When Carl Garland felt chest pains, his partner of 11 years, Shane Turnbeaugh, did not hesitate to take him to the emergency room.
Had Garland's condition required him to be admitted or if he had been unconscious, Turnbeaugh would have had to return home to retrieve their domestic partner agreement.
In the past, doctors have asked Turnbeaugh to leave the room before Garland gives permission for his partner to stay.
The outcome of this week's U.S. Supreme Court consideration of California's Prop 8 and the federal Defense of Marriage Act could make it easier for couples like Garland and Turnbeaugh to care for one another.
For now, they rely on a series of legal documents, developed at a cost of nearly $1,000, to essentially provide the same rights as a legally married couple.
Turnbeaugh also has been grateful to work for two employers that included domestic partners in benefits packages.
During a few years when Garland's employer dropped dental coverage, the legal domestic partner agreement allowed Garland's daughters to be covered under Turnbeaugh's plan.
"We had to prove we were in a relationship," Garland said.
And if Garland was no longer employed with his own health coverage, Turnbeaugh said it is a relief to know his partner could be included on his.
Domestic partner benefits have become more common among Mid-Missouri employers.
In January, Columbia College added a gender-neutral domestic partner benefits to full-time employees.
"In recent years, many colleges in the area have begun to offer partner benefits to their employees," said President Gerald Brouder. "In order to remain competitive in the recruitment and retention of employees, it was time to move this forward to the Board of Trustees."
The employer benefits is only one aspect of several differences experienced between same-sex couples in a committed relationship and heterosexual couples with a marriage license.
Garland and Turnbeaugh admit their domestic partner agreement is a step farther than many same-sex couples might go. But with Garland's children and a previous marriage, they said it was the assurance they needed.
"We had heard horror stories of partners being cleaned out," Garland said.
JoDe and Lisa Layton-Brinker traveled to Iowa in 2010 to get a marriage license, although it carries no legal value in Missouri. They hope some federal rights might be given to them as a result of the U.S. Supreme Court cases this week.
"It's disheartening after what we had to go through to get a marriage license, then you find it's invalid when you cross the imaginary line," JoDe said.
Perhaps one day their license will have more effect, but it also stands as a statement of their commitment as a long-term couple, she said.
"We needed to be able to show our children this is what our value system is," JoDe said.
The Layton-Brinkers also have invested thousands of dollars to create legal documents similar to what heterosexual couples receive through their marriage license.
Also, if one died, the other would have to pay inheritance tax on their assets, and in filing federal taxes, one cannot claim the other's children as dependents.
"It's a struggle for us to be like everyone else," JoDe said. "We're living the American dream by a different set of laws."