Domestic Partner Health Insurance Explained

Legislation surrounding civil unions, same-sex marriages, domestic partnership, and health insurance change often. Laws vary from state to state and can be altered at any time.

At Einsurance.com, we aim to provide readers with accurate, up-to-date information written by licensed individuals. However, it’s critical to pay attention to changes in your specific state. The information we provide in this piece is current as of January 2024; but you can check for statute updates about domestic partnership benefits in your state with the National Conference of State Legislators (NCSL) website.

This article addresses your most frequently asked questions about health insurance for domestic partners. You can skip ahead to read:

• Domestic partner health insurance requirements
• Domestic partner health insurance tax information
• How to add a domestic partner to your health insurance policy
• What if my partner has Medicaid?
• What if my partner has Medicare?
• Health Insurance and Discrimination Prevention

Before we get into all that, let’s clarify a few definitions.

Important Domestic Partner Health Insurance Vocabulary

If you’re researching domestic partner health insurance topics, the following terms will come up often:

• Insured, primary insured, or policyholder: these terms are mostly interchangeable. They refer to the primary individual — usually an employee — covered by a group health plan at work.
• Qualifying events (QLEs): these are instances in your life that allow you to change your health insurance outside of the usual open enrollment period. QLEs could include marriage, domestic partnership agreements or civil unions, retirement, college enrollment, the death of a spouse and so on.
• Open enrollment period: this is the standard annual time to make changes to your health insurance plan. It usually begins November 1, and changes made to your health insurance will take effect on January 1 of the following year.
• HMO, PPO and PSO: these are types of health insurance plans. Some employers only offer one type of plan, others offer a variety. We’ve described them in detail here.
• Beneficiary: if you provide health insurance for a domestic partner or children, they are beneficiaries of the plan.

 Now that we’ve covered those important phrases, let’s dive deeper into domestic partner health insurance topics.

Domestic Partner Health Insurance Requirements

Your first question is, “Does my state allow my domestic partner to be on my health insurance plan?” The answer varies from state to state; and in some states, there is no legal difference between a traditional marriage and a same sex union.

If you’re wondering which states offer domestic partner health insurance, we’ve listed them below.

Which States Recognize Domestic Partnerships?

As of January 2024, domestic partnerships are recognized in:

• The District of Columbia (Washington DC)
• California
• Maine
• Nevada
• Oregon
• Washington
• Wisconsin

In any of these states, you can add your domestic partner to your health insurance plan, either during annual open enrollment, or when your union is certified by the courts.

Hawaii law has a similar system but calls it “reciprocal beneficiaries.”

Which States Recognize Civil Unions?

For the purpose of this piece, civil unions are much the same as domestic partnerships. They are recognized in:

• Colorado
• Vermont
• New Jersey
• Illinois

And the following states previously used the term “civil union” but now call same sex unions “marriages”:

• Connecticut
• New Hampshire
• Delaware
• Rhode Island
• Vermont

In any of these states, you can add your domestic partner / spouse to your health insurance policy.

Do We Need to Have a Formal Ceremony to Become Domestic Partners and Share Insurance?

In states which recognize domestic partnerships, you’ll need to complete some paperwork and probably pay a few small fees, before your domestic partner can be added to your health insurance policy.

The paperwork varies among the states and could potentially vary by county. In short, you need to make your union legal in the eyes of the government. This could involve a courthouse ceremony signed by a judge and sealed by the court, or notarized paperwork, depending on your location.

In California, for example, the domestic partnership must be registered with the state. Once that’s done, you can add your partner to your health insurance. Nevada is much the same.

Now, let’s move forward to discuss domestic partnerships, health insurance and tax information.

Domestic Partner Health Insurance Tax Information

Before addressing this subject, remember that the Einsurance team specializes in insurance. We are not tax experts or CPAs. We will supply some current quotes from the IRS and some helpful links, but if your questions are deeper than what we cover here, you should ask a legitimate tax expert in your area.

Is my Domestic Partner Recognized as a Dependent for Tax Purposes?

The IRS website says, “A registered domestic partner can be a dependent of his or her partner if the requirements of sections 151 and 152 are met. However, it is unlikely that registered domestic partners will satisfy the gross income requirement of section 152(d)(1)(B) and the support requirement of section 152(d)(1)(C).”

In other words, the IRS may or may not accept a domestic partner as a dependent for federal income tax purposes. It depends on how much each partner earns. Talk to a CPA for more nuanced information.

At the state level, remember that some states recognize same sex unions as traditional marriages (see the list above.) In those states, your domestic partnership should offer the same tax benefits as any other marriage when it comes to income taxes.

Will I Get a Tax Benefit for Adding my Domestic Partner to my Health Insurance Policy?

We know this is a common question, but we are reluctant to address it. Income tax laws vary so much from state to state, and they change so quickly, we don’t wish to mislead you!

