Will I be held responsible?

[skramer]

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

I provide insurance for my child that does not live with me that includes medical and dental with the exception of a small copay on office visits and prescriptions. This insurance is set as the primary insurance and only insurance because the mother is not required to provide one on her behalf.

Months ago FOC added a monthly fee to my child support that was supposedly under the medical part of the support which I assumed was going for part of the co pays. I recieved a print out of the break down of my support and the extra medical I am paying for is going to Medicaid.

I had arrearges from long before when the mother was on welfare/medicaid and I paid that off so the amount I am paying is not for back support.

Question:

I am under the impression that in low income families it is okay to have medicaid as a secondary. If the mother lied about what she makes, or that there is no primary insurance can Medicaid come after me to pay back what ever was paid out on my child through this insurance? I checked with my primary insurance and my child has not used it in over a year which makes me think that the mother is using Medicaid as the primary insurance.

Does this count as fraud? I am afraid that if it used as a primary they will want the money back and come after me for it since I paid the full amount for the Medicaid from before.

Thank you for any advice, I posted this in the child support forum and did not receive a reply so I am hoping that maybe someone in the insurance side can help me.What is the name of your state (only U.S. law)?

[ecmst12]

You should call both Medicaid and the primary insurance and inform them both about what has been going on. Hopefully the 2 companies can work it out among themselves (the primary can pay medicaid) so you won't have to worry too much. But mom is causing the problem by not informing his doctors about the correct primary insurance. I'm not sure if it rises to the level of Fraud, but Medicaid might see it that way.

[vestagrayanna]

I'm not sure I'm 100% clear on your post. But, if you have been court ordered to provide insurance, your plan would indeed be primary. Medicaid would be secondary assuming your child qualifies. If your ex has knowingly used Medicaid as primary to somehow circumvent your primary plan, yes, that is fraud, no question about it. However, I don't think you're going to get anyone to care unless there are really large dollars at stake. If Medicaid has paid money as primary when there was another primary payer, rest assured that Medicaid will recoup that money from the other insurer. It might take them 5 years unless they are notified sooner, but they will get there all by themselves. It's not likely, in my opinion, that you personally will be out any substantial payments as Medicaid will seek only to correct the order of payment. IE your insurance to pay first, Medicaid to pay second and you to pick up any balances after both payers have paid.

[skramer]

Yes it is court ordered and the insurance is provided through my employer. I just wanted to make sure that the Medicaid bill will not end up on me because she is running it instead of mine as primary. I think she is either doing it because of the co pays (which is small) or because she does not want me to know what she is doing. Can Medicaid go after her or myself if they can not recoup the money? My insurance is only accepted by certain places and she may be going somewhere that is not covered by mine, what then?

I also do not understand why I am providing the primary AND paying monthly for Medicaid? Shouldn't she be responsible for providing the secondary if she is not wanting to pay the co pays for mine?

Thanks for your help.

Originally Posted by vestagrayanna

I'm not sure I'm 100% clear on your post. But, if you have been court ordered to provide insurance, your plan would indeed be primary. Medicaid would be secondary assuming your child qualifies. If your ex has knowingly used Medicaid as primary to somehow circumvent your primary plan, yes, that is fraud, no question about it. However, I don't think you're going to get anyone to care unless there are really large dollars at stake. If Medicaid has paid money as primary when there was another primary payer, rest assured that Medicaid will recoup that money from the other insurer. It might take them 5 years unless they are notified sooner, but they will get there all by themselves. It's not likely, in my opinion, that you personally will be out any substantial payments as Medicaid will seek only to correct the order of payment. IE your insurance to pay first, Medicaid to pay second and you to pick up any balances after both payers have paid.