who is responsible for what the insurance doesn't pay?

[wlf]

hope someone can help with my question. i live in nc.my child support order was done by the system here in my county.my child lives in wv.on my support order it states the amount i am to provide monthly for support and that i am to provide my child with medical insurance.which i have been doing since we got everything settled.my question is my daughter had to go to the hospital for the first time since everything was settled. pretty big bill,mother says i'm responsible for what the insurance didn't pay. is that true? i thought since i provide the insurance she would be responsible for the remaining owed. hope someone knows the answer to this one.thanks.

[kiddosmom]

Read your CO, NORMALLY both parties pay 50% of all uncovered expenses.

[wlf]

i have read over the CO several times and still don't see where anything that states who would pay what the insurance doesn't.it just states"i agree to provide health insurance coverage for my child when it is available at a reasonable cost." "reasonable in cost is defined as employment related or other group health insurance."
 
it never says who would be responsible for what the insurance doesn't pay.i have no problem agreeing with the mother for each of us to split the cost of what the insurance didn't cover but she says i should have to pay it all by myself. i am going to try and call my case worker and ask her about. that is if you can actually reach her.thanks

[kiddosmom]

f it does not state who pays then it is the party who takes the child to the dr who pays the co-pay, and the party that they ask who is responsible who pays any bills that are encurred. Your ex can write on the forms that you are to be billed and you are screwed.

You may need to ask for a clarification on your orders because they do not tell specifics.

You can get it modified to say 50/50 all uncovered medical expenses, just make sure you put in there also that copies of original bills are to be sent with the request for your part, and that the bills have to be sent within '30' days for payment.

[JAFO]

It might be contained in your state's laws and that's why it's not in the divorce decree.  You might want to check that out.  Otherwise, I agree the person above.

[wlf]

ok,finally talked to my case worker.she read over the CO and says that i am not responsible for any co-pay or any amounts the insurance doesn't cover. she said that if the mother doesn't like it she would have to ask for the CO to be modified and that would mean she would have to come to nc for everything because of the fact i opened the support case on myself here in nc. she also said that if the mother was to ask for it modified it would be split 50/50. she said if i was to recieve any bills to send them back to the bill collector and write a short note explaining.  anyway thanks for listening and giving your input on this.

[KAT]

Yes, I read NC too and the worker is right (suprise!). Do NOT pay any bills!!!! This could possibly make you legally responsible if you do. If you are sent a bill then yes, do send a letter. Make it clear that you did not authorize treatment on the MINOR child nor did is your signature on the forms guaranteeing payment. If your ex has signed your name then that is fraud & forgery for which she can be criminally charged.
That said, start saving money as it's highly likely she will go for a modification and the judge will give it to her. HOWEVER it is also unlikely she will be awarded any bills except from the date of her filing. (HA) In your response ask that she be responsible for the first $250.00 out of pocket medical per calander year. In addition, if you currently aren't getting the tax deduction, that would also be a good time to ask for it. Bring the IRS form with you so that the judge can watch as she signs it if so ordered.
Good Luck to you!
KAT

[wlf]

thanks for posting the worker was right. i couldn't help but wonder if she was right about what she was telling me. hope everyone understands its not that i don't want to take care of my child. its just that i never even knew i had this child until a few years back.her mother and i had dated 11 years ago. out of the blue she decides to contact me and tell me she is my daughter not the stepdad's that she has let raise her all these years. i looked at pictures of her and felt she did look alot like myself and other 2 children i have with my wife. so i went to my local child support office ,explained it all to them and asked for them to help me get a dna done because mother was still refusing to do one. needless to say they looked at me like i was crazy!(small town, don't think they get to many fathers who want to bring support on themselves) so of course she was mine and i have been paying support since and providing insurance.i go see her as often as i can (8 hrs. from me). as for the mother coming here to have the co modified..i doubt it seriously.you would have to know her to understand.she says she can't afford to come here.she was mad when she thought by me opening the dna/support case on myself here in nc she would have to make a trip here,she had a cow. but if it comes to i do have to pay some of the medical bills one day then i will.just didn't think it was fair that i'd have to pay it all.sorry such a long post just wanted to give ya'll a little insight .

[stepmomm]

I went round and round about this same issue.
Here's what.. The cp sent bills to us for copay as well as what Insurance would not pay. The insurance company sent us bills also but added that we should pay 0 amount..
The cp called us and asked about it. I said I didn't know.
I never paid anything, It is their responsiblity to pay the copays as well as what ins doesn't cover.

[KAT]

I wouldn't feel bad. Listen, it's the CP's RESPONSIBILTY to request child support & to make sure all their ducks are in a row. If they don't bother then too bad. She's getting tax free money, plus the deducation let her pay the bills with her refund damnit I wouldn't feel bad for her. Just as your OBLIGATION is pay it's HER responsibility to be pro-active. As far as I"m concerned she was ONLY concerned with the cash money & didn't bother to think of the consequences for not asking for medical.
Think of this as making up for all the hugs & kisses you missed for 11 years. Women like this really tank my token. They make us ALL look bad.
KAT