Does being lesbian, gay, bisexual, or transgender (LGBT) affect my health insurance coverage and options? What if I am married to my same-sex partner?

You cannot be turned away or charged more for being lesbian, gay, bisexual, or transgender. You also can’t be denied coverage or charged more because of any pre-existing health condition, such as HIV status. Insurers can’t have any annual or lifetime limits on how much they’ll spend on your medical care.

Additionally, health programs that receive federal funding, such as Marketplace plans, Medicaid, and Medicare, cannot discriminate based on sex. Notably, though, the legal landscape is evolving. While the Trump administration has said it will interpret these nondiscrimination protections to cover binary biological sex assignments at birth only, courts can and have found that these protections extend to cover sexual orientation and gender identity.

Married same-sex couples can apply jointly for Marketplace coverage and premium tax credits. Tax credits are calculated based on your federal income tax filing, so Marketplaces must recognize same-sex marriages and base eligibility on a married couple’s income.  Married couples, including same-sex couples, must file a joint tax return to receive premium tax credits. If you are not married, but you are in a domestic partnership, a civil union, or another similar relationship, you may still qualify for tax credits, but you will need to apply for them separately as individuals instead of as a couple. Depending on your state Marketplace, you may be able to use your individual credits to buy a family policy rather than two individual policies.