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Author Topic: BM won't use both insurance policies  (Read 7850 times)

MixedBag

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Re: BM won't use both insurance policies
« Reply #10 on: Jul 10, 2013, 06:40:20 AM »
Medical Insurance, Dental Insurance, Perscription Insurance, Vision Insurance -- all separate companies, but in terms of "insurance" -- handle them all the same way.
 
And NOPE, do not reimburse the other parent until properly processed.
 
And YEP, start a letter writing campaign to all individuals/companies involved and send it in a way that you can track the other side received it.
I'm not in favor of "certified"mail -- when there's first class delivery confirmation available now a days.  And even priority confirmed delivery....
 
THEN use certified to send a stronger message when they continue to play the GAME of "Geez, I didn't get that memo"


MixedBag

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Re: BM won't use both insurance policies
« Reply #11 on: Jul 10, 2013, 07:05:26 AM »
another thought that just came to mind.
 
You're talking Pharmacy and medicine -- but also talking medical deductibles (I think)....
 
IMHO -- that's mixing apples and oranges -- both "medical" issues (like that's both fruit), but one is the medical insurance (visit to the doctor where there is a high deductible), and the other is pharmacy/perscription insurance (for the Adderal/medicine).
The "high cost" of the medicine is not going to be applied to the medical deductible side of the house (IMHO).
 
I shared the complicated situation of my past above......and never was the true cost or any cost of my medications applied towards my deductible on the medical policy.
 
For example.....annual physical OB/GYN exams are medical.  I have $150 deductible then 80/20.  Then, every month I go get my BCP....that's separate and about $5 a month.  The two don't blend......because they are handled under separate programs.  So the annual cost to me of $5 x 12 of $60 does not go toward the $150.
 
Just trying to share and help.....k?  sometimes understanding outside influences help make things clearer and stuff starts to settle down.

Apple

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Re: BM won't use both insurance policies
« Reply #12 on: Jul 10, 2013, 10:22:19 AM »
Good point on the meds not going towards deductible.  I'm sure you're correct.
 
BM's birthday is in May, DH in December.  But the order is for DH to carry insurance, I'm guessing BM is carrying it too because it's free or very inexpensive, not sure.
 
Twist to this now...   BM is suggesting they remove the clause that DH must cover SD and just use BM's policy.  DH asked her for copies of the coverage her employer offers and a recent paycheck.  We want to calculate to see if DH dropping policy on SD would be enough to increase his CS obligation and what kind of coverage she actually has. 
 
Waiting for the documents from BM...
 

MixedBag

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Re: BM won't use both insurance policies
« Reply #13 on: Jul 10, 2013, 12:18:24 PM »
Seee....BM using Birthday rule -- and potential increase in CS.
 
Dad using court order....
 
As for the CS, ask the Family Court Clerk for a copy of the last CS calculation work sheet.
 
It might already be on there so you can see how it overall effects that part of the equation.
 
Personally (since at one time there were 3 insurances on some of the kids), I'd carry the child until BM files a motion etc.
 
Then I'd STILL carry the child....just to be safe.
 
Chances are that the policy is single and then family.  So if you two are married -- and "drop" his child, there won't be a savings.
Chances are that the court will include Mom's premiums into the calculations similarly to whatever they did for Dad's...
 
WV court did it one way, NV court another....AL court a third (different cases, but same subject), so there is no ONE WAY -- except how it was handled in the past by Dad's judge.

Apple

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Re: BM won't use both insurance policies
« Reply #14 on: Jul 10, 2013, 02:43:40 PM »
Trust me, BM knows nothing about any rules!   :D
 
Yep, we have access to the on line CS calculator for our state and will run the numbers every which way when we see how much BM pays for insurance and how much she makes. 
 
Actually, if we didn't cover the SD we'd each go single on our respective employers plan and save over $250 each  month.  In our case, singe + single is WAY less than 1 +. 
 
BUT this is all dependent on BM getting us the paperwork.  Until then, we'll keep the SD covered and require insurance to be used as it should before we pay her.


ocean

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Re: BM won't use both insurance policies
« Reply #15 on: Jul 10, 2013, 03:00:17 PM »
Keep insurance until you go to court. He is court ordered to keep it, so he can not stop until he gets to court.

Sounds like child is on monthly meds, how much would it be out of pocket with her insurance each month? if is a small amount then not worth spending it on your insurance.

Make a deal with her, You will give her xx ($150?) more a month BUT she pays copays. Some people have that they split medical/prescriptions IF it goes over a certain amount.

Does BM have a family plan now? Does she have other children? If she has other children then when you figure her cost, figure in the other children or you can make the argument that since there are other children on the plan it does not cost her anything for this child.



MixedBag

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Re: BM won't use both insurance policies
« Reply #16 on: Jul 10, 2013, 07:15:32 PM »
That's if you trust mom to keep the insurance going....how stable is she in that area?
 
I can see Ocean's point....sorta...
 
And fortunately, if BM drops insurance on SD, that should be an event where either Dad or SM can pick her up within 30 days even if it is outside the open enrollment period.
PROVIDED BM tells either one of you that she dropped the insurance.
 

Kitty C.

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Re: BM won't use both insurance policies
« Reply #17 on: Jul 11, 2013, 01:50:55 PM »
Why couldn't he just go to the pharmacy with his ins. and CO and tell them to register his insurance and it MUST be used first, per the CO?
Handle every stressful situation like a dog........if you can't play with it or eat it, pee on it and walk away.......

MixedBag

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Re: BM won't use both insurance policies
« Reply #18 on: Jul 11, 2013, 07:42:31 PM »
Kitty -- because of the birthday rule...
 
That confuses "people" in general because Dad has a court order saying one thing, and "industry standard" says Mom's birthday falls first.
 
I would agree to give it a try....but honestly, I'm not sure where it would get anybody as more and more information from this poster gets shared.
 
I think the poster was wanting the pharmacy medication to count towards medical deductible -- because she mentions how expensive it is...  Well, that ain't gonna happen no matter what.
 
Then, I would think it's smart to use who ever's perscription co-pay is cheaper -- and that could be BM
 
HOWEVER, even with perscriptions, both insurances can be used -- and maybe the together will cover 100% maybe not.....
 
What about Dad approaching his insurance and saying "Hey I'm secondary now using the birthday rule, so here please process this perscription against my insurance too?"
 
This case for these people -- goes back and forth.

Apple

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Re: BM won't use both insurance policies
« Reply #19 on: Jul 15, 2013, 05:48:32 PM »
DH insurance is primary and can't be changed to secondary without a CO.  This is according to the insurance company.


My biggest concern is the net cost of medical expenses.  Because BM is only using her insurance neither is getting the benefit DH insurance.  And net out of pocket is more than it should be for both parents.


BM has now presented DH with bills from several months ago asking for 50%.  SD were covered under DH insurance and Medical Assistance at the time.  One bill is for glasses for OSD.  DH asked BM why MA didn't cover the portion insurance didn't.  Her response was that OSD prescription didn't change so MA would not cover new glasses.  So is DH responsible for 50% of glasses that weren't necessary?   SD had perfectly good glasses.  What's to stop any parent from taking advantage? 


Since SD were on MA DH has never had to deal with these issues. 








 

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