and Pennsylvania, certain qualifying life events allow you to enroll in or change health insurance plans outside the usual open enrollment period.
This is called a Special Enrollment Period (SEP), and knowing how it works can save you from unexpected gaps in coverage.
What Counts as a Qualifying Life Event?
In NJ and PA, you generally have 60 days from the date of the event to enroll in a new plan through Get Covered NJ or Pennie. Common qualifying events include:
Divorce or Legal Separation — If you lose coverage from a spouse’s plan, you can get your own policy.
Death of a Spouse or Dependent — Losing the person who held your policy qualifies you for a SEP.
Turning 26 — You’ll age off your parent’s health plan and need your own.
Marriage or Domestic Partnership — You may be able to join your spouse’s plan or get a joint policy.
Birth or Adoption of a Child — Adding a new family member means adjusting your coverage.
Loss of Employer Coverage — Job loss, reduced hours, or an employer dropping benefits all count.
Moving to a New ZIP Code or State — If your old plan doesn’t cover your new area, you can switch.
Why Acting Quickly Matters
The 60-day clock starts ticking from the date of the event. If you miss it, you’ll likely have to wait until the next open enrollment period (Nov. 1–Jan. 15 in PA, Nov. 1–Jan. 31 in NJ) to get coverage—unless another event happens in the meantime.
This means it’s critical to:
Document your life event (marriage certificate, job termination letter, etc.)
Start comparing plans right away
Consider your budget, doctors, and prescription needs before selecting a plan
Your Coverage Options in NJ and PA
Marketplace Plans — Apply through Get Covered NJ or Pennie for ACA-compliant plans that may include subsidies.
COBRA Coverage — Keep your previous employer’s plan for up to 18 months (but expect higher costs).
Private Insurance Plans — Purchase directly from a carrier, sometimes with broader networks.
Medicaid — If your income drops significantly, you may qualify for free or low-cost coverage.
How an Agent Helps During Life Transitions
Navigating a SEP while dealing with a major life change can be stressful. At Truce Benefits, we take the complexity off your plate by:
Determining which SEP you qualify for
Explaining your options in plain English
Helping you compare costs and benefits
Making sure you meet all deadlines
Submitting your application correctly to avoid delays
Real-Life Example
One of our clients in Cherry Hill recently went through a divorce at age 55. She lost coverage under her ex-husband’s employer plan but didn’t want to pay COBRA rates. We helped her enroll through Get Covered NJ within two weeks, securing a plan with the same doctors and a monthly premium reduced by state and federal subsidies.
Bottom line: Life changes fast—but with the right guidance, your health insurance can change just as quickly. Contact Truce Benefits today for a free, no-pressure consultation, and we’ll help you find the right coverage for your new chapter.
