Insurance Question

[Newlydivmomto4]

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

I was just reading how our chidlren's insurance will be changing next year due to budget cuts for military retirees. Life goes on, no big deal, the kids will still have insurance.

My question arises when for their insurance it says the annual deductible is $300 per family. The "family" in this case consists of my ex, our 4 children, ex's wife and their two children. Due to his retiring/lack of finding a new job/VA disability not paying yet, I have been footing the medical copays, childcare etc, and only receiving 1/2 of child support; this should all change around January when he should be getting his VA disability in addition to his retirement check. Then October will come around and this new policy will take effect on the kids insurance. Obviously with the number of "family" members, the annual deductible will be met quite quickly, but whose responsibility is it to pay for it? The div decree says dad provides insurance, which he has faithfully done, and the out of pockets are split 50/50.

 

[ecmst12]

It depends on which family member incurs the bill. If it's your child's bill, you and dad split it 50-50 per your court order. If it's someone else's bill, it has nothing to do with you. You will have to wait for the bills to be submitted and you get the explanation of benefits back.

 

[SESmama]

I think OP is asking who is responsible for the premium on the insurance.

If it is dad's policy then dad is responsible. Would be nice if you guys split the cost if it is going up. The cost of your mutual child's portion that is.

 

[Zigner]

I think OP is asking who is responsible for the premium on the insurance.

What makes you think that?

Obviously with the number of "family" members, the annual deductible will be met quite quickly, but whose responsibility is it to pay for it?

 

[Newlydivmomto4]

Its not for the premium, its for the deductible. Sorry, I have never had to deal with deductibles before.

Thanks for the answers, to add a question on from another response. Dad has always been responsible for the insurance. His premiums have gone up since he retired, that said, it does not matter if he has 2 kids or 6 kids on the insurance, its the same amount. He has not asked me to help pay for it, but I'm wondering how the courts would look at it. I realize there aren't any crystal balls on here, but would I have to pay half his premium when the premium also covers his wife and 1.8 children (she's pregnant)?

 

[latigo]

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

I was just reading how our chidlren's insurance will be changing next year due to budget cuts for military retirees. Life goes on, no big deal, the kids will still have insurance.

My question arises when for their insurance it says the annual deductible is $300 per family. The "family" in this case consists of my ex, our 4 children, ex's wife and their two children. Due to his retiring/lack of finding a new job/VA disability not paying yet, I have been footing the medical copays, childcare etc, and only receiving 1/2 of child support; this should all change around January when he should be getting his VA disability in addition to his retirement check. Then October will come around and this new policy will take effect on the kids insurance. Obviously with the number of "family" members, the annual deductible will be met quite quickly, but whose responsibility is it to pay for it? The div decree says dad provides insurance, which he has faithfully done, and the out of pockets are split 50/50.

Your question deals solely to with the language of the divorce decree and has nothing to do with the father's personal issues with United States Department of Veteran Affairs!

If the decree specifically directs the father to keep the health insurance coverage in place, that means he is responsible for the cost of maintaining that coverage.

Had the court intended for the husband to assume full responsibility for all costs related to that coverage it would be stated in the decree.

Unless I am misunderstanding your question, I fail to see the problem in understanding that "out of pocket" in this context means health care costs over and above premium costs. Or that keeping the premiums current has anything to do with the annual deductible.

 

[Newlydivmomto4]

Your question deals solely to with the language of the divorce decree and has nothing to do with the father's personal issues with United States Department of Veteran Affairs!

If the decree specifically directs the father to keep the health insurance coverage in place, that means he is responsible for the cost of maintaining that coverage.

Had the court intended for the husband to assume full responsibility for all costs related to that coverage it would be stated in the decree.

Unless I am misunderstanding your question, I fail to see the problem in understanding that "out of pocket" in this context means health care costs over and above premium costs. Or that keeping the premiums current has anything to do with the annual deductible.

