QUESTION PRESENTED
You asked whether J~ (Applicant) and the number holder R~ (NH) are “spouses” for purposes
of the Medicare Part B Special Enrollment Period (SEP) related to group health plans
where the Applicant alleges that she and the NH are opposite-sex domestic partners
in Connecticut.
ANSWER
No. SSA and CMS consider an individual to be a “spouse” for purposes of the Medicare
Part B SEP related to group health plans if the individual is a spouse for benefit
eligibility purposes under Title II of the Social Security Act (Act). See POMS HI 00805.266A. For Title II benefits, a “spouse” is someone who (1) is married to an individual
under the laws of the State of the individual’s domicile at the time the individual
files for benefits, or (2) has the right to inherit a spouse’s share of an individual’s
intestate personal property under the intestate succession laws of the State of the
individual’s domicile at the time of filing. See 42 U.S.C. § 416(h)(1)(A); 20 C.F.R. §§ 404.344, 404.345; POMS GN 00210.004, GN 00305.005A, RS 00202.001A.1. The Applicant and the NH are not validly married under Connecticut law. Connecticut
law does not authorize domestic partnerships under state law. Further, only parties
to a valid marriage can qualify as a surviving spouse with the right to inherit a
spouse’s share under Connecticut intestate succession law. Thus, given the lack of
a valid marriage under Connecticut law, we believe there is legal support for the
agency to find that the Applicant and the NH are not “spouses” for Title II benefits
and consequently for purposes of the Medicare Part B SEP related to group health plans.[1] See 42 U.S.C. §§ 416(h)(1)(A), 1395p(i)(1); 20 C.F.R. § 404.345; 42 C.F.R. § 407.20;
POMS GN 00210.700B.1, HI 00805.266A, HI 00805.270A.1.
BACKGROUND
It is our understanding that the Applicant declined enrollment in Medicare Part B
during the initial enrollment period, and you are seeking legal advice on whether
the Applicant and the NH are “spouses” for purposes of the Medicare Part B SEP related
to group health plans.[2] You advised that the Applicant alleges she is the opposite-sex domestic partner of
the NH in Connecticut. She submitted documents to support her claim that she is a
domestic partner, including a bank statement showing both individuals on a joint account
at the same address in Connecticut, mortgage information indicating joint ownership
of their residence in Connecticut, and a health insurance coverage summary for October
2024 listing the NH as the employee and the Applicant as his domestic partner and
a covered individual for health coverage. There is no allegation or evidence that
the Applicant and the NH are married.
ANALYSIS
A. Federal Law and Policy: Status as a “Spouse” for the Medicare Part B Special
Enrollment Period Related to Group Health Plans
Medicare, established under Title XVIII of the Social Security Act (Act), is a federally
subsidized health insurance program for individuals age 65 or older and certain qualified
individuals under age 65. See 42 U.S.C. § 1395 et seq. An individual who becomes entitled to Medicare Part A (Hospital Insurance) may choose
to decline enrollment in Medicare Part B (Medical Insurance), which requires a payment
of a monthly premium. See 42 U.S.C. §§ 1395c – 1395i-6 (Part A), 1395j – 1395w-6 (Part B); 42 C.F.R. § 407.17;
POMS HI 00805.001A, HI 00805.005A, HI 00805.015, HI 00805.035, HI 00805.055. An individual may later choose to enroll in Part B during a general enrollment period,
even after turning it down during his or her initial enrollment period but usually
must pay a late enrollment penalty (increased premium), unless the individual qualifies
for a Special Enrollment Period (SEP). See 42 U.S.C. §§ 1395p(i), 1395q(e), 1395r(b); 42 C.F.R. §§ 407.20, 408.22; POMS HI 01001.010, HI 00805.025.
An individual may qualify for a SEP if he or she is covered under a group health plan
based on the individual’s own current employment status or a spouse’s current employment
status. See 42 U.S.C. § 1395p(i)(1); 42 C.F.R. § 407.20; POMS HI 00805.265, HI 00805.266A, HI 00805.270A.1. SSA and CMS consider an individual to be a “spouse” for purposes of the SEP related
to group health plans if he or she is a spouse for benefit eligibility purposes under
Title II of the Act. See POMS HI 00805.266A. Title II in turn defines a “spouse” as someone who (1) is married to the individual
under the laws of the State of the individual’s domicile at the time the individual
files for benefits, or (2) has the right to inherit a spouse’s share of the individual’s
intestate personal property under the intestate succession laws of the State of the
individual’s domicile at the time of filing. See 42 U.S.C. § 416(h)(1)(A); 20 C.F.R. §§ 404.344, 404.345; POMS GN 00305.005A, RS 00202.001A. If an individual is not married but is in a valid non-marital legal relationship
that conveys the right to inherit a spouse’s share under state intestate succession
law, SSA and CMS consider the individual to be a “spouse” for Title II benefit purposes
and for the SEP. See 42 U.S.C. § 416(h)(1)(A)(ii); 20 C.F.R. § 404.345; POMS RS 00202.001A.1, GN 00210.004, GN 00210.700B.1,[3] GN 00305.005A.
