Part 12 – Individual Policy (continued) WORDS IN ITALICS ARE EXPLAINED IN PART 2. Page 105 eligible spouse must also meet all of the same eligibility conditions as described above for an eligible individual. (If the spouse is eligible for Medicare, this health plan cannot be issued to the spouse. You should use the Guide to Health Insurance for People with Medicare to find a health plan that is designed to supplement Medicare. To ask for a copy of the Guide, you can call the Blue Cross Blue Shield HMO Blue customer service office.) Former Spouse In the event of a divorce or a legal separation, the person who was the spouse of the subscriber prior to the divorce or legal separation may maintain coverage in this health plan under the subscriber’s individual contract. This coverage may continue only until: the subscriber is no longer required by the divorce judgment to provide health insurance for the former spouse; or the subscriber or former spouse remarries. In either case, the former spouse may wish to enroll as a subscriber under their own individual contract. The Blue Cross Blue Shield HMO Blue customer service office can help you with these options. In these situations, Blue Cross Blue Shield HMO Blue must be notified within 30 days of a change to the former spouse’s address. Otherwise, Blue Cross Blue Shield HMO Blue will not be liable for any acts or omissions due to having the former spouse’s incorrect address on file. Eligible Dependents The subscriber may enroll eligible dependents for coverage in this health plan under their individual contract. Eligible dependents must meet all of the same eligibility conditions as described above for an eligible individual. However, a dependent child may live outside of Massachusetts to attend school as long as they have not moved out of Massachusetts permanently. “Eligible dependents” include the subscriber’s (or subscriber’s spouse’s) children until the end of the calendar month in which the child turns age 26. To be an eligible dependent, the child is not required to live with the subscriber or the subscriber’s spouse, be a dependent on the subscriber’s or spouse’s tax return, or be a full-time student. These eligible dependents may include:  A newborn child. The effective date of coverage for a newborn child will be the child’s date of birth provided that the subscriber formally notifies Blue Cross Blue Shield HMO Blue within 30 days of the date of birth. (A claim for a member’s maternity admission may be considered by Blue Cross Blue Shield HMO Blue to be this notice when the subscriber’s coverage is a family plan.) This health plan provides coverage for newborn infants for injury and sickness. This includes the necessary care and treatment of medically diagnosed congenital defects, birth abnormalities, and premature birth. The coverage for these services is subject to all of the provisions of this health plan.  An adopted child. The effective date of coverage for an adopted child will be the date of placement of the child with the subscriber for the purpose of adoption. The effective date of coverage for an adoptive child who has been living with the subscriber and for whom the subscriber has been getting foster care payments will be the date the petition to adopt is filed. If the subscriber is enrolled under a family plan as of the date they assume custody of a child for the purpose of adoption, the child’s health care services for injury or sickness will be covered from the date of custody. (This coverage is provided without a waiting period or pre-existing condition restriction.) This includes the necessary care and treatment of medically diagnosed congenital defects, birth abnormalities, and premature birth. The coverage for these services is subject to all of the provisions of this health plan.  A newborn infant of an enrolled dependent child immediately from the moment of birth and continuing after, until the enrolled dependent child is no longer eligible as a dependent. If an eligible dependent child is married, the dependent child can enroll for coverage under the subscriber’s individual contract. And, as long as that enrolled child is an eligible dependent, their children are also eligible for coverage under the subscriber’s individual contract. The dependent child’s spouse is not eligible to enroll as a dependent for coverage under the subscriber’s individual contract.