Medical/Dental Reimbursement

UNREIMBURSED MEDICAL AND DENTAL EXPENSES OF THE CHILDREN

Your judgment provides that you and your former spouse will each be responsible for one-half of your children’s medical and dental expenses not covered by insurance. The best an attorney can do for you is to obtain a court order that the other parent is to pay a designated share of these expenses. If the other parent does not pay, you will have to be prepared to provide the following:

 

• That the medical or dental services were provided after the Judgment of Dissolution of Marriage was entered and while your child was still eligible to receive child support (i.e. under 18, or 18 but still in high school).
• That you paid the bill; [You can obtain reimbursement for medical expenses paid after the child was no longer eligible to receive child support, as long as the bill was incurred during an eligible period].
• That you submitted the bill to all applicable insurance.
• That the insurance company has paid any reimbursement that will be paid.
• That you requested the reimbursement from the other parent and
• That the other parent has not paid you.

Careful record keeping at the time the expenses are incurred can help ensure that the other parent pays you on time. Additionally, if you must go to court, it will be far easier to prepare for the hearing. REMEMBER that if you cannot prove it, you lose it. Try to keep an accounting of the children’s expenses and the other parent’s payments to you.

If necessary, additional records can be obtained from the doctors, insurance companies, banks, etc. but it is much less ex pensive to save these items from the beginning. To help you, I have included a “log” to keep track of the expenses, etc. To prove the elements listed above, keep the following documents:

 

• Original or duplicate original statement for each medical, dental or prescription expense for which you seek reimbursement.
• Copy of each insurance claim form.
• Original statement from insurance in connection with each claim, detailing the portion of each charge that will and will not be reimbursed and the amount of reimbursement.
• Your original canceled check, receipt for case or original credit cared statement establishing the amount that you paid to each doctor, dentist, pharmacist, therapist, etc.
• Copy of your letter to the other parent requesting reimbursement; [ideally, sent by certified mail with the certified mail receipt attached if you think you may have a problem getting the other parent to pay].

Here are some additional factors to bear in mind:

• Judges may be reluctant to require the other parent to share in the cost of chiropractors – before you incur large chiropractic expenses, get a written and signed agreement that the other parent will pay half, or be prepared to be responsible for the entire bill.
• If the other parent has an “HMO” or pre-paid plan in which there are no un-reimbursed expenses or the insurance carrier pays a larger portion of the expenses if the plan’s doctors or the dentists are used, try to use the plan. If you do not have adequate reason for rejecting the plan’s services, the court may deny reimbursement.
• If at all possible, reach an agreement with the other parent regarding the payment of orthodontia, counseling, or other long-term non-emergency services. YOUR JUDGMENT MAY REQUIRE PRIOR CONSULTATION OR AGREEMENT. Please review it before you begin treatment.
• Send the parent bills regularly. They are more likely to be paid when the amount is not overwhelming and a judge could think it unfair that you saved up several years of expense and hit the other parent with them all at once, especially if the other parent had insurance coverage then, which is no longer applicable.

GOOD LUCK! THESE TIPS ARE MEANT TO MAKE THINGS EASIER IN THE LONG RUN RATHER THAN TO OVERWHELM YOU. IF YOU DO NOT TAKE SOME OF THESE PRECAUTIONS AT THE TIME THAT THE EXPENSES ARE INCURRED, WE CAN OFTEN “FIX-IT” LATER, BUT IT IS LIKELY TO COST YOU MORE.