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  1. #1
    stevear22 is offline Junior Member
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    Question Child Support-Medicaid even though 50/50

    What is the name of your state (only U.S. law)? Texas

    I've been married to my wife for 2 1/2 years and she's got an 11 year old with her former husband. In their divorce decree everything is 50/50 with alternating week custody with the exception of Christmas and Summer break and we claim him on our taxes every other year. The decree states that the father must maintain the child's medical insurance. Here's where the problem lies.

    He is on/trying to get unemployment through his job so he's now on Medicare. Recently my wife was summoned to the DA's office along with the father so they could come to an agreement on matters of child support... without having to go to court. She went and he failed to show up... so now they're going to have to go to court.

    We do not understand why we're being asked to pay anything at all. At this point, we're really not even sure if the father lied on some paperwork somewhere or if this is how Medicaid works.

    I appreciate any help
  2. #2
    mistoffolees is offline Senior Member
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    Quote Originally Posted by stevear22 View Post
    What is the name of your state (only U.S. law)? Texas

    I've been married to my wife for 2 1/2 years and she's got an 11 year old with her former husband. In their divorce decree everything is 50/50 with alternating week custody with the exception of Christmas and Summer break and we claim him on our taxes every other year. The decree states that the father must maintain the child's medical insurance. Here's where the problem lies.

    He is on/trying to get unemployment through his job so he's now on Medicare. Recently my wife was summoned to the DA's office along with the father so they could come to an agreement on matters of child support... without having to go to court. She went and he failed to show up... so now they're going to have to go to court.

    We do not understand why we're being asked to pay anything at all. At this point, we're really not even sure if the father lied on some paperwork somewhere or if this is how Medicaid works.

    I appreciate any help
    First, 'WE' are not being asked to pay anything. Your wife is.

    Have your wife sign up with her own account and start by giving us the exact wording of the medical insurance portion of her decree. In short, if ex is not following the decree, she can file for him to be held in contempt, although if he's not working, the judge may change the order rather than hold Dad in contempt. But we'll need to specifics from your wife.
  3. #3
    LdiJ is offline Senior Member
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    Quote Originally Posted by mistoffolees View Post
    First, 'WE' are not being asked to pay anything. Your wife is.

    Have your wife sign up with her own account and start by giving us the exact wording of the medical insurance portion of her decree. In short, if ex is not following the decree, she can file for him to be held in contempt, although if he's not working, the judge may change the order rather than hold Dad in contempt. But we'll need to specifics from your wife.
    The medical portion of her decree may not matter if dad is applying for medicaid...and if her state goes after child support from the other parent if one parent is receiving medicaid.
  4. #4
    loohoo82 is offline Junior Member
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    Hello,

    Here is the medical portion of the divorce decree:

    Health Care
    1. IT IS ORDERED that FATHER and MOTHER are each ORDERED to prvide medical support and health insurance coverage for the child the subject of this suit as additional child support for as long as the Court may order FATHER and MOTHER to provide support for the child under sections 154.001 and 154.002 of the Texas Family Code. Beginning on the day FATHER and MOTHER's actual or potential obligation to support the child under sections 154.001 and 154.002 of the Family Code terminates, IT IS ORDERED that FATHER and MOTHER are discharged from the obligations set forth in this medical support order, except for any failure by a parent to fully comply with those obligations before that date. IT IS FURTHER ORDERED that FATHER and MOTHER shall each provide medical support and health insurance coverage for the child as set out in this order.

    2. Definitions
    (skipped)

    3. Obligations of FATHER - FATHER is ORDERED to include and maintain the child in FATHER's health insurance available through employer no later than the date the Court signs this order.

