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Out-of-Pocket Medical Expenses

CastleJJ's picture

I haven't posted much on this site lately as not much has happened outside of the usual - BM doing nothing, GF raising SS, and us just being the child support ATM with 6 weeks of visitation. BM has started zero drama since March, but it is hard to start drama when DH responds to everything with "Thank you for the update."

I checked the mail this morning and found mail from BM. She was requesting reimbursement for out-of-pocket medical expenses. We have not received one of these in years because SS has very few medical needs and BM is required per the CO to pay $400 out of pocket herself before requesting reimbursement from DH. Well, according to the paperwork, BM is saying she met her $400 annual obligation due to SS' OT services for his "sensory-processing disorder." If you recall from my earlier posts, BM emailed DH right around the time I gave birth to DD in February, claiming that SS10 developed a full blown sensory processing disorder overnight. She then sought "OT services" to correct this issue. BM has been refusing to provide any actual proof of this diagnosis - no medical documentation, therapy progress notes, nothing. So in this mail, BM provided DH with print outs of the payment confirmation... As someone who works in healthcare (me), if SS was in OT for a legitimate reason, it would be billed through BM's insurance, and she would likely owe something out-of-pocket depending on her insurance plan. So instead of us getting an auto-generated payment confirmation like you would get at a nail salon or for some other elective service, shouldn't we be getting a medical bill of some sort. But again, BM is refusing to provide any documentation related to this "sensory-processing disorder" or his therapy and we know this place has open gym that you can pay to use, so more than likely, BM is just paying for open gym hours for SS and claiming it as "OT." 

I am also frustrated because the day before pickup for last visitation, BM emailed DH that she took SS to urgent care for a pin-sized dot on his arm. We received the bill today and it wasn't urgent care at all, it was the emergency room. Our BM has a tendency to use the ER as her primary doctor. Why? Because she works for the hospital and says she gets an employee discount. What she fails to understand is that her normal doctor office copay is $20 and this ER visit was $400, and after insurance and her 50% employee discount, she still paid $130 for the same service, which means she is literally paying so much more money, even with her discount. DH has disputed her use of ER services for routine care and BM still continues to do it. 

What irks me about all of this is that DH has no form of custody, which means no medical decision making, yet when BM makes all of these medical decisions and claims that SS has all of these issues (which he doesnt), we have to pay for it. BM can make the decision to use the ER for every little thing and we can dispute it, but ultimately she has sole decision-making and we have to pay the bill. Why can't it just be no medical decision making, no payment or just grant 50/50 for medical decision making. 

Oh and DH had his tonsils out last Monday. He kept getting inflammation due to tonsil stones. BM emailed DH last week that SS has chronic croup (the kid is never sick) and has a consult with the ENT today. Today, BM texts DH that DH's tonsillectomy may be related to SS' issues and she wanted to know if a genetic condition is the reason DH needed his tonsils out... she is probably advocating for SS to have his tonsils removed. Can't wait to pay for that bill. 

** I should also highlight that I'm not against paying our share of SS' medical expenses. I am against DH not having a say in SS' medical care and then getting slammed with bills because BM is a hypochondriac who seeks medical attention for every scratch, bug bite, and fictitious condition, all while refusing to provide documentation to back up the medical care.**

Comments

Harry's picture

Get a Lawer and go to court to get this settled. Or else,  you will have a lifetime of this nonsense.  Older the child gets the more they cost.  There will be school activities ,cost. Field trips cost sports, cost, band, cost , cars ,cost 

CastleJJ's picture

We have been to court on numerous occasions. Going to court did nothing for us. BM has not sent a request for reimbursement in years and we do not pay for extracurriculars or extras as the judge ruled that was all covered in CS. SS is already 10, so we are more than halfway there. 

dragonfly878's picture

Does BM have Münchausen? Sounds like she makes up medical problems for SS so that she feels important... that she and ONLY SHE can address... I'd be burnt out by that behavior if I were you... our BM is similar but not as extreme

CastleJJ's picture

I've thought this, but all the conditions she comes up with don't actually harm SS. She claims he has ADHD, but doesn't medicate him or do anything to treat it. She just uses it as a means to approve sports as a "medical need." The sensory-processing disorder she claimed is related to the ADHD. Again, he attended "OT services," which SS said was stretching and that was the last we heard of it. SS seems to accumulate conditions for BM to gain attention from DH, but then when DH doesnt engage, we never hear about these conditions again; they just kind of go away. SS is never sick and he is perfectly on track developmentally, but with BM, he develops all of these illnesses and conditions. 

