Medical Support / Health Insurance

[snowmen]

What is the name of your state? Tennessee

I have another question in regard to Health Insurance. I have provided my ex with Health Insurance on our teenage son. The insurance has over 30 pages of Pediatricians/Primary Care Physicians that would only cost us a co-pay of $15.00. However, she is taking him to a doctor that does not accept the co-pay and therefore, we are out a deductible plus 20%. Do I have any recourse on making her take him to a dr. within the PPO/copay? I live out of state and always choose the best plan(lowest copays/ded.) my employer offers to attempt to keep the medical bills to a minimum. Thanks for any advice/help.

 

[stealth2]

Let's start with exactly what your order says about insurance and non-insured expenses.

 

[snowmen]

It requires that I carry insurance medical/dental coverage for our son. She is allowed to carry her insurance but only as secondary coverage at her cost but only if she wants too. Any prepayment of expenses are to be shared equally and any reimbursements by insurance are to be shared equally 50/50.

 

[stealth2]

I'm going to play BelizeBreeze for a moment and say - that is not exactly what your order says. Please - type it out so that we can figure out if there's any other way to interpret it. Thanks.

 

[snowmen]

Okay its long, but here goes:

Father shall continue to be responsible for providing medical insurance on the parties minor child. The parties shall share equally in any uncovered medical expenses of said child. If the Mother has insurance coverage for the child available to her, then Mother may elect to insure the child as well and the Father's insurance shall be the primary coverage and Mother's insurance shall be the secondary coverage. If either insurance requires prepayment of any expenses, then the parties shall share equally in said prepayment and any reimbursement shall be immediately disclosed and said reimbursement shall be divided equally.

 

[stealth2]

Okay, I would refuse to pay any more than the half of the copay that you're required to pay for an in-network doctor. Let her take you to court for it - and make sure you have a current copy of doctors who will take that insurance with you.

I'm on the flip side - my ex has insurance that has no in-network docs in our area. I was told that his insurance meets the requirements of our order and unless he agrees to my taking them to a doctor here - he doesn't legally have to pay a dime. Of course, he never agrees to my taking them to a doctor.

 

[snowmen]

I been covering my son for 10 years and during the first few years of coverage it was only out of network docs because we live in different states. At that time I paid my 1/2 of whatever the insurance didn't cover -we had no choices. But now insurance companies, in my opinion, have gotten wise to the CP/NCP interstate problems with insurance and have been able to provide PPO's for both states - everybody benefits!
Thanks