    4. Obligations of FATHER - FATHER is ORDERED
    a. to furnish to each conservator of the child and the child support registry the following information no later than the thirteenth day after the date the notice of the rendition of this order is received:
    i. the Social Security number of the parent providing insurance;
    ii. the name and address of the employer of the parent providing insurance;
    iii. whether the employer is self-insured or has health insurance available;
    iv. proof that health insurance has been provided for the child; and
    v. the name of the health insurance carrier, the number of the policy, a copy of the policy and schedule of benefits, a health insurance membership card, claim forms, and any other information necessary to submit a claim or, if the employer is self-insured, a copy of the schedule of benefits, a membership card, claim forms, and any other information necessary to submit a claim;
    b. to furnish to each conservator of the child a copy of any renewals or changes to the health insurance policy covering the child, or any additional information regarding health insurance coverage of the child, including any change in the actual cost of the health insurance for the child, no later than the fifteenth day after the party providing the health insurance receives or is provided with the renewal, change, or additional information;
    c. to furnish each conservator for the child and the child support registry with all documentation accessible to FATHER of any termination or lapse of the health insurance coverage of the child no later than the fifteenth day after the date of the termination or lapse;
    d. after termination or lapse of health insurance coverage, to furnish each conservator of the child and the child support registry with all documentation accessible to FATHER of the availability of additional health insurance for the child no later than the fifteenth day after the date the insurance becomes available.
    e. after a termination or lapse of health insurance coverage, to furnish each conservator of the child and the child support registry with all documentation accessible to FATHER of the availability of enrollment of the child in a medical assistance program under chapter 32 of the Texas Human Resources Code or a state child health plan under chapter 62 of the Texas Health and Safety Code, no later than the fifteenth day after the date the enrollment in the program becomes available;
    f. to enroll the child at the next available enrollment period in a health insurance plan that is available at reasonable cost after the previous health insurance has been terminated or has lapsed; and
    g. to enroll the child in a medical assistance program under chapter 32 of the Texas Human Resources Code or a state child health plan under chapter 62 of the Texas Health and Safety Code if the child is eligible for enrollment in the program and no health insurance plan is available at reasonable cost.

    5. Secondary Coverage - IT IS ORDERED that nothing in this order shall prevent either party from providing secondary health insurance coverage for the child at that party's sole cost and expense. IT IS FURTHER ORDERED that if a party provides secondary health insurance coverage for the child, both parties shall cooperate fully with regard to the handling and filing of claims with the insurance carrier providing the coverage in order to maximize the benefits available to the child and to ensure that the party who pays for health=care expenses for the child is reimbursed for the payment from both carriers to the fullest extent possible.

    6. Compliance with Insurance Company Requirements - Each party is ORDERED to conform to all requirements imposed by the terms and conditions of the policy of health insurance covering the child in order to assure maximum reimbursement or direct payment by the insurance company incurred health-care expense, including but not limited to requirements for advance notice to carrier, second opinions, and the like. Each party is ORDERED to attempt to use "preferred providers," or services within the health maintenance organization, if applicable, however, this provision shall not apply if emergency care is required. Disallowance of the bill by a health insurer shall not excuse the obligation of either party to make payment; however, if a bill is disallowed or the benefit reduced because of the failure of a party to follow procedures or requirements of the carrier, IT IS ORDERED that the party failing to follow the carrier's procedures or requirements shall be wholly responsible for the increased portion of that bill.
    IT IS FURTHER ORDERED that no surgical procedure, other than in an emergency or one covered by insurance, shall be performed on the child unless the parent consenting to the surgery has first consulted with at least two medical doctors, both of whom state an opinion that the surgery is medically necessary. IT IS FURTHER ORDERED that a parent who fails to obtain the required medical opinions before consent to surgery on the child shall be wholly responsible for all medical and hospital expenses incurred in connection therewith.

    7. Claims - Except as provided in this paragraph, the party who is not carrying the health insurance policy covering the child is ORDERED to furnish the party carrying the policy, within fifteen days of receiving them, any and all forms, receipts, bills, and statements reflecting the health-care expenses the party not carrying the policy incurs on behalf of the child. In accordance with article 3.51-13 of the Texas Insurance Code, IT IS ORDERED that the party who is not carrying the health insurance policy covering the child may, at that parts option, file directly with the insurance carrier with whom coverage is provided for the benefit of the child any claims for health=care expenses, including but not limited to medical, hospitalization, and dental costs, and receive payments directly from the insurance company.
    The party who is carrying the health insurance policy covering the child is ORDERED to submit all forms required by the insurance company for payment or reimbursement of health-care expenses incurred by either party on behalf of the child to the insurance carrier within fifteen days of that party's receiving any form, receipt, bill, or statement reflecting the expenses.

    8. Constructive Trust for Payments Received - IT IS ORDERED that any insurance payments received by a party from the health insurance carrier as reimbursement for health=-care expenses incurred by or on behalf of the child shall belong to the party who incurred and paid those expenses. IT IS FURTHER ORDERED that the party receiving the insurance checks or payments for health-care expenses incurred and paid by the other party, and the party carrying the policy shall endorse and forward the checks or payments, along with any explanation of benefits received, to the other party within three days of receiving them.