While this may sound like a broken record, it bears repeating: Please speak to a genuine, licensed tax expert in your local area to really understand the tax implications of adding a domestic partner to your health insurance plan. You may discover that it’s better for each individual to maintain a separate health insurance policy and file individually. Or, you may discover meaningful tax benefits.

Now, let’s move on to the process of adding a domestic partner to a health insurance policy.

Adding a Domestic Partner to a Health Insurance Policy

If your state allows domestic partnerships or civil unions — or if it recognizes all sorts of marriages equally — you’ll be able to add your domestic partner to your health plan.

You may do so either:

• During the annual open enrollment period, which usually begins November 1
• Immediately after a qualifying life event (QLE)

Timing is important, but the process isn’t difficult. You’ll contact your current health insurance company and provide them with your partner’s information.

Where Can I Find Contact Information for my Health Insurance Provider?

Check your health insurance card for a toll-free number to call, that’s usually the fastest way to speak to a representative. Your human resources contact at work will also have this information, and you might be able to find it online.

What Will the Insurance Company Need to Know About my Partner and Myself?

Gather your documents and have your health insurance policy or ID card at hand when you call. They’ll ask you for some information to verify that they’re speaking to an insured. Then, they’ll to ask about:

• Your name
• Your contact information
• Your group number or policy number

Regarding your partner, they’ll need:

• Their full, legal name, spelled correctly
• An exact birth date
• Current health status (like a list of prescriptions)
• Their current health insurance status
• And some may ask for a Social Security number

They may ask you to choose a preferred healthcare provider, or they may send some paperwork to get that part done.

A Note About Effective Dates

Remember, if you add your domestic partner to your health insurance plan during the usual open enrollment period (in the fall), coverage will take effect on January 1 of the following year.

If you add your domestic partner to your health insurance policy after a QLE, the effective date will be a few weeks after you make the call. You’ll be able to find the effective date on your partner’s insurance card when it arrives in the mail.

What if my Partner has Health Insurance Through Their Employer? Can I Still Add Them to my Policy?

If your domestic partner has another health insurance plan through work, they can keep that plan and become “double insured.” Their current plan will become their primary health plan, and your insurance will be called “secondary.”

If your domestic partner were to find themselves in a medical emergency, the final out-of-pocket expenses would be very small, because they are doubly insured.

And you could also become a beneficiary on their plan and have access to secondary health insurance!

Of course, many couples find this cost prohibitive. In other words, it might be very expensive to keep this much health insurance on both partners.

If both partners currently have health insurance through work, and plan on staying employed, be sure to check prices at both organizations. Partner A may be the primary breadwinner, but Partner B might have more affordable insurance options through work.

Remember to compare “apples to apples,” however.

Health insurance plans are divided into metal tiers, Bronze, Silver, Gold, and Platinum. All Bronze plans offer about the same coverage, but there are significant differences between Bronze and Gold plans. If you’d like to know more details, check out our earlier piece on How to Buy Health Insurance.

What if my Partner has Medicaid? Can I Add Them to my Policy?

Medicaid provides health insurance to low-income individuals and people with unique needs. You can add your partner to your health plan, but they will lose access to Medicaid-funded care. Put another way, one cannot be doubly-insured using Medicaid as either a primary or secondary insurer.

What if My Domestic Partner has Medicare? Can I Add Them to my Policy?

The answer to this question is incredibly complicated, you should speak to both a Medicare representative and your current health insurance company before moving forward with any changes.

Know that Medicare is a federally-funded health benefit for retired individuals ages 65 and up, certain younger people with disabilities, and individuals with End-Stage Renal Disease (ESRD, or permanent kidney failure.)

Here are some points to consider:

• If your domestic partner has ESRD, they almost certainly need to stay with Medicare.
• Medicare is generally very affordable (Part A is totally free.) It might not make financial sense to change.
• No law states that an individual on Medicare should go back to a group health insurance plan if it becomes available through marriage / domestic partnership.
• Your domestic partner has paid into the Medicare program all their life. It’s a point of pride for many people, to finally reap the benefits they’ve earned.

In sum, just because you can add your domestic partner to your health insurance policy, doesn’t always mean that you should do so. Move forward thoughtfully, by speaking to your current insurer and a Medicare professional first.

Health Insurance and Discrimination Prevention

It’s 2024, and the insurance industry has gone a long way towards ending discrimination. Just decades ago, many insurers could, and often did, refuse to insure individuals based on sexual preferences, pre-existing conditions, and HIV status.

State and federal laws continue to evolve, and many states have introduced legislation that prevents discrimination for sexual orientation, marital status, gender identity and so on. Still, individuals seeking health insurance for domestic partners may still face more subtle roadblocks.

If you’re struggling to find the right health insurance plan for yourself and/or your domestic partner, we invite you to try our handy online quoting tool. Our goal is to match consumers with the insurance they need, at prices that make sense.