Medical bills

[NCMomof5]

What is the name of your state (only U.S. law)? Paperwork in TN, we reside in NC.

My ex is supposed to pay uncovered medical. It says in our order that we will pay pro rata in accordance with our income. The child support worksheet says I have 27% of the income while he has 73%. That means he would be responsible for 73% of these bills, correct?

I emailed him our last bill (a scan of it) and he did reply to the email and acknowledge that he got the bill, but has not paid anything towards it, claiming he can't afford to pay. I told him even half would be fine. That was February 15th. We had another appointment on Monday, and I again emailed him the scan of the bill, and I also sent it as a message on facebook because he has mentioned that he goes there more often than he checks email. He has not replied, but I can see that he has been online multiple times since then. I understand that for a contempt case, I would need proof that he has recieved the bills. Would printing out the emails for the first one be sufficient? How would I go about getting the other bill to him? He is deployed, and will not give me his deployment address and I don't think I could send anything CRR anyways. He has given me his "home" address where his girlfriend lives, but I am afraid if I mail it there he won't ever actually see it.

He owes over $400 at the moment, and we have more work coming (one of my children is autistic so we do just one tooth at a time. Each time he has to have anesthesia which insurance does not pay towards at all, so it adds up very fast) which will total over $1200 for his part by the time the whole treatment plan is completed. Is this an amount that would even be worth filing on? I am really struggling.

 

[Ohiogal]

How much does dad earn? It could be possible that he doesn't have the money. In order to prove contempt you have to show that he is WILFULLY not paying it -- in other words he has the money (or could have the money if he were not wilfully underemployed or unemployed). Does your child qualify for state medical?

 

[NCMomof5]

This is for three kids. It is expensive which is another reason I've broken it into separate sessions. They do qualify, but I have been unable to find a pediatric dentist within 2 hours that will take medicaid. As it is, I am driving an hour away to see the one we are seeing.

He makes 3 times as much as I do, over $4k a month, plus he is deployed and earning more right now. He should be able to afford it, but it is possible that he has gotten himself into a hole with bills. I know he is supporting his girlfriend back in the states, but my feeling about that is that his kids dental needs should come before his girlfriends cell phone bill. She can get a job, the kids can't.

I did tell him I would be willing to take just half of it, so I am trying to work with him on the issue. I really can't afford it either, but the oldest especially has bad problems with his teeth (He needed multiple root canals). I don't know why his teeth are so bad, we brush three times a day, and he's always gone in for his cleanings as scheduled, and has sealants on these molars.

 

[mistoffolees]

I would file for contempt. It should be straightforward enough that you could do it without an attorney.

HOWEVER, you may have a problem if he's still deployed. You might have to wait until he's back in the country.



NOTE:
After reading the additional information provided below - my response would have been different. OP would have a very hard time winning a contempt hearing.

 

[NCMomof5]

Yes, I figured he would hae to be back first, and he may pay them before he comes back. I am hoping anyways. I wish I could find somewhere cheaper to take them, but my oldest has such a hard time at the dentist anyways that a lot of people won't take him after an initial consultation. The current dentist works with him really well, and they do take the tricare insurance, however tricare won't pay anything at all for him to have nitrous, which I think completely sucks. It is mainly his bills that are owed, the other kids just needed simple fillings, and were done in one visit.

So does anyone know where I should send the bill to then? I do have the address at his unit back in the states but I don't know how long it would take for him to get them from there.

 

[neopandora]

This is for three kids. It is expensive which is another reason I've broken it into separate sessions. They do qualify, but I have been unable to find a pediatric dentist within 2 hours that will take medicaid. As it is, I am driving an hour away to see the one we are seeing.

He makes 3 times as much as I do, over $4k a month, plus he is deployed and earning more right now. He should be able to afford it, but it is possible that he has gotten himself into a hole with bills. I know he is supporting his girlfriend back in the states, but my feeling about that is that his kids dental needs should come before his girlfriends cell phone bill. She can get a job, the kids can't.

