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In a common law marriage state, in order to qualify for such status, you need to do things that will make people believe that you are actually married. Those things include filing tax returns as married (you can file a married "joint" or married filing individually, but the better tax benefits occur if you file married "joint" -- either filing status is your choice), changing your name to his name, and anything else that would make people tend to think that you are married. If you do this, the law will consider you married and you will have to divorce just like a regularly married couple and each of you will be entitled to property benefits from the other in the event of a divorce. My suggestion is that if you want to prove that you are married for health insurance purposes, simply go to your local town hall and get married. A marriage certificate is the best proof that you can get for the health insurance company. Obviously, that is up to you and your friend -- but if you put out all indications of being married in Texas, then you will have to go through the same steps to dissolve the marriage as any other married couple would.
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Claiming any or all of these things is legal -- in other words if you just want to claim married for health insurance purposes and claim "single" on taxes -- you can do what you want. The overall question is whether or not the health insurance will believe that you are actually married so that you can get the benefits. To do that, you are probably going to have to show them something that indicates that you are actually married. Most married people do this by providing either a marriage certificate or tax returns. If you have neither of these, then the health insurance company might not believe that you are married -- common law or otherwise -- and the company may deny you benefits.
It's not illegal. As I said earlier, if you claim "married" just for insurance purposes and you do not have anything else in your life that indicates that you are married, if the insurance company or the employer decides to dig a little deeper and they turn up nothing that shows that you are actually married to this man -- legally or common law, then they may cut off the benefits and tell you that you are not married in any sense of the word. Just being together for 20 years is not enough to be married for common law purposes -- you have to have something more -- such as filing joint tax returns, using his last name, wearing wedding bands and generally telling people that you are married. If the insurance company or the employer finds that you are not doing any of these things and yet you claimed health insurance as married -- they will probably stop the insurance.