Not sure why I am getting chastised for giving background, but okay.

The question I was asking is when it comes to paying the 300 dollar family deductible. I believe that is considered part of the 50/50 out of pocket expenses. What I am wondering is (for sake of discussion, our children 1-4, their children 5-6) if child 5 goes to the doctor and meets 180 of the deductible, then child 1 goes to the doctor and has 120 of the deductible, can he say that he has already paid 180 of the deductible and that the 120 is my responsibility? Like I said in previous posts, I have never had to deal w/ deductibles and right now I am footing all the out of pocket expenses because he cannot pay anything towards them. I am looking at the future and what the children's expenses will be in the future.

 

[cbg]

Who is responsible for what is decided by the terms of your divorce decree, not by law.

 

[Zigner]

Not sure why I am getting chastised for giving background, but okay.

The question I was asking is when it comes to paying the 300 dollar family deductible. I believe that is considered part of the 50/50 out of pocket expenses. What I am wondering is (for sake of discussion, our children 1-4, their children 5-6) if child 5 goes to the doctor and meets 180 of the deductible, then child 1 goes to the doctor and has 120 of the deductible, can he say that he has already paid 180 of the deductible and that the 120 is my responsibility? Like I said in previous posts, I have never had to deal w/ deductibles and right now I am footing all the out of pocket expenses because he cannot pay anything towards them. I am looking at the future and what the children's expenses will be in the future.

With this scenario, I would say that you would be responsible for $60 of the $120.

 

[Zigner]

Who is responsible for what is decided by the terms of your divorce decree, not by law.

Right - and the OP is asking for help in interpreting the decree based on the circumstances.

 

[Newlydivmomto4]

With this scenario, I would say that you would be responsible for $60 of the $120.

Thank you Zigner. I ask these questions now because in the past with dental work he has said something along the lines of, I paid the insurance premiums and my insurance paid for more than half so you are responsible for the rest. We straightened that out a few years back, new things seem to always draw new problems. lol

 

[OHRoadwarrior]

I would say the order is clear. You draw 50% of out of pocket for your children. That appears to be pot luck, based on where they fall in the billing year. By the time they incur a bill, you may pay nothing or $150.

 

[nextwife]

The deductable is only $300 a year for EVERYONE combined? Holy smoke, that's a deal!

You should be thrilled your ex got a plan with such a really tiny deductable.

 

[LdiJ]

Not sure why I am getting chastised for giving background, but okay.

The question I was asking is when it comes to paying the 300 dollar family deductible. I believe that is considered part of the 50/50 out of pocket expenses. What I am wondering is (for sake of discussion, our children 1-4, their children 5-6) if child 5 goes to the doctor and meets 180 of the deductible, then child 1 goes to the doctor and has 120 of the deductible, can he say that he has already paid 180 of the deductible and that the 120 is my responsibility? Like I said in previous posts, I have never had to deal w/ deductibles and right now I am footing all the out of pocket expenses because he cannot pay anything towards them. I am looking at the future and what the children's expenses will be in the future.

Basically what it means is that you each cover 1/2 of the costs related to your relative children until the deductible is used up.

As far as the premium is concerned, your children do not cost him any additional money, therefore it is highly unlikely a judge would require you to pay 1/2 of his premium.

 

[Newlydivmomto4]

The deductable is only $300 a year for EVERYONE combined? Holy smoke, that's a deal!

You should be thrilled your ex got a plan with such a really tiny deductable.

He's earned it, trust me. Its Tricare Standard, only reason we are going to standard next year is because of budget cuts. Still can't complain, its better than most civilian insurance.

Basically what it means is that you each cover 1/2 of the costs related to your relative children until the deductible is used up.

As far as the premium is concerned, your children do not cost him any additional money, therefore it is highly unlikely a judge would require you to pay 1/2 of his premium.

Thanks for answering. I try to be prepared as much as I can.