Domestic Partner Coverage vs. Marriage Coverage


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Finding health insurance is not always easy, especially for non-married couples in search of comprehensive benefits. Domestic partners are entitled to certain legal benefits of marriage, but not all. Before making a decision regarding health insurance, it is important to consider all aspects of both domestic partner coverage and marriage coverage and what laws apply in your state in regards to domestic partner benefits. Learn more about the similarities and differences between domestic partner coverage and marriage coverage and why you should speak with a health insurance broker.

Domestic Partner Coverage

Domestic partner benefits date back to the early 1980s when San Francisco considered legislation to help unmarried couples acquire insurance benefits. The term “domestic partners” soon became a common label among both public and private employees who wanted to extend their benefits to their unmarried partners. Domestic partners apply to both same sex and opposite sex couples. It was not until 1982 that a New York City employer chose to offer domestic partner benefits, becoming the first private employer to do so. By 2015, the Supreme Court had ruled that domestic partner benefits applied to all same sex couples and unmarried opposite sex couples.

Benefits offered to domestic partners are usually similar to those offered to married couples. These benefits may include sick leave, long-term care insurance, relocation benefits, and group life insurance. Most employers now offer comprehensive health, vision, and dental insurance too. Before you can offer employees domestic partner coverage, you must ensure that you are following all state and federal laws. While not all states mandate that insurance benefits be extended to domestic partners, an employer can choose to include domestic partners in their group benefit plans. Most of the larger group health insurance companies provide insurance through employers for domestic partners.

Many employers require proof to approve domestic partner coverage. However, not all employers ask for documentation for eligibility. For those that do, the Human Rights Campaign Foundation states that all employers should treat beneficiaries equally when requesting documentation. There are a number of ways happy couple that just got back from visiting an insurance broker to talk about their health insurance that a domestic couple can show proof for coverage eligibility, such as providing a partnership affidavit, state domestic partnership registration, municipal domestic partnership registration, state marriage license, state civil union license, or marriage license issued by another country. Both same sex and opposite sex spouses can take advantage of spousal benefits if they meet the definition of “partner.”

Recognition of domestic partnerships is not clearly defined by the federal government. However, each individual state maintains a set of guidelines that describe the characteristics and requirements that deem a relationship eligible for benefits. Some states are fairly lenient when requesting documentation and may ask for bills or other documents that show that a couple is sharing a common residence. Although statistics show that individuals in domestic partnerships are twice as likely to be uninsured than those who are married, there are a number of family health insurance plans available to domestic partners.

Marriage Coverage

When two people get married, both individuals often gain access to family health insurance. What makes these plans so attractive is that they often come discounted as more than one person is covered. Gaining family health insurance through an employer is an affordable way to acquire essential benefits like medical and dental. However, with the extension of state, federal and private health insurance marketplaces, married couples have more options than ever when it comes to health insurance. While most married couples choose to go on the same plan, married individuals can choose to have their own individual plans.

Today, an insurance company that offers health insurance to opposite sex couples must also offer these same coverage benefits to same sex couples. This law applies to any couple married in a jurisdiction with legal authority to authorize same sex marriages. The Marketplace treats same sex couples who are married in the same manner as married opposite sex couples in all aspects of benefits. Both same sex and opposite sex couples can gain access to premium tax credits and may have access to lower out-of-pocket costs if they choose a private insurance plan. However, filing a joint federal tax return may be necessary to be eligible for premium tax credits.

figurines of a couple sitting on a stack of coins to resemble health insurance for couples There are several things that married couples should consider when determining whether or not to get a plan together or to have separate health insurance. Out-of-pocket expenses are one of the most important considerations. The Affordable Care Act puts a limit on out-of-pocket costs. In 2018, this limit was $14,700 for a family. However, if a family is separated by multiple insurance plans, the out-of-pocket limits apply to each policy separately. This means that a family’s total exposure can be significantly higher than if the family was all on a single plan.

There are certain situations that may call for the use of separate policies. For example, if one spouse is healthy and requires little to no medical intervention, while the other spouse has ongoing and significant medical conditions, having two separate policies may be the best choice financially. However, it is important to base your choice partially on which individuals have access to employer-sponsored plans and what the terms are on that plan. However, even if both spouses work for the same employer, they can each have their own individual plan or choose to be covered as a family.

Contact a Health Insurance Broker

While being in a domestic partnership can provide many of the same benefits that married couples receive, there are still some critical differences between a partnership and marriage. It is important to understand that each individual state has the right to define marriage and a domestic partnership may not be recognized by some employers when it comes to insurance benefits. Due to the complexity of coverage requirements, a growing number of employers are now requiring same sex couples to be married before employer health benefits can be provided. To learn more about domestic partner or marriage coverage, contact a health insurance broker today.