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Spouse / Partner

A spouse or partner is the person legally married to or living in a committed relationship with the insured plan member or policyholder. In insurance terms, a spouse includes both legally married and common-law partners who meet the eligibility requirements defined by the insurer. Common-law partners are generally recognized after living together continuously for a specific period, often 12 months or longer, in a relationship similar to marriage.

How It Works

Spouses and partners are considered eligible dependents under most health, dental, and life insurance plans. To extend benefits to them, a plan member can switch from single-level coverage to family-level coverage. Adding a spouse or partner typically requires proof of the relationship, such as a marriage certificate or a signed declaration of common-law status. Definitions vary by plan and jurisdiction. Under British Columbia's Medical Services Plan, a spouse is a resident married to, or living and cohabiting in a marriage-like relationship with, the applicant, and may be of the same gender. Under the federal Public Service Health Care Plan Directive, a common-law partner is someone with whom a member has cohabited in a conjugal relationship for at least one year. If both partners enrol each other as dependents under their respective employer plans, they may be able to coordinate benefits between the two plans to receive up to full reimbursement for medical and dental claims.

Example:

Suppose you and your partner have lived together in a conjugal relationship for over one year and you are enrolled in a group benefits plan through your employer. Because you meet the common-law threshold, you can add your partner as an eligible dependent so your health and dental coverage extends to them. If your partner also has coverage through their own employer, the two plans can coordinate benefits, so the portion of something like a dental cleaning not reimbursed by your plan may then be claimed against theirs.

What to Watch For:

Eligibility hinges on the relationship requirements set by the insurer, so confirm how your plan defines a spouse or partner before assuming someone qualifies. Common-law recognition generally depends on cohabiting in a conjugal relationship for a continuous period, often at least one year, and that threshold can differ between plans and jurisdictions. Because adding a spouse or partner usually requires proof such as a marriage certificate or a signed declaration of common-law status, keep that documentation ready. Where both partners carry their own coverage, coordinating benefits between the two plans is what allows claims to be reimbursed more fully across both.

Related Terms

Coordination of Benefits

Coordination of benefits (COB) is the process used by insurance companies to determine the order in which multiple plans will pay for the same claim when a person is covered under more than one policy. The goal is to ensure that combined reimbursements do not exceed 100 percent of the eligible expense, while allowing the insured to receive the maximum possible coverage across all plans.

Dependent

A dependent is a person, usually a family member, who qualifies for coverage under someone else’s insurance plan. Dependents are typically the spouse or children of the primary insured person, also known as the plan member or policyholder. Some plans may also cover other individuals who rely on the plan member for financial support, such as a common-law partner or a child with a permanent disability.

Insured Person

An insured person is the individual covered under an insurance policy who is entitled to receive benefits for eligible claims. In a personal policy, the insured person is typically the policyholder who owns the coverage. In a group insurance plan, the insured person is the employee or member enrolled in the plan, and their eligible dependents may also be covered under the same contract.

Plan Member

A plan member is an individual who is enrolled in and eligible to receive benefits under a group insurance plan. Typically, the plan member is an employee of a company or a member of an organization that sponsors the group policy. The plan member is covered for the benefits outlined in the plan - such as health, dental, life, and disability insurance - and may also extend coverage to eligible dependents, including a spouse or children.

Member

A member is an individual who is enrolled and covered under a group insurance plan, typically through their employer, association, or organization. The member is often referred to as the insured employee or plan participant and receives coverage for benefits such as health, dental, life, and disability insurance. The member may also extend coverage to eligible dependents, such as a spouse or children, under the same plan.

Relevant Plans

Plans that relate to Spouse / Partner

Alberta Blue Cross - Blue Assured - Basic

Alberta Blue Cross - Blue Assured - Basic

Can apply at anytime, at any age.

Alberta Blue Cross - Blue Assured - Enhanced

Alberta Blue Cross - Blue Assured - Enhanced

Can apply at anytime, at any age.

Alberta Blue Cross - Blue Assured - Enhanced+

Alberta Blue Cross - Blue Assured - Enhanced+

Can apply at anytime, at any age.

Alberta Blue Cross - Blue Assured - Premium

Alberta Blue Cross - Blue Assured - Premium

Can apply at anytime, at any age.

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