Domestic partner health insurance: a coverage option for unmarried couples

What is a domestic partnership?

A domestic partnership – officially recognized in some states and municipalities but not by the federal government – represents a committed relationship between two people, but it does not confer the same rights and protections as marriage.¹

Same-sex couples no longer need to rely on domestic partnerships since they can legally marry in every state as a result of the Supreme Court’s 2015 decision in Obergefell v. Hodges. But as cohabitation rates have increased in the U.S.,² some couples – gay or straight – choose to enter into a domestic partnership rather than marriage, in the areas where this is an option.

Since domestic partnerships are not recognized or defined by the federal government, the specifics vary by state and by city (including whether domestic partnerships are recognized, and if so, what’s required in terms of how long the couple has cohabitated, financial interdependence, etc.). In some cases, registered domestic partnerships are only available to state employees¹ or local government employees.³

Which states recognize domestic partnerships?

Connecticut and New Jersey recognize domestic partnerships statewide for any couples who meet the state requirements. In Hawaii, Illinois, Iowa, Massachusetts, Montana, New Mexico, New York, Rhode Island, and Vermont, domestic partnership health benefits are available to state employees. There are also numerous cities throughout the United States (including some in the aforementioned states) where residents can register their domestic partnerships.³

This just means that domestic partnership registration is available in all of those areas. It doesn’t mean, however, that private health plans or employers in those cities or states are required to provide domestic partner health benefits. In some cases, there are local rules that require plans or employers that offer spousal benefits to also extend them to domestic partnerships, but the specifics vary from one area to another.

But even if you’re in an area where domestic partnerships are not formally recognized by the state or local government, your employer might choose to offer domestic partnership health insurance benefits. You’ll need to check with your employer to see whether this is the case, and if so, what they require as proof of domestic partnership.⁴

Are domestic partner health benefits the same for same-sex and opposite-sex couples?

Before the Obergefell v. Hodges ruling, same-sex couples could only get married in certain states. Domestic partnerships were an alternative in some states, providing some of the benefits that opposite-sex couples could obtain via marriage.

Since 2015, same-sex marriage has been legal in every state and same-sex partners no longer have to rely on domestic partnerships.

However, domestic partnerships are still available in some areas and domestic partnership health benefits are offered by some employers. The requirements to register or swear an affidavit of a domestic partnership differ by area and by employer. For example, you may need to be a government employee, or you may need to be at least 62 years old. (Some areas allow older individuals to avoid losing access to Social Security benefits under a former spouse’s record, which could happen if they remarried.)⁵

But if domestic partnership benefits are available, they’re available on the same terms to same-sex and opposite-sex couples, just like marriage.⁶

Do Marketplace plans offer domestic partnership health insurance benefits?

If you buy your own (non-group) health insurance, the insurer may either allow you to be on the same policy with your domestic partner or require you to have separate policies. This will vary depending on where you live and the health plan you select.⁷

Most people who buy their own health insurance do so through the health insurance Marketplace (exchange),⁸ but it’s also possible to buy individual/family health insurance directly from an insurance company (albeit without Marketplace subsidies). In both cases, the option to purchase a single policy to cover yourself and your domestic partner will depend on whether your domestic partnership is registered with your state or municipality, on local rules applicable to domestic partnerships, and on the health plan’s rules.

If you’re in a state or municipality that recognizes domestic partnerships, the registration of your domestic partnership may or may not be considered a qualifying life event that triggers a special enrollment period. For example, it is not a qualifying life event in states that use HealthCare.gov,⁹ but it is a qualifying life event in California’s state-run Marketplace.¹⁰

Is my employer required to provide health insurance that includes domestic partnership benefits?

In some states and municipalities, employers that offer spousal health benefits are required to extend their benefit offers to registered domestic partners. Absent this sort of local requirement, employers can choose to offer health benefits to domestic partners, and some do so.⁴

To be clear, employers – even large employers that are subject to the ACA’s employer mandate – are never required to offer coverage to employees’ spouses.¹¹ But nearly all employers that offer health benefits do allow employees to add their legally married spouse to the plan.¹²

However, only about a third of employers that offer health benefits allow employees to add a domestic partner to the group plan.¹³

It’s also important to note that employers can choose to provide their employees with domestic partner benefits even if domestic partnership is not legally recognized in that state or municipality. In that case, the employer can set their own eligibility rules for domestic partner health insurance. (They may, for instance require that the domestic partners live together for a certain amount of time, be 18 or older, or have joint finances or shared property.)⁴

How do I add my domestic partner to my health insurance?

If your employer offers domestic partner health benefits, you should be able to add your domestic partner to your policy during your employer’s open enrollment period or during a special enrollment period triggered by a qualifying life event. (The timing of open enrollment differs from one employer to another.)

But while getting married will trigger a special enrollment period that allows you to add your spouse to your group health plan, obtaining an affidavit of domestic partnership is not a federally recognized qualifying life event.¹⁴

If your employer offers domestic partner health benefits, they may offer a special enrollment period that begins when you register your domestic partnership with your state or municipality. But this enrollment opportunity will vary depending on the applicable insurance plan and carrier, the employer’s business needs and coverage rules, and state requirements regarding domestic partnerships.¹⁵

You should check with your employer to find out whether they offer domestic partner health insurance benefits, and if so, what they require as proof of domestic partnership.

If you have a Marketplace plan, you’ll need to check with your plan to see whether you can add a domestic partner to your plan, and if so, what documentation will be needed. As noted above, access to a Marketplace special enrollment period due to registration of a domestic partnership will vary by state.