Same-sex couples often couldn’t enjoy the insurance benefits that were common for heterosexual couples until the Supreme Court legalized same-sex marriage in 2015.
In addition to the legal recognition granted same-sex marriage, couples gained new avenues for lower insurance rates and expanded coverage.
A 2017 report by Gallup found that just slightly more than 10% of LGBTQ couples are married. Nearly 7% live with their partners.
Same-sex married couples now usually enjoy the same benefits as any other couple. However, there are exceptions — namely with employer-based health insurance and federal programs like Medicare and Medicaid.
Let’s take a look at what you need to know about insurance when you’re in a same-sex relationship.
Same-sex marriage and health insurance
Employer-based health insurance is how most Americans get coverage. Employers in most states offer equal coverage for heterosexual couples and same-sex couples. Loretta Worters, vice president of media relations at the Insurance Information Institute, said the Supreme Court decision in 2015 solidified the anti-discrimination piece.
“The Supreme Court’s (Defense of Marriage Act) decision provides that the federal government may not discriminate against same-sex couples who are legally married,” she said.
It’s not black and white, though. If an employer is self-insured, they aren’t required to cover a same-sex spouse. Most large employers offer self-insured plans. However, it’s rare for smaller employers.
Also, if state law doesn’t require parity, the employer doesn’t have to offer the same benefits to same-sex spouses. Texas is one state that doesn’t demand employers offer the same benefits. At the same time that the Supreme Court was ruling on same-sex marriage in 2015, the Texas Supreme Court heard a case on same-sex spouses getting insurance benefits. The Texas Supreme Court unanimously voted that same-sex spousal coverage wasn’t required.
“The Supreme Court held … that the Constitution requires states to license and recognize same-sex marriages to the same extent that they license and recognize opposite-sex marriages, but it did not hold that states must provide the same publicly funded benefits to all married persons,” Texas Justice Jeff Boyd wrote.
Another twist is that employers are only required to offer insurance to their employees. As long as the same rule applies for straight and gay employees, employers aren’t required to insure spouses, according to JUSTIA’s LGBT legal resources center.
You don’t have those kinds of issues in the health insurance marketplace, which the Affordable Care Act created. Marketplace health insurance options for same-sex spouses have to be equal to those of opposite-sex spouses.
The ACA says that gay couples who are married enjoy the same premium tax credits and lower out-of-pocket costs from private insurance plans as straight couples as long as you file a joint tax return and meet income limits.
The ACA provides subsidies to people in the exchanges with an income of less than 400% of the federal poverty limit. For 2021, 400% of the federal poverty level is about $51,000 for single people, $69,000 for a couple and $105,000 for a family of four.
There aren’t as many protections for those in same-sex partnerships who aren’t legally married. You will find some companies, especially the larger ones, offer a domestic partnership plan. It’s not as common for smaller businesses.
There are still companies that provide health insurance for domestic partners regardless of sexuality. There is a potential issue with those plans, though. The company’s health plan cost for the employee’s partner is taxable.
A couple of practical issues to keep in mind when you get married: most insurers give you 60 days to notify them of your nuptials. That’s called a special enrollment period. You may have to wait until the next open enrollment to include your spouse if you miss the special enrollment.
The other thing to consider is whether partnering up in your health insurance is the most financially sound move. If both spouses work, make sure that the money is worth combining your coverage. You may find that one spouse’s employer is more fiscally reasonable than the other’s.
Check out the following when comparing health plans:
- Out-of-pocket costs
- Provider network
Once you gauge the costs and factor in which doctors and hospitals you can visit, you’re able to make an informed decision about which health plan is best.
Same-sex marriage and life insurance
There are no limits for same-sex married couples when it comes to life insurance. In fact, being married can save money.
“Research suggests that marriage is associated with longer life span, so that they may actually get a discount because they are married,” Worters said.
That said, marriage is not the only way to benefit from a life insurance policy. You can still apply for life insurance and name your significant other or their children as beneficiaries. Just be prepared to answer questions. The underwriting department may want to know your relationship to the beneficiary or beneficiaries and how they would be affected in the event of your death. This is standard practice regardless of your sexual orientation.
With the ever-changing landscape of the legal scene in regards to civil rights, buying a life insurance policy — term or permanent — can protect your loved ones regardless of where the law falls at the time of your death.
Same-sex marriage and auto insurance
Worters said age influences auto insurance rates more than if you’re married.
“I haven’t heard a lot about same-sex marriage and auto insurance, probably because the difference in gender pricing ends around age 26 most of the time. At least a couple of years ago, the average age for getting married for gay men was 46 and for gay women 36.”
The first step you want to take when you get married is to look at your auto insurance policy and see if combining your policy with your spouse’s will save money. That includes auto insurance discounts.
“You would get things like multi-car discounts,” said Megan MacBey, CIC, account executive at Eagle Insurance Group, LLC, in Massachusetts.
But, she said, don’t expect a windfall.
“[You will get little discounts] but no substantial savings in general from being married versus being single,” she said.
At the very least, if you decide to maintain separate policies when you get married, you need to add each other to your policies. Keep in mind that keeping policies separate, while legal, will probably cost you more than combining policies.
The average discount for a married couple versus partners who are single is about 10% across the board. The reason for the discount? Research shows married people are less risky than single people because they tend to file fewer claims. Insurers like this because, in the long run, it’ll save them money and be a lower risk.
Same-sex marriage and home insurance
Whether you’re same-sex or straight, marriage affects your policy positively. It means that you and your spouse can now both be listed as “named insured” or owner of the policy. With that title, all possessions owned by either spouse will be covered in the event of a claim.
Things to consider: put the wedding jewelry on your policy’ personal property riders. You’d hate to have something happen to the jewelry and not be able to replace it.
If one spouse is now moving in with the other one, they’re automatically covered. What’s not covered, and needs to be beefed up in terms of value, are the material items brought into the marriage by that suppose he’s moving in.
How to appeal denied coverage
Should you be denied coverage or a particular service, the first thing you should ask the company about the denial.
Find out the reason for the denial. That will help in an appeal.
The recourse you have may be available through your employer, the company offering the services or legal agencies, such as the American Civil Liberties Union. You can also contact your state’s division of insurance, which can guide you depending on the exact issue.
The good news for same-sex married couples is that the Supreme Court cleared many barriers. However, depending on your employer and state, you may find issues remain when it comes to getting health insurance for your spouse.