Medical Bills???

[whyohwhy]

What is the name of your state? North Carolina

According to my husband's divorce papers, the state of Ohio (where the court order is filed) calculates child support and then assigns a percentage to each parent. That percentage is used to cover medical bills that is not covered by both insurances. Therefore requiring him to pay child support and 80% of all medical bills. The problem is his ex-wife is accumulating medical and dental bills that she knows her and his insurance will not pay which results in him paying more and more. For example, his daughter has had 6 pairs of glasses and 2 boxes of contact lenses in 11 months. That he has to pay for. Meanwhile paying child support (that is current) and paying for braces. Is there anything that he can do to legally to change the percentage from 80/20 to 50/50? If he doesn't pay for these bills and continues to pay child support, will the courts garnish his wages for those bills? HELP!!!

[LdiJ]

Originally Posted by whyohwhy

What is the name of your state? North Carolina

According to my husband's divorce papers, the state of Ohio (where the court order is filed) calculates child support and then assigns a percentage to each parent. That percentage is used to cover medical bills that is not covered by both insurances. Therefore requiring him to pay child support and 80% of all medical bills. The problem is his ex-wife is accumulating medical and dental bills that she knows her and his insurance will not pay which results in him paying more and more. For example, his daughter has had 6 pairs of glasses and 2 boxes of contact lenses in 11 months. That he has to pay for. Meanwhile paying child support (that is current) and paying for braces. Is there anything that he can do to legally to change the percentage from 80/20 to 50/50? If he doesn't pay for these bills and continues to pay child support, will the courts garnish his wages for those bills? HELP!!!

No, he can't get it changed from 80/20 to 50/50....or at least there is very little chance that he could get it changed. Yes, the courts may garnish his wages if he doesn't pay his court ordered share of the medical bills.

However...6 pairs of glasses in 11 months is pretty outrageous...2 boxes of contacts is NOT....braces are not. Why in the world has the child needed 6 pairs of glasses in 11 months...particularly since the child has contacts? A judge would want to know the answer to that.

[frankrozanc]

Your husband may be liable from the medical providers for failing to pay his portion of them, and might be held in contempt of court for failure to pay. He needs to file a motion in the court where the decree was entered to have his ex-wife's practices reviewed by the court. Also, the standard Ohio health insurance order does not generally cover extraordinary child medical expenses, such as orthadontia, which are usually dealt with in a separate order.

[whyohwhy]

In order for these medical bills to get paid, it is her responsibility to send a bill for each doctor visitl. She is also required to send medical records for these bills. She refuses to send the medical records. She also sent a financial contract that she signed for the braces. Is that contract considered a bill? Is he entitled to get a second opinion or is his only right is to pay every bill that she sends to him? What if he financially can not send the full payment for each bill, what can happen?

[LdiJ]

Originally Posted by whyohwhy

In order for these medical bills to get paid, it is her responsibility to send a bill for each doctor visitl. She is also required to send medical records for these bills. She refuses to send the medical records. She also sent a financial contract that she signed for the braces. Is that contract considered a bill? Is he entitled to get a second opinion or is his only right is to pay every bill that she sends to him? What if he financially can not send the full payment for each bill, what can happen?

You are mistaken about the medical records. (unless their agreement is VERY unusual) She just needs to send a copy of the bill. Yes, the contract for the braces is considered a bill. Yes, he has to pay any bill that she sends (of course he only has to his share of the amount not covered by insurance) If he cannot send the full amount then he needs to at least make payments. Otherwise, he can be held in contempt.

What would he want to get a second opinion about? Once she sends him a bill the expense is already incurred.

[tigger22472]

I want to add something here. Your husband should take her to court for a modification stating that she is only to use doctors etc. within the network. Most insurance companies only allow one eye exam every one or two years. She could be ordered not to abuse the issue.

[whyohwhy]

Per the court order, "The parties share any and all medical and education information pertaining to the minor child with the other party". Which she refuses to do. The reason he wants a second opinion is because, his insurance was billed $5780 for braces that are only on the top 4 teeth. No where else. The child goes to the ortho once a month. He doesnt know why they are only on the top 4 teeth or what was wrong with her teeth to begin with. All he knows is that the braces will not be put on any other teeth.

Also per court order "Plaintiff (CP) shall submit any and all uncovered medical expenses to Defendant within 30 days from receipt of the explanation of benefits forms". What is explanation of benefits forms?

Per court order " Plaintiff shall immediately submit any and all medical expeses to Plaintiff's insurance carrier and Defendant's insuarnce carrier". She has never submitted anything to his insurance pertaining to her eye glasses or exams. His insurance allows one visit per year. How can she be ordered not to abuse the issue.

This is why it is so frustrating. She makes $20679 per year he makes $44370 per year. He pays 80% of all uncovered medical bills. According to CS he makes 44370 but according to his W2 he isn't. I understand that he is in the military and that he gets BAH and BAS but that is not taxable income. He would not be receiving those benefits if he was not remarried. He would only be receiving BAH-Diff not the full amount for housing. If he would get a re-enlistment bonus she is also entitled to a portion of that. Why?

[LdiJ]

Originally Posted by whyohwhy

Per the court order, "The parties share any and all medical and education information pertaining to the minor child with the other party". Which she refuses to do. The reason he wants a second opinion is because, his insurance was billed $5780 for braces that are only on the top 4 teeth. No where else. The child goes to the ortho once a month. He doesnt know why they are only on the top 4 teeth or what was wrong with her teeth to begin with. All he knows is that the braces will not be put on any other teeth.

Also per court order "Plaintiff (CP) shall submit any and all uncovered medical expenses to Defendant within 30 days from receipt of the explanation of benefits forms". What is explanation of benefits forms?

Per court order " Plaintiff shall immediately submit any and all medical expeses to Plaintiff's insurance carrier and Defendant's insuarnce carrier". She has never submitted anything to his insurance pertaining to her eye glasses or exams. His insurance allows one visit per year. How can she be ordered not to abuse the issue.

This is why it is so frustrating. She makes $20679 per year he makes $44370 per year. He pays 80% of all uncovered medical bills. According to CS he makes 44370 but according to his W2 he isn't. I understand that he is in the military and that he gets BAH and BAS but that is not taxable income. He would not be receiving those benefits if he was not remarried. He would only be receiving BAH-Diff not the full amount for housing. If he would get a re-enlistment bonus she is also entitled to a portion of that. Why?

It doesn't matter that BAS and BAH isn't income for tax purposes...its still income for child support purposes. Apparently any reinlistment bonus would be income for child support purposes as well.

He actually doesn't need her to "share" medical information with him, as the child's father he is entitled to get that directly from the providers...and should do so....particularly the orthodontist since he has questions. That part also doesn't have anything to do with unreimbursed medical expenses. Again, she doesn't have to give him medical records to get reimbursed, only the bill.

Does she have an insurance card for the child? If she does, then remind her to submit it to the eye doctor....and to use it when buying glasses. If she doesn't have one....GIVE her one.