I did tell him I would be willing to take just half of it, so I am trying to work with him on the issue. I really can't afford it either, but the oldest especially has bad problems with his teeth (He needed multiple root canals). I don't know why his teeth are so bad, we brush three times a day, and he's always gone in for his cleanings as scheduled, and has sealants on these molars.

You are correct as to how pro rata works on the plan. However, based on the above, you may find it hard to get a TN Judge to hold him in contempt. If you read the parenting plan closely you will see it says something along the lines of uncovered reasonable and necessary medical expense.

ETA: While I agree with you about the nitrous, it's not paid under the "medically necessary" part of insurance and the Judge could very well rule Dad doesn't have to pay a portion of that if Dad balks. However, when Dad is stateside, let him take little one to the dentist and I would bet he will more than likely agree nitrous is necessary to calm your (pl) child.

I've seen more than a few TN Judges say the NCP doesn't owe because of the above language in cases where the CP went outside of the insurance for coverage (providers not covered under the plan or outside of network). Many of them view that if you choose an alternate provider for convenience or by preference, that's on your dime.

As an aside, I have had terrible teeth most of my life despite all the efforts to take care of them. If your child drinks carbonated beverages with any regularity, you will want him to stop. And, on special occasions where they are drank, have him brush or rinse out with water immediately afterwards. It will make any dental situation worse as it will soften the enamel including at the gum line and between the teeth.

 

[NCMomof5]

We are using the insurance he provides. Tricare pays for cleanings, but almost anything else we have to pay a cost share, which is 40-60% of the allowed amount. The dentist we are seeing is a Tricare network dentist, so they are only billing the amount that tricare allows them to bill for each procedure. The only thing I could maybe see as a possible issue of being outside of reasonable would be the nitrous. That costs $52 each time we go. If I had to eat the cost of that myself I would, because I feel it is necessary, and the dentist agrees, that in his case we have to use it. They don't use restraints on him at all. The other dentist we saw wanted to skip nitrous and use the straight jacket thing, and I think for him that would have been extremely traumatic. I don't want him to see the dentist as a scary terrible place.

He drinks mostly water. We do have juice once in awhile, about a jug a week, but the three kids are all drinking it so it comes out to 1-2 glasses a week. Once it's gone, it's gone until the next time we go to the store. We don't keep carbonated anything here, the only time he has that is when we are out to eat, which is rare, at most once a month. He does eat a lot of citrus fruit. I suspect that plays a part in the enamel problems, but he has such a limited diet (self limited, he has sensory issues and is very picky about what he will eat) that I hate to take something healthy away, kwim?

 

[Ohiogal]

This is for three kids. It is expensive which is another reason I've broken it into separate sessions. They do qualify, but I have been unable to find a pediatric dentist within 2 hours that will take medicaid. As it is, I am driving an hour away to see the one we are seeing.

He makes 3 times as much as I do, over $4k a month, plus he is deployed and earning more right now. He should be able to afford it, but it is possible that he has gotten himself into a hole with bills. I know he is supporting his girlfriend back in the states, but my feeling about that is that his kids dental needs should come before his girlfriends cell phone bill. She can get a job, the kids can't.

I did tell him I would be willing to take just half of it, so I am trying to work with him on the issue. I really can't afford it either, but the oldest especially has bad problems with his teeth (He needed multiple root canals). I don't know why his teeth are so bad, we brush three times a day, and he's always gone in for his cleanings as scheduled, and has sealants on these molars.

Actually if they qualify for medicaid he may not have to pay because you are CHOOSING not to take them to a dentist that will cover them Is there a DENTIST that takes medicaid that also treats children within a certain mileage? Maybe affiliated with a local hospital. If so, You are making a decision which is costing him money. Hence, that may not qualify as contempt against him.

 

[NCMomof5]

There are dentists that will take medicaid yes. I was completely unable to find any other endodontist that would see him, because of his age and his condition, unless I drove to Charlotte, which is 3+ hours away. It does say in our decree that I am on the hook if I take them to a non netowrk provider, unless there isn't one withina 60 mile radius. This IS a network provider though.

I was not ordered to apply for state medical for them, and he was ordered to provide insurance. We are using the insurance. I wish I could find a cheaper alternative. I make minimum wage so I am struggling to pay for this myself.