    9. Health-Care Expenses Not Paid by Insurance
    I'm getting tired of typing. let me know if you want this section.

    10.WARNING - A PARENT ORDERED TO PROVIDE HEALTH INSURANCE OR TO PAY THE OTHER PARENT ADDITIONAL CHILD SUPPORT FOR THE COST OF HEALTH INSURANCE WHO FAILS TO DO SO IS LIABLE FOR NECESSARY MEDICAL EXPENSES OF THE CHILD, WITHOUT REGARD TO WHETHER THE EXPENSES WOULD HAVE BEEN PAID IF HEALTH INSURANCE HAD BEEN PROVIDED, AND FOR THE COST OF HEALTH INSURANCE PREMIUMS OR CONTRIBUTIONS, IF ANY, PAID ON BEHALF OF THE CHILD.

    Miscellaneous Child Support Provisions
    No Credit for Informal Payments
    IT IS ORDERED that the child support as prescribed in this decree shall be exclusively discharged in the manner ordered and that any direct payments made by FATHER to MOTHER or any expenditures incurred by FATHER during FATHER's periods of possession of or access to the child, as prescribed in this decree, for food, clothing, gifts, travel, shelter, or entertainment are deemed in addition to and not in lieu of the support ordered in this decree.


    phew, that was a lot of typing. Thank you for the help!
  5. #5
    Proserpina is offline Senior Member
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    Quote Originally Posted by LdiJ View Post
    The medical portion of her decree may not matter if dad is applying for medicaid...and if her state goes after child support from the other parent if one parent is receiving medicaid.


    Agreed. The State is not going to care what her decree says - they just want reimbursement.
  6. #6
    milspecgirl is offline Senior Member
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    it says dad is ordered to provide it thru his employer. He no longer has an employer if he is looking at unemployment. Is mom or stepdad not able to put the child on their insurance?
    The state does not care what a court order says- they are going to require the parents to reimburse the state for what the state pays. since dad obviously cant (since he's applying), they will go after mom to pay it.
    mom may be able to have the court order that dad reimburse her the costs but the court may take pity on dad being unemployed and change the order and decrease his support until he gains employment
  7. #7
    mistoffolees is offline Senior Member
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    Quote Originally Posted by LdiJ View Post
    The medical portion of her decree may not matter if dad is applying for medicaid...and if her state goes after child support from the other parent if one parent is receiving medicaid.
    I agree, but wanted to know what the order said to see if there was any contempt.

    Since the court says Dad must have insurance through his employer and he doesn't have an employer, he's probably not in contempt. Mom is also required to have insurance, btw.

    As you say, the state can go after Mom to collect the cost of Medicaid. However, if Mom were doing what the order says and carrying insurance on the child, Medicaid would not be necessary.
  8. #8
    stevear22 is offline Junior Member
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    Quote Originally Posted by milspecgirl View Post
    it says dad is ordered to provide it thru his employer. He no longer has an employer if he is looking at unemployment. Is mom or stepdad not able to put the child on their insurance?
    The state does not care what a court order says- they are going to require the parents to reimburse the state for what the state pays. since dad obviously cant (since he's applying), they will go after mom to pay it.
    mom may be able to have the court order that dad reimburse her the costs but the court may take pity on dad being unemployed and change the order and decrease his support until he gains employment
    Yes, we can put him on ours... but the father neglected to tell us that he didn't have insurance. There is a short window where the child is uninsured and we can add him. We would love to add him to ours... that way we'd be sure that he's covered. We would have gladly told the DA that today at the meeting if he showed up.. now we have to go to court because he didn't show up.

    Thank you very much
  9. #9
    Ohiogal is offline Senior Member
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    Quote Originally Posted by stevear22 View Post
    Yes, we can put him on ours... but the father neglected to tell us that he didn't have insurance. There is a short window where the child is uninsured and we can add him. We would love to add him to ours... that way we'd be sure that he's covered. We would have gladly told the DA that today at the meeting if he showed up.. now we have to go to court because he didn't show up.

