Insurance/Legal question re: marriage

Hypothetical question here (but based on a real story, as they say): Joe is a 380 pound 5'10" man who has been over 300 pounds for fifteen years. Joe does his insurance company's 6 month supervised diet and loses 60 pounds-- and pays the $350 hospital program fees, attends pre-op classes, and does all medical testing---but is then denied for surgery because his employer has an exclusion. Joe cannot self-pay. Joe sticks to his diet diligently, but after losing 60 pounds, he finds that can lose no more and hasn't lost in 6 months despite sticking to a rigorous daily cardio exercise schedule and eating 1700 calories a day. Joe is now scared he may not survive as his co-morbidities (severe sleep apnea, hypertension, etc.) are ever increasing despite his best efforts. Joe's employer refuses to change the policy or offer a rider on his policy. They offer no coverage which will pay for WLS. Joe's girlfriend -- concerned about his declining health-- says, "Hey, let's just get married-- on paper for now-- we'll catch up in church later.." She has better coverage with no exclusions, and had an RNY herself. She is terribly worried that Joe will not survive long without a malabsorptive surgery (and her policy unfortunately excludes the DS.) While they are not yet ready for marriage, they both sadly think this might be their best shot at extending Joe's life. Questions: 1) If Joe and his girlfriend marry, how long until Joe will have benefits?  2) Do you usually have to pay to add a spouse to your policy? (Sorry, I'm single and I don't know this stuff.) 3) How long would Joe have to wait to submit his (already completed) paperwork to have the RNY under the new policy? Could it be denied if submitted "too soon?" 4) Is there anything regarding "pre-existing conditions" that could be of issue, since he already "applied" for surgery under his old insurance? Thanks!

While I didn't get married for the weight loss surgery.  I got married due to other health problems for my husband.   My insurance covered him as soon as I registered him as my spouse.  I had a additional fee to cover him.  As I said Terry didn't need weight loss surgery but had other health problems.  So I can't answer the RNY question.  I would ask at work how soon he would be covered in general then call the ins. co. and ask how soon he would be covered for RNY.  By the way I really admire your own weightloss/ journey.  Always enjoy when you post on the non-surgical board. 

Your premiums will go up. Joe will have coverage the first of the month following Joes wife submitting the proper paperwork at the very worse. Joe can submit on the 2nd of the same month. I do hope if Joe gets married they do live at the same address Don't want to commit INS. fraud

Please get a pre-nup in place before getting married.  If what is forcing the issue is his health he should have no problems with agreeing to this.