Even for federal employees, there is no currently available definitive answer regarding which rights legally married same-sex couples will now be entitled to in non-recognition states. The following is a list of some of the rights that will now be available to legally married same-sex federal employees and their spouses in states that do recognize their marriages as valid, and that may be available even in states that do not.

• Health Insurance (FEHB): Legally married same-sex spouses of federal employees will now be eligible family members under a Self and Family enrollment. In addition, the children of same-sex marriages will be treated just as those of opposite-sex marriages and will be eligible family members according to the same eligibility guidelines. This includes coverage for children of
  same-sex spouses as stepchildren.
• Life Insurance (FEGLI): Legally married same-sex spouses of federal employees and children of those same-sex marriages will now be considered eligible family members under the FEGLI Program.
• Dental and Vision Insurance (FEDVIP): Legally married same-sex spouses of federal employees will now be eligible family members under a Self and Family enrollment or a Self Plus One enrollment.
• Long-Term Care Insurance Program (FLTCIP): Although the Judiciary’s long-term care program offered through CNA has always permitted domestic partners to apply for coverage, all legally married same-sex spouses of federal employees can now apply for long-term care insurance under Federal Long-Term Care Insurance Program (FLTCIP).
• Health Care Reimbursement Account (HCRA): For the purposes of the Judiciary’s HCRA, eligible dependents meeting the definition of “qualifying relative” were always permitted claim reimbursement. However, now the HCRA will permit eligible claim reimbursement for same-sex spouses of all legally married federal employees, even if they fail to meet the “qualifying relative” definition.
• Retirement and Survivors’ Benefits: Eligible federal employees are entitled to federal retirement benefits under either the Civil Service Retirement System (CSRS) or the Federal Employees Retirement System (FERS). Each of these plans includes certain benefits which will now be available to an employee’s same-sex spouse.
• Federal Family and Medical Leave Act (FMLA) Benefits: Legally married same-sex federal employees will now be allowed leave to care for an ailing spouse and to arrange for and attend a spouse’s funeral.

Rights Related to Federal Funding

One of the most difficult situations for married same-sex couples involves hospital visitation policies. Policies that allow visitation only by spouses and other family members (and fail to include same-sex spouses and their children in these categories) often leave a same-sex spouse to spend his or her final hours alone.

Even before section 3 of DOMA was declared unconstitutional, President Obama requested a federal regulation that would require any hospital receiving federal funding for Medicare or Medicaid to allow visitation by same-sex spouses. In response, the Department of Health and Human Services now requires hospitals that receive such funding to allow visitation by same-sex spouses and their families and to grant same-sex partners the right to make medical decisions on behalf of their spouses.  The requirement applies to all such hospitals, even those located in states that do not recognize same-sex marriages.

Hospitals may also receive federal funding for something other than Medicare or Medicaid. If such funding was conditioned upon a hospital’s denial of certain rights to same-sex married couples, it is probable that, after Windsor, such funding could no longer be withheld from hospitals in states that recognize same-sex marriage. On the other hand, hospitals in non-recognition states will probably not be required to provide benefits to same-sex couples in order to maintain such funding.