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The Gay Doctor Dilemma

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Understanding Domestic Partnership Problems

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Legal Strangers

In spite of many changes to state laws and with a few exceptions, for all intents and purposes, unmarried physician couples are still considered strangers to one another. The unmarried partner has no right to make health care decisions, no right to Social Security survivor benefits, and no inheritance rights without proper documentation. An unmarried partner generally has no standing to seek damages for the “wrongful death” of a spouse, nor any standing for any other contractual rights.

Tax Treatment

Unmarried couples do not get the same tax treatment—such as the ability to file a joint tax return—as do married couples. While this may not necessarily mean higher taxes for married couples, it can make deductions difficult to determine for unmarried couples. Nor can an unmarried couple use the spousal Individual Retirement Account deductions for a nonworking spouse. An unmarried couple may not use a family partnership for tax purposes.

Non-Tax Benefits

Unmarried partners do not have the benefits that spouses have when a relationship ends or one partner dies. Domestic partners may not receive alimony or child support, except in special cases. A partner may not receive pension rights, and generally will not receive employer benefits, except in certain companies and municipalities. One partner who is forced to quit practice when the other partner is transferred may not receive unemployment benefits, while a spouse can. Unmarried partners may not qualify to get residency status for a non-citizen partner to avoid deportation.

Estates and Gift Problems

Estate tax law allows married couples an unlimited deduction for estate and gift tax purposes. Unmarried couples do not get this benefit, and may be taxed on what would otherwise be a tax-free transfer. If one partner dies intestate (without a will) the couple’s joint property would not necessarily go to the survivor. A married couple can give away $26,000 per recipient each year without gift tax consequences, but an unmarried individual with a high income is limited to $13,000, per recipient per year, even when living with a partner.

Personal Benefits

Domestic partners may be kept from visiting a partner in a prison or in the hospital or any other place restricted to “immediate family” members. Without specific legal permission, such as a durable power of attorney, the blood relatives of the partner who is ill can keep the domestic partner from seeing his or her mate. Except in a few municipalities and companies, domestic partners may not be eligible for bereavement leave when one partner dies.

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18 Responses

  1. Gay Doctors – Gay Patients – Gay Rights

    When a loved one is in the hospital, you naturally want to be at the bedside. But, what if the hospital staff won’t allow it? Read this article by Tara Parker-Pope, published in the NYT on May 18, 2009.

    Link: http://www.nytimes.com/2009/05/19/health/19well.html?_r=2&emc=tnt&tntemail0=y

    This piece indicates that we have very far to go and defining marriage is only one step in the gay rights process.

    PS: Thank you for including this topic in your book, Dr. Marcinko.

    Richard

    Like

  2. Do Hospitals Still Discriminate Against Gays?

    President Obama issued a memorandum two month ago mandating hospitals to update their visitation policies to include equal treatment for gays.

    http://www.fiercehealthcare.com/story/obama-nationally-mandates-hospital-visitation-rights-gays/2010-04-16

    Today, the statistics are out as far as how many hospitals currently comply with that presidential order, and the numbers aren’t pretty.

    http://www.fiercehealthcare.com/story/majority-u-s-hospitals-dont-have-nondiscrimination-policy-gays/2010-06-07

    In fact, the topic is big news in the virtual and real world.

    http://www.miamiherald.com/2010/06/07/1667882/jackson-memorial-hospital-scores.html

    Richard

    Like

  3. Financial advisors vary greatly in their expertise on the matter. For the single physician with a domestic partner, be sure to find a financial advisor with knowlegde, expertise, and experience in this particular area of planning.

    Brian J. Knabe MD CMP™

    Like

  4. On Being Gay in Medicine

    Brian – An interesting personal essay by Mark Schuster MD.

    http://thehealthcareblog.com/blog/2012/04/07/on-being-gay-in-medicine/

    Freda

    Like

  5. A Disadvantage

    One big disadvantage domestic partners have not mentioned here based on current tax law is the treatment as a “non-spouse beneficiary” when a partner dies in regards to IRA accounts.

    An IRA account tends to be one of the largest assets left to heirs. A surviving spouse can roll over the inherited IRA account into an existing IRA they own as a nontaxable event. The IRS treats a domestic partner as a “non-spouse beneficiary”. If a non-spouse beneficiary does this, it is treated as a distribution and the proceeds must be included in the beneficiary’s income in the year the rollover occurs. As a “non-spouse”, a partner is denied the benefit of a non-taxable distribution and is treated the same as if the IRA was inherited by a child or even unrelated party. Distributions must occur then either under the 5 year rule or under the exception to the five-year rule which is an election to receive distributions over a period not exceeding your life expectancy (usually a better option for most people).

    The rule is a little complicated depending on whether the partner died before or after starting the required minimum distributions which begin at age 70 ½, but the outcome is the same: distributions must be taken from the IRA. Of course, the forcing of distributions from an IRA causes then the taxes to be due on the increased “income”, which increases the tax burden of a surviving partner.

    David K. Luke MIM
    CMP candidate
    http://www.CertifiedMedicalPlanner.org

    Like

  6. Gay Doctors

    Did you know that financial planners see affluent gay and lesbian clients as an important growth market?

    http://wealthmanagement.com/wealth-planning/planners-now-regard-affluent-gay-and-lesbian-clients-important-growth-market-it-s-ti

    But, the LGBT community faces unique financial planning challenges – and the ground is shifting rapidly, especially where same-sex couples are concerned.