 

[Ohiogal]

There are dentists that will take medicaid yes. I was completely unable to find any other endodontist that would see him, because of his age and his condition, unless I drove to Charlotte, which is 3+ hours away. It does say in our decree that I am on the hook if I take them to a non netowrk provider, unless there isn't one withina 60 mile radius. This IS a network provider though.

I was not ordered to apply for state medical for them, and he was ordered to provide insurance. We are using the insurance. I wish I could find a cheaper alternative. I make minimum wage so I am struggling to pay for this myself.

Great. He was ordered and he is doing so> But YOU are not taking them to the closest provider that will cost the least. That is where dad has a defense. You are making decisions that are costing him money. A great deal more money than YOU have to pay. So you should take them to a dentist that takes medicaid as well as tricare. Then your out of pocket would be NOTHING. You are choosing to take them to someone who doesn't take medicaid as well. You may very well lose this. And did you make sure dad was informed of the medicaid coverage?

 

[NCMomof5]

There isn't a pediatric endodontist, or even a regular endodontist that will agree to see him, within a reasonable distance, that takes medicaid. He is having root canals done, those cannot be done at a regular dentist office, or at least not at any of the local dentists offices that I called. They all said they would have to refer us out to an endodontist.

 

[NCMomof5]

I've been taking them to see this dentist since we have lived here. In the past, they have needed just minor stuff done and the costs are small ($12-16 for a filling, etc) so I have just eaten the cost myself. I am asking him to help out this time because there is extensive work being done. Yes, they could go to a closer dentist that will take medicaid, for regular work. The bills that I am asking him to pay, the vast majority are not for the regular work, they are about 90% for the one child, and for the root canals. For those, I have been unable to find any cheaper option. I have told him if he could pay 50% I would be ok with that. 50% of the whole bill is less then the 73% he would be paying on just the endodontist stuff that I really don't have the option to take elsewhere, unless I drive to Charlotte once a month for the next 6 months, and it says specifically in our decree that I won't have to do that.

There is another pediatric endodontist that taked medicaid, in Wilmington, but that is still over 60 miles away, and they were not accepting any new medicaid patients when I called. There honestly just isn't much to chose from where we are at.

 

[neopandora]

Great. He was ordered and he is doing so> But YOU are not taking them to the closest provider that will cost the least. That is where dad has a defense. You are making decisions that are costing him money. A great deal more money than YOU have to pay. So you should take them to a dentist that takes medicaid as well as tricare. Then your out of pocket would be NOTHING. You are choosing to take them to someone who doesn't take medicaid as well. You may very well lose this. And did you make sure dad was informed of the medicaid coverage?

I agree 100% with this and you said it much clearer than I did. I've seen many TN Judges rule with the NCP on these very same issues.

OP - I get what you are saying, I do, but I'm afraid the Judge is going to see that there was a free/reduced cost option and you want Dad to pay for your choice. I've seen it happen more than not.

 

[NCMomof5]

So I suppose then the better option would be to take him to the local dentist who will tie him up and pull all those molars (which would leave him with no adult molars) rather than trying to save the teeth? That seems really messed up....And having them pulled really is the only other option outside of this ONE dentist who agreed to see him and do the root canals. He has had one done there before a year and a half ago where his dad DID pay for half of it. Does that make any difference at all?

 

[mistoffolees]

So I suppose then the better option would be to take him to the local dentist who will tie him up and pull all those molars (which would leave him with no adult molars) rather than trying to save the teeth? That seems really messed up....And having them pulled really is the only other option outside of this ONE dentist who agreed to see him and do the root canals.

Oh, well. You can't always get what you want.

You have several choices:
1. Choose the most reasonably priced dentist - which would be what is required as reasonable.
2. Choose any dentist of your choice - and pay the difference out of your own pocket.
3. Talk with Dad about the issue and see if he will pay part of the extra so you can choose a different dentist. However, Dad has NO obligation to go along.

He has had one done there before a year and a half ago where his dad DID pay for half of it. Does that make any difference at all?

Nope.