On July 14, 2015, the Supreme Court of the United States made the historic ruling that states could not prevent same-sex marriages. Celebrations immediately erupted across the country, but there are still lots of details to work out, including how healthcare will work for those in same-sex marriages and how you can pay less for health care.
Special Enrollment Period
When you get married, the benefit of switching over to a single plan that includes your spouse is that the marriage will count as a “qualifying life event.” This means you have access to a special enrollment period and you are not limited to the 2016 annual enrollment period from November 1, 2015–January 31, 2016. If you were married prior to the SCOTUS ruling and did not receive a special enrollment period, you will not be able to get one now.
Family Plan Deductible
When you get a family plan as a married couple, there is also the benefit of having a family deductible. As individuals, you both would have to meet two separate deductibles before insurance kicked in. As a family, only one of you has to meet the deductible before insurance kicks in for both of you.
Protections Against Discrimination
The biggest concern for many same-sex couples and healthcare is fear of discrimination. Thankfully, it is illegal for any insurance company to discriminate against a couple based on their sexual identity. This applies to every state no matter where the couple lives, where the insurance company is based, or where the plan is sold, issued, renewed, or used.
Access to Premium Tax Credits and Lower Out-of-Pocket Costs
Same-sex married couples can be eligible for premium tax credits and lower out-of-pocket costs from private insurance plans just like opposite-sex couples. In order to access this, a married same-sex couple must file jointly. In order to be considered for financial assistance towards health care coverage, select “Yes” on the 2014 joint federal tax return when you are asked if you are married.
Wiley Long is President of HSA for America, and a passionate advocate for consumer-based solutions that will improve price transparency and lower health insurance and medical costs for people purchasing individual and family health insurance plans.