Help-Dad enrolls adult son in plan without his knowledge

[Bluerat]

What is the name of your state?Oregon

My son is 22 years old. I have been divorced from his dad since he was a baby. His dad lives in Illinois and has not been in touch at all over the years. He paid child support as required and we’ve always been on our own healthcare plan. Over the past few years, my son has been on the Oregon health plan. He had medical issues throughout 2019 and 2020. We got a letter stating that Oregon Health Plan was reversing payment to my son’s doctor in 2019 because they were not in the network of Humana. When I ask about Humana, since we were not on that plan, I found out that his dad had put him on it with his other kids. He never told us anything about this so we had no idea. The only reason I can think of for him doing this is because it probably benefited him in some way—perhaps as a tax deduction?? He had issues with the IRS over the years, so this would not surprise me. Although I don’t know for sure his reason for doing it and I don’t know how to reach him.

Humana wouldn’t talk to us at first because his father apparently didn’t submit him under the correct birthdate. So we couldn’t track his membership down at first. We finally were able to but they still wouldn’t talk to us much without more information. All we know is that it expired in early 2020.

I am at a loss as to why his dad would do this and put us in such a mess. Is it even legal that he did this? My son was 21 when he was enrolled and wouldn’t my son need to give him permission first? I’m so confused. I wasn’t even sure if I needed to contact family law about this or ??

If we had known he was on this plan, we certainly would have taken advantage of it and put him in a better position medically than he was. But we chose the doctor that accepted Ohp, not Humana, so I don’t see why he has to pay this bill. By the way, we don’t even have the details of the bill yet so we don’t even know how much it’s going to be, but I would imagine it’s going to be several thousand dollars.

Was anything done here illegally? What are my son’s rights and recourse?

 

[cbg]

Under the law, Dad has the absolute right to provide coverage for his children until they reach the age of 26. It has nothing whatsoever to do with his taxes; the right is absolute whether his child is a tax dependent or not; in fact, he can insure his child until the age of 26 even if the child is married. So yes, it is legal that he did this, and although I have worked in employee benefits for over 40 years and am very familiar with the laws and processes, I am unable to think of any benefit Dad will receive if his son is covered that he would not receive if he is not covered. Particularly since he has other children covered as well.

When your son incurred these bills, since you did not know about the coverage through his Dad, obviously you must have submitted those bills through your insurance. What happened with your insurance for these bills? How would your Oregon providers know about Dad's Illinois coverage?

 

[Bluerat]

Under the law, Dad has the absolute right to provide coverage for his children until they reach the age of 26. It has nothing whatsoever to do with his taxes; the right is absolute whether his child is a tax dependent or not; in fact, he can insure his child until the age of 26 even if the child is married. So yes, it is legal that he did this, and although I have worked in employee benefits for over 40 years and am very familiar with the laws and processes, I am unable to think of any benefit Dad will receive if his son is covered that he would not receive if he is not covered. Particularly since he has other children covered as well.

When your son incurred these bills, since you did not know about the coverage through his Dad, obviously you must have submitted those bills through your insurance. What happened with your insurance for these bills? How would your Oregon providers know about Dad's Illinois coverage?

So I understand that he had this right but he never told us. Apparently, Oregon health plan, which is our state plan, found out somehow that my son was enrolled. I still don’t understand how they found out. I had no idea so it certainly didn’t come from me. And I would’ve happily chosen a doctor in the Humana plan had I known because the Oregon health plan doesn’t leave us with many options. But because we didn’t know, we ended up unknowingly choosing an out of network doctor and now we are stuck with this big bill. This is the part that I’m concerned about is the fact that his dad didn’t even tell us about this. What’s the point in paying for something if you know the person cannot even use it? And the fact that he chose to do this was not out of the goodness of his heart. He had to have had an ulterior motive. He fought me for years to be able to claim our son as a dependent for tax purposes but had no interest in being in his life otherwise. I didn’t allow him to because he was very inconsistent with filing and kept getting into trouble with the IRS. He was not someone who would just voluntarily insure his son because it was the right thing to do. I heard this theory from someone else and it doesn’t add up with this individual. If that were true, he would be chomping at the bit to tell us so that we could take advantage of such a wonderful opportunity. He certainly could’ve used the help the past two years. I’m wondering if this could be more of a family law issue? As far as a non-custodial parent required to communicate with the custodial parent regarding things like insurance? If he wants to insure my son, great! I’m all for it. But we just need to know so that we choose a doctor that will actually be covered. It’s pretty common sense. It looks like he only did it for a period of time and then dropped him. That’s the part I don’t understand either.

 

[cbg]

I am unable to locate any law that requires a parent to notify their child that they have been insured or procure the child's permission.,

Maybe it doesn't make sense. But nothing illegal occurred.

 

[Taxing Matters]

He would not have added your son simply to get a tax deduction if he was thinking logically. Health insurance costs money. If he added your son because doing that would increase his medical care expense deduction that would mean that adding your son was costing him additional money in health insurance premiums. So let's suppose that the increased premiums amounted to $1000 over the tax year. Assuming he was eligible to take the medical expense deduction, that would mean he'd get a deduction of $1000. But that deduction does not reduce tax by $1000. It simply reduces his taxable income by $1000. The amount of tax that is saved is a fraction of that; exactly how much tax savings there would be depends on his marginal tax rate. Keeping the math simple, suppose that his marginal tax rate is 25%. That would mean the $1000 deduction saves him $250 in tax. But spending $1000 to save $250 in tax is, of course, not a smart financial move. You'd only do that if you were getting some benefit from the $1000 beyond just the tax savings.

The only other benefit to health insurance for the kid is, of course, the health benefits that the kid gets. But if he didn't give a damn about your son, as you imply, he wouldn't care about providing health benefits for the kid, at least not at extra expense. The tax deduction certainly wouldn't make that worthwhile. And if he really did care about providing the health care benefits, it would of course make sense for him to tell your kid about the coverage.

Thus, my best guess is that he simply filled out the forms the insurer gave him and where it asked him to list his kids under age 26 he just answered the question and didn't think about the fact that by doing that he was getting coverage for the kid. If that's what happened then he wouldn't have told your kid about the coverage because he himself wasn't really aware that he got the coverage. And the reason the kid got dropped about a year later may have been because after he signed the kid up the first year he realized the mistake and dropped him at the earliest chance he had — the next open season or when he changed health insurers.