Same sex couples who are married can purchase a family health insurance plan without being concerned about any restrictions.
The landmark Supreme Court case that legalized same sex marriage in June, Obergefell v. Hodges, paved the way for consistent insurance options for married same sex couples.
“This provided same sex couples with the same access to family health insurance as heterosexual couples and uniform access from one state to another,” said Nate Purpura, vice president of consumer affairs at eHealth.com, an online health insurance exchange based in Mountain View, California.
The Supreme Court ruling protects against discrimination and insurance companies must offer the same coverage for both same sex and opposite sex spouses, according to Healthcare.gov.
“This is true regardless of the state where: the couple lives, the insurance company is located and the plan is sold, issued, renewed or in effect,” the website says.
Married same sex couples can also qualify for subsidies, which lower the amount of their monthly premiums, making them more affordable and accessible.
“Like other married couples, married same-sex couples who file taxes jointly may be eligible for government subsidies, if they meet the income requirements of the Affordable Care Act,” Purpura said.
Moving to another state is no longer an issue with the Supreme Court ruling and couples can buy comparable coverage in another state.
Is Family Coverage the Right Option?
In many cases, seeking family coverage saves people money on not only monthly premiums, but also deductibles. With most plans, you typically “share a family deductible equivalent to two individual deductibles,” said Purpura. “If you have children and hence have three or more persons on your plan, you can potentially save a significant amount of money in terms of your annual deductible.”
It may make more sense to cover your dependent spouse on an individual plan of his or her own.
Depending on the coverage offered at your company, family coverage may not prove to be the best financial decision as individuals determine what plan to purchase since open enrollment began on November 1. Some employers will pay a larger share of your health insurance premium but offer little for your dependents. In these instances and similar to many heterosexual couples, you might determine that it is better to have separate individual plans financially, he said.
“It may make more sense to cover your dependent spouse on an individual plan of his or her own,” Purpura said.
Only couples who file their taxes together can qualify for subsidies. The government subsidies help lower the cost you pay each month for health insurance and married families with household income of 400% of the federal poverty level or less may qualify for them. In order to qualify, the federal tax return must be filed as “married filing jointly.
Companies don’t need to ask employees for documentation of a domestic partnereither in civil unions or registered domestic partnerships in order to be eligible, said The Human Rights Campaign Foundation, the Washington, D.C.-based lesbian, gay, bisexual and transgender civil rights organization.
“The Human Rights Campaign Foundation encourages employers to treat all beneficiaries equally when requesting documentation to determine eligibility,” said the civil rights organization. “In other words, documentation should not be required of partners if it is not required of spouses.”
Domestic partner coverage for couples who aren’t married might be facing the possibility that it might be phased out in the future. Some state and federal entities are reconsidering the domestic partner laws or policies which existed before the Supreme Court ruling that gave same-sex couples access to coverage.
“To learn more about your options, contact your state’s department of insurance,” Purpura said. “If you’re in a legal same-sex domestic partnership, you may need to get married in order to keep your family covered under a family health insurance plan.”
What the Previous Health Insurance Market Was Like
Before the ruling in June, same sex couples faced a myriad of inconsistent policies when they were choosing health insurance options. Moving to another state often meant even more confusion and headaches, depending on whether same sex marriage was legal.
“There was a patchwork of laws and regulations that often varied significantly from one state to the next,” Purpura said.
When couples lived in states that already deemed same sex marriage as legal, married couples could purchase family health insurance plans like heterosexual couples. In a state where legal same sex domestic partnerships were recognized, but not marriages, often family health insurance plans were also made available.
Residing in a state without any recognition for same sex domestic partnership or marriage, finding a family health insurance plan was nearly impossible unless the insurer or sponsoring employer chose to offer the coverage, he said.
Moving meant many couples lost their coverage for health insurance, leaving them vulnerable and at risk of having no coverage, putting them at greater risk financially.