It used to be that only spouses and children could be covered under a family health insurance plan. But over the years this has slowly changed. Now, couples who are committed in a domestic partnership (i.e. they share a residence and financial responsibilities) can be covered under one another’s employee benefits package or a shared private plan.

But since insurance is regulated on a state-by-state basis there are different rules governing domestic partnership health insurance plans (i.e. who qualifies, how you qualify, what employers are and are not required to offer you). Let’s dig into the details.

Who qualifies as a domestic partner?

Hint: It isn’t your roommate. To qualify for a domestic partnership, you and your significant other must be in a romantic relationship in which you live as though you are married. You must live together in a permanent residence and share basic financial responsibilities like those for food and shelter. It’s ok if one of you pays rent and the other pays for groceries and the electricity, but the point is, you’re both financially invested.

The other requirement is that neither of you can be married to another person. So if your partner is separated from their former spouse but is not yet legally divorced, you two don’t qualify as domestic partners in the eyes of a health insurance administrator.

How can we get health insurance as domestic partners or an unmarried couple?

There are two ways to get covered as a domestic partnership: employer-sponsored health benefits and private health insurance. Unfortunately, the federal government doesn’t recognize domestic partnerships and federal law governs Medicaid and Medicare, so those aren’t options even if you would otherwise qualify if you were a married couple.

If you’re seeking employer-sponsored health insurance for your domestic partner and any children they have, you should reach out to your HR department directly and ask about your company’s policy. Even if it doesn’t partially cover domestic partners’ health insurance, you still might be able to buy their health insurance through your employer’s plan. This could end up being cheaper than your domestic partner purchasing a private health plan in the marketplace because employers (particularly large ones) can negotiate lower premiums than an individual and the premium will be taken out of your paycheck pretax, which will lower the effective cost of the health plan.

If you’re seeking a private plan, you can go to Healthcare.gov and search for health insurance plans that include domestic partnerships in their family plans.

Regardless of whether you’re seeking employer-sponsored or private health insurance coverage, your ability to get a family plan as a domestic partnership is largely governed by where you live.

For example, if you live in California, as of 2019, all registered domestic partners must be treated as spouses by both employers and health insurance companies. That means if your company covers spouses’ premiums at 60%, they must also cover a domestic partner’s premiums at the same rate.

Conversely, in Texas, employers and health insurance companies are free to develop their own policies around domestic partnerships and thus your options will be determined by either where you’re employed or the health insurance administrators active in your area.

Are my significant other’s children covered?

If your domestic partner is eligible for coverage under your health plan, their children are too. Their children can be biological, adopted or stepchildren from a previous marriage.

How do we prove we're in a domestic partnership?

The rules vary by state and health insurance administrators, but most companies will require you to sign a form that makes several declarations as to your relationship as a domestic partner. These declarations include things like: you’ve lived together for at least six months (sometimes the requirement is a year) and intend to live together indefinitely, your relationship is public, and neither of you are married.

Your employer or health insurance administrator might also require you to provide documentation to prove your relationship. This could include a copy of both of your driver’s licenses that show the same address, ownership of common property like a car or home, a joint bank account or credit card, and designation of each other as the primary beneficiary for life insurance.

How do we choose a plan?

Choosing a health insurance plan while in a domestic partnership isn’t much different than choosing a plan for yourself as an individual. In order for it to be the right fit, the plan must provide adequate coverage for your needs and those of your family, and the premium must be affordable. If you live in a state that doesn’t formally recognize domestic partnerships as comparable to married couples, your insurance options might be more limited than if the two of you purchased plans separately.

While health insurance options for domestic partners aren’t as ubiquitous as they are for married couples and their families, it’s getting more common for employers and states to treat these two relationships the same. If you have any questions as to the laws in your state or your employer’s policy around domestic partnership, reach out to your HR department.