Since the 2015 Supreme Court ruling in Obergefell v. Hodges, same-sex marriage is legally recognized nationwide. For health insurance purposes, legally married same-sex couples have the same rights and options as any other married couple, across Marketplace plans, employer coverage, Medicare, and Medicaid.
This means you can add your same-sex spouse to your employer health plan during open enrollment or after your marriage (which is a qualifying life event). On the Marketplace, you file your application as a married household, potentially increasing your household size and adjusting your subsidy eligibility. You must file taxes jointly to claim premium tax credits, just like any other married couple.
Same-sex spouses qualify as dependents for enrollment purposes. If one spouse loses coverage, the other can add them during a Special Enrollment Period. Divorce also triggers a SEP, giving both spouses 60 days to find new coverage.
For federal programs, same-sex spouses are treated identically to opposite-sex spouses. Medicare spousal benefits, Medicaid household calculations, and COBRA continuation rights all apply equally.
While insurance and legal rights are federally consistent, be aware that some states may have additional domestic partnership or civil union categories that carry different (and sometimes fewer) insurance benefits than marriage. If you're in a domestic partnership rather than a marriage, check your specific plan and state laws for coverage eligibility.
Yes. Marriage, regardless of whether it's same-sex or opposite-sex, is a qualifying life event. You have 60 days from the date of marriage to enroll in a new plan, add your spouse to your existing plan, or make other coverage changes.
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