I'm sure this is a question heterosexual couples in the same situation have to ask as well. However, I'm particularly sensitive to it as 1) it's only been legal for same sex couples to marry in Massachusetts for just over 5 years, 2) we're only married in Massachusetts, not at the Federal level (talk about screwing up your tax situation), so we really don't reap all the benefits possible from our married status and 3) we're officially not married in most states in the US and most countries around the world.
This question came up because I started doing some digging into the health coverage that's available in Massachusetts for the disabled. Massachusetts is the only state in the US, to my knowledge, that requires every citizen to have health coverage, and they have a lot of state-sponsored options to help individuals get access to coverage. Anyone who is disabled can have coverage through a plan called CommonHealth.
I started looking into the provisions of CommonHealth last week to see if Skip should change to it. One amazing thing is, if you have CommonHealth, you're eligible for 40 hours of paid Personal Care Attendant services per week! Yippee! Visions of someone to help out with some of the "heavy lifting" danced through my head.
The plan seemed fairly complicated if you're eligible for Medicare. It was hard to tell what you needed to keep and it sounded like you needed to get drug coverage through Medicare Part D, which would be a viable option. But, nowhere could I get the details on premiums.
Yesterday, I finally found a highly legalistic, technical document that outlined premiums. Premiums are indexed relative to the "family unit's" household income in relation to the Federal Poverty Level. If your family's income is below the FPL, your coverage is free. The higher your income in relation to the FPL (an unbelievably low number), the higher your premium. So, if Skip counted only her income, CommonHealth would be close to free. Add me in and it rockets through the roof.
I need to get more details before I can truly understand how CommonHealth coverage works in coordination with Medicare. I spent 30 minutes on hold with the Massachusetts Health plan folks last week, never getting through to a live operator. I'll try again this week so I can speak with someone concerning how the plans work together and find out what the premiums really are.
This is a troubling quandary. I can understand the logic behind setting up premiums in a way that reflects ability to pay. But, with the stroke of a pen on a divorce decree, we could establish a different legal relationship that would dramatically change the income used to determine premiums. And, it would alter the legal protections we automatically receive (albeit only at the state level) due to our married status. (And, I'm just starting to get used to introducing Skip as my wife instead of my partner!)
I'm sure we won't get divorced, but I'm made crazy contemplating Skip's medical options and costs if we did. What a terrible dilemma for couples like us.