    Thank you very much
    Mother is in violation of the decree then. Why? Because it says:

    Health Care
    1. IT IS ORDERED that FATHER and MOTHER are each ORDERED to prvide medical support and health insurance coverage for the child the subject of this suit as additional child support for as long as the Court may order FATHER and MOTHER to provide support for the child under sections 154.001 and 154.002 of the Texas Family Code.
    So why didn't Mother have him covered on HER health insurance?
    Parents should remember 3 things: Love your kids more than you hate your ex; when you have children the relationship with the other parent is until death; your children determine what type of nursing home you end up in.
    Nothing stated by me should be taken as giving you legal advice or forming an attorney/client relationship.

    Attorney-GAL in Ohio.

    I've removed the knife from my back, polished it, and will one day return it -- long after you think I have forgotten.
  10. #10
    Ohiogal is offline Senior Member
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    Quote Originally Posted by milspecgirl View Post
    it says dad is ordered to provide it thru his employer. He no longer has an employer if he is looking at unemployment. Is mom or stepdad not able to put the child on their insurance?
    The state does not care what a court order says- they are going to require the parents to reimburse the state for what the state pays. since dad obviously cant (since he's applying), they will go after mom to pay it.
    mom may be able to have the court order that dad reimburse her the costs but the court may take pity on dad being unemployed and change the order and decrease his support until he gains employment
    WRONG! It says that both MOM and DAD are each ordered to insure the child. So how is MOM going to get dad to reimburse HER the costs when she is in contempt as well as he is?
    Parents should remember 3 things: Love your kids more than you hate your ex; when you have children the relationship with the other parent is until death; your children determine what type of nursing home you end up in.
    Nothing stated by me should be taken as giving you legal advice or forming an attorney/client relationship.

    Attorney-GAL in Ohio.

    I've removed the knife from my back, polished it, and will one day return it -- long after you think I have forgotten.
  11. #11
    OHRoadwarrior is offline Senior Member
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    Did dad have the key that unlocks your lips?
  12. #12
    stevear22 is offline Junior Member
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    Quote Originally Posted by mistoffolees View Post
    I agree, but wanted to know what the order said to see if there was any contempt.

    Since the court says Dad must have insurance through his employer and he doesn't have an employer, he's probably not in contempt. Mom is also required to have insurance, btw.

    As you say, the state can go after Mom to collect the cost of Medicaid. However, if Mom were doing what the order says and carrying insurance on the child, Medicaid would not be necessary.
    Where does it say that it is ordered that the Mom carry insurance on the child?
  13. #13
    stevear22 is offline Junior Member
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    Quote Originally Posted by Ohiogal View Post
    WRONG! It says that both MOM and DAD are each ordered to insure the child. So how is MOM going to get dad to reimburse HER the costs when she is in contempt as well as he is?
    ok... it does say that in #1... but in #3 it more specifically says the father has to maintain him on his. In #5 it states that we may keep secondary coverage.
  14. #14
    TheGeekess is offline Senior Member
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    Quote Originally Posted by mistoffolees View Post
    I agree, but wanted to know what the order said to see if there was any contempt.

    Since the court says Dad must have insurance through his employer and he doesn't have an employer, he's probably not in contempt. Mom is also required to have insurance, btw.

    As you say, the state can go after Mom to collect the cost of Medicaid. However, if Mom were doing what the order says and carrying insurance on the child, Medicaid would not be necessary.
    e. after a termination or lapse of health insurance coverage, to furnish each conservator of the child and the child support registry with all documentation accessible to FATHER of the availability of enrollment of the child in a medical assistance program under chapter 32 of the Texas Human Resources Code or a state child health plan under chapter 62 of the Texas Health and Safety Code, no later than the fifteenth day after the date the enrollment in the program becomes available;
    f. to enroll the child at the next available enrollment period in a health insurance plan that is available at reasonable cost after the previous health insurance has been terminated or has lapsed; and
    g. to enroll the child in a medical assistance program under chapter 32 of the Texas Human Resources Code or a state child health plan under chapter 62 of the Texas Health and Safety Code if the child is eligible for enrollment in the program and no health insurance plan is available at reasonable cost.
    Dad is supposed to utilize state health insurance (SCHIPS/MEDICAID) if he can't get any other insurance.
  15. #15
    stevear22 is offline Junior Member
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    Quote Originally Posted by OHRoadwarrior View Post
    Did dad have the key that unlocks your lips?
    What are you talking about?

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