    Richard

    Like

  7. Gay marriage can muddle finances

    http://money.msn.com/personal-finance/gay-marriage-can-muddle-finances

    Although some states now allow same-sex marriage, the federal government does not recognize it, and that complicates things.

    Richard

    Like

  8. DOMA Repealed

    On the morning after the demise of the Defense of Marriage Act, this FA conducted a financial assessment for one of her same-sex clients.

    http://www.financial-planning.com/news/how-gay-marriage-ruling-gave-benefits-to-a-client-2685621-1.html?ET=financialplanning:e14121:86235a:&st=email&utm_source=editorial&utm_medium=email&utm_campaign=fp_alert_063013

    Learn the results.

    Leslie

    Like

  9. Big Changes for Gay Doctors and FA Clients

    The Supreme Court ruling clarified the financial status of some legally married same-sex couples – but muddied it for others.

    http://www.financial-planning.com/fp_issues/43_8/for-gay-clients-doma-rulings-financial-impact-2685891-1.html?ET=financialplanning:e14427:86235a:&st=email&utm_source=editorial&utm_medium=email&utm_campaign=fp_alert_080213

    Any thoughts?

    Barrington

    Like

  10. On Gay Med Students

    Making the decision to be out on a medical school application.

    http://www.kevinmd.com/blog/2013/11/making-decision-medical-school-application.html

    Jane

    Like

  11. Feds ease rules on same-sex health care tax breaks

    The Obama administration is letting legally married same-sex couples claim some health care tax benefits for this year.

    The new notice lets an employee receiving certain health care tax breaks to claim them for their same-sex spouse this year. Usually, an employee must make their selections about who qualifies for those tax breaks before a tax year begins. They normally cannot be changed until the next tax year.

    The notice covers flexible spending accounts, health care savings accounts and cafeteria plans.

    Jerime

    Like

  12. The Dilemma

    If Dr. Martin Luther King Jr. can overturn racial inequality through nonviolence protests, I do not see why a gay couple would not be treated on such an equal level playing field as traditional couples.

    After all, if same sex marriage is the norm, then all these special situations about the gay doctors would be unconstitutional.

    Ken Yeung MBA CMP™ candidate

    Like

  13. Retirement Benefits and Same-Sex Couples

    Spousal rights to retirement benefits is now open to same-sex couples, thanks to the Supreme Court’s decision to strike down the Defense of Marriage Act.

    Here’s what you need to know.

    http://wealthmanagement.com/retirement-planning/retirement-benefits-and-same-sex-couples?NL=WM-10&Issue=WM-10_20140718_WM-10_175&YM_RID=marcinkoadvisors%40msn.com&YM_MID=1476358&sfvc4enews=42&cl=article_2

    But, implementation has been uneven.

    Ann Miller RN MHA

    Like

  14. New Strategies for Same-Sex Life Insurance

    Demand is brewing for same-sex life insurance in the wake of the Supreme Court decision to strike down the Defense of Marriage Act.

    http://wealthmanagement.com/insurance/new-strategies-same-sex-life-insurance?NL=WM-06&Issue=WM-06_20140715_WM-06_572&YM_RID=marcinkoadvisors%40msn.com&YM_MID=1476836&sfvc4enews=42&cl=article_1

    That opens up new wealth management strategies for same-sex couples.

    Ann Miller RN MHA

    Like

  15. Percentage Uninsured in the US by LGBT Status

    According to an August 2014 survey by Gallup, LGBT adults are more likely to lack a personal doctor and enough money for healthcare.

    Below are the results:

    Q3 2013 Q4 2013 Q1 2014 Q2 2014
    Non-LGBT 17.2% 16.7% 15.0% 13.2%
    LGBT 24.2% 22.0% 23.7% 17.6%

    Note: LGBT stands for lesbian, gay, bisexual and transgender along with heterosexual. The acronym describes people’s sexual orientation or gender identity.

    Source: Gallup
    http://www.amazon.com/Financial-Planning-Handbook-Physicians-Advisors/dp/0763745790/ref=sr_1_1?ie=UTF8&s=books&qid=1275315635&sr=1-1

    Like

  16. The Supreme Court

    The Supreme Court ruled on Friday that the U.S. Constitution provides same-sex couples the right to marry, handing a historic triumph to the American gay rights movement.

    http://www.msn.com/en-us/news/us/us-supreme-court-rules-in-favor-of-gay-marriage-nationwide/ar-AAcaBM5?ocid=iehp

    The court ruled 5-4 that the Constitution’s guarantees of due process and equal protection under the law mean that states cannot ban same-sex marriages. With the ruling, gay marriage will become legal in all 50 states.

    Jerime

    Like

  17. Asking difficult questions
    [Meaningful use means difficult questions – especially for dentists]

    “HHS to Include Sexual Orientation & Gender Identity in Meaningful Use of Electronic Health Program – In a landmark step to address health care disparities affecting LGBT people, last week U.S. Department of Health and Human Services has included sexual orientation and gender identity data collection to its requirements for Electronic Health Records (EHRs) certified under the Meaningful Use program. The change is planned to take effect in 2018 after health care providers have received training on how to collect sexual orientation and gender identity data.”

    By Jason Brown
    [McCleary Law Fellow to HRC Blog]
    October 13, 2015

    http://www.hrc.org/blog/entry/hhs-to-include-sexual-orientation-gender-identity-in-meaningful-use-of-elec

    Do you feel comfortable asking your dental patients if they are gay, Doc? How will your patients feel about it?

    DK Pruitt DDS

    Like

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