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Can you choose whether your ex or your new spouse is covered by your medical insurance?

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Well, I will try to keep my personal comments to myself in regards to your future husband continuing to have his ex on his policy. I would suggest you call the Department of Insurance for your state government and pose this question. They can give you all the answers. Be ready to wait and go through a few people when you call but you should be able to get your questions answered. You could also call the insurance company anonymously and ask this question as well.  
I have always been under the impression that coverage is only available to those persons that are dependents of the head of household, which is usually determined by income. Now that your husband will be YOUR husband, he becomes the head of household for you and not his ex unless you bring in more income to the household. If you bring in more money, you will be considered "head of household." He may still be required to keep insurance on her, however, if it is court ordered such as part of her alimony (if any was allotted). Legally, I don't think she has right to coverage because she is no longer his dependent because she is no longer his spouse even if by common law. Whether the insurance company will keep coverage will depend on your husband paying for it if they give him an option. If after investigating this you find that she will be cancelled, make sure to tell her. Even if she gets mad over it, she needs to be told that she will be uninsured. It wouldn't be right to cost her money for an expensive procedure or medical stay because she never realized her coverage was cancelled. In fact, I would put this in writing with a copy in your files so that she cannot try to sue for not notifying her of cancellation. This would be a good time, too, to review coverage of the children. Determine who will keep coverage. If she will be paying for coverage, then ask if the insurance company will send cancellation notices to more than one address. That way, if for any reason, she cannot pay for her premiums (non-payment is not always avoidable), your husband can pick up coverage until she can resume.  
Once it's your X, they are no longer eligible. So it would be your new spouse. Your x though could get COBRA.  
When I answer a question - I like to show you the SOURCE and proof. Here's an excerpt from the Blue Cross CA Individual Brochure
Members who become divorced or who have children's coverage and become overage dependents will be moved to their own policy.
Under federal law a spouse is entitled to coverage on your group health plan for up to 36 months under COBRA. If you keep the spouse on your health plan as a regular dependent after the divorce is final that is considered insurance fraud and prosecutable by the insurer. It is a very serious crime and can, and usually does, result in large financial penalties and felony convictions that include prison time. However, under COBRA that ex has the right to coverage. The only time you would have to pay for it is if it was part of a divorce settlement or ruling by the divorce court that you were responsible for the premiums.
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