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In Delaware, where Highmark also offers plans and same-sex marriage is legal, the insurer already provides such coverage for gay couples.
The company expects to offer family coverage in the early spring in Pennsylvania and West Virginia.
Other gay couples have found uneven access to family plans.
Al Cowger Jr. and Tony Wesley Jr. of suburban Cleveland sued the state of Ohio and U.S. government after hours-long phone calls and months of trying to get family coverage through the federal insurance marketplace.
The couple, who have been together for 28 years, married in 2012 in upstate New York and have a 7-year-old adopted daughter. They say that because of Ohio's gay marriage ban, they have been denied a family plan under Obama's law in violation of their constitutional rights.
In their lawsuit, Cowger said he talked to help-desk personnel with healthcare.gov who told him that he and Wesley had been approved for family coverage in the marketplace. But a problem surfaced when the representative tried to purchase the policy and couldn't.
Cowger said he was then told he couldn't get family coverage because Ohio does not recognize his marriage. But the insurance company, Medical Mutual of Ohio, says it offers family coverage to same-sex couples both on and off the exchange.
"After 28 years," Cowger said recently, "we're just so sick of having to jump through hoops and get around all these restrictions, all the stuff that comes with these prohibitions, to be treated like a family."