Here, to determine status as a “spouse” for the Medicare Part B SEP related to group
health plans, we consider whether the Applicant and the NH are validly married or
whether their alleged opposite-sex domestic partnership in Connecticut conveys spousal
inheritance rights under Connecticut intestate succession law.
B. Connecticut Law on Marriage and the Right to Inherit as a Surviving Spouse’s
Share under Connecticut Intestate Succession Law
Here, there is no evidence or claim of a valid ceremonial marriage between the Applicant
and the NH under Connecticut’s state laws. See Conn. Gen. Stat. Ann. §§ 46b-20 – 46b-38z (marriage statutes); Conn. Gen. Stat. Ann.
§ 46b-20(4) (“‘Marriage’ means the legal union of two persons.”). The Applicant alleges
that she and the NH live together as opposite-sex domestic partners in Connecticut.
Connecticut state law does not authorize or recognize domestic partnerships on a state-wide
basis or provide for a state-wide domestic partnership registry.[4] See Newsome v. AAA Insurance Company, No. 21-6108030-S, 2024 WL 1878659, at *6 (Conn. Super. Ct. April 23, 2024) (“Domestic
partnerships are, in fact, not recognized in Connecticut as stand-alone status….no
status of domestic partnership is possible under Connecticut law….”). Further, Connecticut
law does not authorize common-law marriage or living arrangements or informal commitments
entered into in Connecticut as valid marriages. See McAnerney v. McAnerney, 334 A.2d 437, 441-442 (Conn. 1973) (“Although other jurisdictions may recognize
common-law marriage or accord legal consequences to informal marriage relationships,
Connecticut definitely does not.”). “[A]lthough two persons cohabitate and conduct
themselves as a married couple, [Connecticut] law neither grants to nor imposes upon
them marital status.” Id. at 442; see also State
ex rel. Felson v. Allen, 29 A.2d 306, 308 (Conn. 1942) (“Cohabitation does not make a marriage.... Our law
does not recognize common-law marriages.” [Internal quotation marks omitted.]). Thus,
under Connecticut law, cohabitation, in and of itself, does not create any legal or
support obligations. See Boland v. Catalano, 521 A.2d 142, 145 (Conn. 1987) (“rights and obligations that attend a valid marriage
simply do not arise where the parties choose to cohabit outside the marital relationship”);
see
also Loughlin v. Loughlin, 910 A.2d 963, 643-644 (Conn. 2006) (Connecticut does not recognize common-law marriage
and has drawn a clear distinction between marriage and cohabitation).
Further, only spouses in a legal marriage can inherit a surviving spouse’s share under
Connecticut’s intestate succession law. According to Connecticut intestate succession
law, if an individual dies without a will, the individual’s estate passes to his or
her heirs, including any “surviving spouse.” See Conn. Gen. Stat. Ann. § 45a-437 (intestate succession and distribution to a spouse).
Connecticut intestate succession statutes do not define “surviving spouse.” In interpreting
statutes to determine the legislative intent, courts look at the plain meaning of
the text of the statute and refer to dictionaries to determine the plain meaning of
an undefined statutory term. See Conn. Gen. Stat. Ann. § 1-2z; State v. Moore, 336 A.3d 1222, 1228-1229 (Conn. 2025); State v. Inzitari, 329 A.3d 215, 223-224 (Conn. 2025). Dictionaries define “spouse” as a “married person:
husband, wife” and a “surviving spouse” as a “spouse who outlives the other spouse.”
Merriam-Webster.com
Dictionary, spouse, Merriam-Webster, https://www.merriam-webster.com/dictionary/spouse (last visited Sept. 17, 2025); Black’s Law Dictionary, surviving spouse (11th ed. 2019). Further, Connecticut courts considering the right
to inherit as a surviving spouse under intestate succession law have required a valid
marriage to the decedent. See e.g., Mongillo v.
Estate of Bevenesee, No. 196031587S, 2020 WL 3120340, at *4 (Conn. Super. Ct. May 12, 2020) (finding
that the probate court properly considered whether a Mexican divorce decree was valid
in order to determine whether the plaintiff was the decedent’s surviving spouse for
intestate inheritance purposes). Because the Applicant and the NH did not have a valid
marriage, we believe Connecticut courts would find that the Applicant does not qualify
as the NH’s “surviving spouse” entitled to inherit a spouse’s share of the NH’s property
under Connecticut intestate succession law.
In summary, the Applicant and the NH are not validly married under Connecticut law.
Connecticut law does not authorize domestic partnerships under state law. Only parties
to a valid marriage can qualify as a surviving spouse with the right to inherit under
Connecticut intestate succession law.
CONCLUSION
Because the Applicant and the NH are not validly married under Connecticut law, we
believe there is legal support for the agency to find that the Applicant and the NH
are not “spouses” for purposes of the Medicare Part B SEP related to group health
plans.