Same-sex marriage refers to lawful marriage between spouses of the same sex. Same-sex marriage is legal and recognized in every U.S. state and the District of Columbia (Washington, D.C.).

As long as a same-sex couple is married in a jurisdiction with legal authority to authorize the marriage, a health insurance company that offers health coverage to opposite-sex spouses must do the same for same-sex spouses.

The federal Health Insurance Marketplace® also treats married same-sex couples the same as married opposite-sex couples in every state when they apply for premium tax credits and lower out-of-pocket costs on private insurance plans.

In Michigan, same-sex marriage is legal and recognized, consistent with the nationwide legalization of same-sex marriage in the United States following the Supreme Court's landmark decision in Obergefell v. Hodges (2015). This ruling requires all states to issue marriage licenses to same-sex couples and to recognize same-sex marriages validly performed in other jurisdictions. Consequently, in Michigan, health insurance companies that offer coverage to opposite-sex spouses are mandated to provide the same coverage to same-sex spouses. This includes eligibility for premium tax credits and lower out-of-pocket costs on private insurance plans through the federal Health Insurance Marketplace®. Same-sex married couples are treated identically to opposite-sex married couples for the purposes of health insurance coverage and benefits in every state, including Michigan.