Insurance question

[fight4him]

i have a question. We live in TN. Mom isn't working and when she does it's minimum wage jobs, which makes SS eligible for Tenncare insurance indefinitely. DH is debating on asking the judge to order him put on his work insurance when we go back to court. IF he gets put on his insurance can she still get Tenncare and use it before she uses the paid insurance?

I am just wondering what the point of him paying an extra 50.00 a week for it if she can just use the state insurance first. If she can, she would never need the paid insurance, which means DH is wasting money. Mom is adamant that dad not put him on his insurance because she knows it means she pays all co pays and they split evenly anything not covered.

Anyone know anything about this?

Also, I was wondering how far fetched it would be to ask that if either parent is unemployed and can't file income tax that the working parent gets to claim the child regardless of who's year it is. (We are going to be asking for every other year when we go back). She hasn't worked most of this year and I am not sure if she intends to or not. However, if she loses the cs I can't imagine how she can't work.

We go back to court in a couple of weeks and we are hopeful....

[ocean]

If he gets insurance the state may make him/her pay back the state for their insurance. There are cases that the state takes the child support minus the medical or any other state services she gets for child. I am surprised the state did not make him get the insurance already...she may not of put him down as the father...

[fight4him]

Last October when we went to court and got all the child support set and all he did get a letter from the state saying he was being required to carry insurance. They were supposed to send a letter to his employer telling them how and all but the employer never received anything. He told the bm about it and she went ballistic. I'm not sure if she called and said something or had it changed or what happened but nothing else was ever done about it.

[Kitty C.]

Your DH better be looking into it or he could get hosed.  And it makes no difference whatsoever if the BM goes ballistic or not.....if the state is telling him he has to carry ins. (which would probably be primary before any state ins.), he HAS to carry it.  If the BM has a problem with that, she can take it up with the state...........but do you really think she would?  I doubt it.

[MixedBag]

o.k.,, this is coming from a parent who has at one time had 3 health insurance for some of the kids some of the time.  Basically, if we/I could get the insurance, then I got it REGARDLESS if it was court ordered or not.

If Dad gets insurance -- which I'm of the opinion BOTH parents and steps should sign the kids for whatever is available -- then DAD's insurance pays first, and the state will pay after dad's insurance, and THEN everything gets split according to the divorce decree.

A similar subject has been debated -- when all the health care ummm stuff was in the news etc...

IF a person has access to company health care, they should get it.

If they don't -- and because their wages are "so low" and they qualify for cheaper federal or state plans, HOW is that fair to the state or federal government for them to pick up the cost when there's insurance available at work.

The words "at a reasonable cost" come into play -- because what's within reason to me, may not be to you.

So...let me give you an example.  I am retired military and so I have Tri-Care for health insurance.  THAT's free.  Now my (former) spouse went to work for the city, and they offered a package to cover health, dental, vision, perscription at $XXX per month.  Tri-Care's take is that we should be forced to buy into the program to take the burden off the government because it's available.  Yes, we chose to go that route because it was reasonable per month, gave us dental too, we could follow BC/BS rules for doctors vs. Tri-Care (nicer rules with BC/BS).    EX#1 I know once told me that this philosophy is somewhere in a more recent federal law.  I haven't got a clue about the exact reference.  He too was making a transition from Active Duty (100% coverage under Tri-Care) to retirement (lower levels of coverage) TriCare and actually talked to me about it a bit.  He retired a few years after me and during his outprocessing briefings got told about the "new law" but couldn't quote what law.

Advantage of DAD carrying PRIMARY INSURANCE:  She will be forced to use it before HER insurance will kick in and pay anything.  SO, DAD will know about stuff if she doesn't tell him.  It might not be as fast as he likes, but if he watches the claims (on-line) as they process through, he will know what's going on.

[fight4him]

Thanks everyone. I will have him check in to it. He prefers to take it out on him actually but it hasn't happened. Maybe he should call the state tomorrow and see what they think. I just hate to think he would pay the extra 50 a week and then it not even get used. So, if he did, would mom still be responsible for the co pays or would tenncare pick that up?

[Kitty C.]

'So, if he did, would mom still be responsible for the co pays or would tenncare pick that up?'

That's a question only TennCare can answer...and I would definitely ask them what they will cover as secondary ins.

[MixedBag]

Chances are that TN would pick that up.

For our three insurances...

CP's insurance paid first, NCP's second, Tri-Care third.

Say the bill was $200.  CP's insurance only ALLOWED $180, so off goes $20.  Doctor's office removes that.

CP's insurance says "$500 deductible, so $180 is yours to pay."

NCP's insurance says $180 allowed, $20 co-pay, so they pay $160.

Tri-Care says $180 allowed, $150 annual deductible, 20% co-pay.  SO...they take off $150 from the $180.  That leaves $30.  Then 20% of that is yours to pay.  That's $6.  Sooo  Since the balance from the second insurance is $10, Tri-Care pays $4, and you pay $6

[bloom6372]

Look up the policy handbook online to see if SS would be eligible for TennCare. I know my DH covers my SD under his insurance, and that BM has her on Medicaid for their state. SD is NOT eligible to have Medicaid through the state if she is otherwise covered by a comprehensive insurance. DH has reported it twice, but nothing has been done about it. But, I also know that if DH DOESN'T report the fraud (i.e. SD being covered by another insurance) HE could be held responsible to pay back whatever was paid for through Medicaid. So, make sure you check the rules for the insurance so that you can inform them if your DH adds SS. And if he is COed to add him, then he needs to do it ASAP! And I'd also contact all of SS's doctors to GIVE THEM the insurance information for his file. That way, you don't have to worry about BM using it--the doctor will automatically use it.

[MixedBag]

you know. THAT actually brings up a question in my mind.

because when I read your response, I thought "WHY NOT?"

Why can't mom apply and get the child qualified based on HER situation?

When you read the guidelines, and they're all gonna say it a bit differently, ....  I would think that it's meant for either home, separately.

So if MOM qualifies -- she should be able to get that for the child.

And then Dad gets what he can for insurance, and THEN the two insurances work together to work it out.

Bloom -- in your case, since Dad is active duty -- there should be 100% coverage for the child anyways.   And if that's how dad is interpreting the rules, be sure to send the notification certified returned receipt or something that hold TN accountable down the road to NOT come after dad.