dragonfly878's picture

Ahhh got it... "Ex DH look at what a wonderful mother I am for tending to all of these issues yet you better not have an opinion as I run the show"  and then when your DH acts indifferent and/or doesn't give her the attention she wants she backs off.... sounds like a controlling pain in the backside 

dragonfly878's picture

Ahhh got it... "Ex DH look at what a wonderful mother I am for tending to all of these issues yet you better not have an opinion as I run the show"  and then when your DH acts indifferent and/or doesn't give her the attention she wants she backs off.... sounds like a controlling pain in the backside 

Survivingstephell's picture

In my state, BM  had to provide receipt's to the state proving payments and anything over the threshold to get anymore reimbursement from DH.  She submitted it to the state, they check the records then make copies and send a big envelope DH.  There is nothing wrong with asking for and expecting authentic receipts, not random requests for money, which this sounds like.  Unless there is documentation, no money.  

CastleJJ's picture

BM filled out the FOC request for medical reimbursement and she provided the print outs of the statements from the online medical portals. The only thing we don't have is proof of the OT services, because she only provided a payment confirmation, but she isn't asking for reimbursement for that. She is saying because she paid all of that out-of-pocket, she has met her annual obligation per the CS agreement, so we are now responsible for our half of all medical expenses going forward. The issue is, based on the receipts, we cannot confirm she actually paid for a medical service at all. 

CastleJJ's picture

Something didn't sit right with DH either. DH emailed BM asking for medical bills related to the OT services or an EOB from insurance regarding the OT services. DH told BM that a payment confirmation would not suffice to prove she has met her annual medical expense obligation since that facility offers more than medical care. It also offers an open to the public gym for recreational use. 

I hate confronting BM. I know she will make an excuse about why she doesn't have it or she will refuse to provide it and then spiral, making it somehow our fault because we are legally obligated to cover the medical expenses she submit for. I just hate dealing with her. It gives me anxiety and now I will sit anxiously waiting for her to email DH back. 

lieutenant_dad's picture

Can your DH contact the facility himself and request a copy of the medical records and billing information? I know he doesn't have medical decision-making, but I assume he has the right to access information?

CastleJJ's picture

He has the right to access medical information, but he couldn't ask about the bill since that falls under financial. 

dragonfly878's picture

What about a summary of services? It won't have the price, but isn't that public record? Places aren't supposed to hide what they charge for services?

Thumper's picture

Does this mean DH has zero access to medical billing with providers?

BM has sole custody of SS?

He should be able to call billing. Or has she blocked him from that too?

 

CastleJJ's picture

BM has sole custody of SS. BM and DH were teenagers when SS was born so sole custody defaulted to BM. DH has the right to access medical and academic records but not financial records, ie medical bills. 

stepmomnorth's picture

If she expects him to pay for an expense then she needs to provide the adequate bill or proof. If she doesn't well... Too bad for her I guess. 

CastleJJ's picture

BM emailed DH back and attached a copy of medical bill. The OT services were legit, so BM did meet her annual out of pocket obligation, so DH will send the check for the other medical expenses. BM did make the shitty comment though that if the OT had recommended the open to the public "open gym" for SS outside of OT services, then BM could have forced DH to reimburse for that as a medical expense. DH just ignored her and let her know the check will be mailed. 

dragonfly878's picture

That's wild. The way she can control the purse strings indirectly... is there a cap to what DH has to pay? That's rediculous she uses him as an ATM...

CastleJJ's picture

Nope, no cap. If BM pays $400 in out of pocket medical per year, then DH is responsible for 42% of all medical expenses beyond that $400. And when BM uses the ER as her doctor, it adds up quickly. Luckily SS has been pretty healthy and we haven't owed BM anything in recent years. This year I think will be expensive. 

BM loves to use DH as an ATM. Two years ago, BM was enrolling SS in tons of sports camps and activities, all to interfere with DH's parenting time, and she wanted DH to pay half. DH refused and BM blew a cork. Per the CO, extra curriculars are covered under general CS, so she didn't get extra money. Since DH won't pay, BM has stopped enrolling SS in so many activities. It's all about the all mighty dollar for BM and it is why she fights so hard to maintain physical custody even though SS is never with her during her time. 

strugglingSM's picture

Same thing happened with our BM....except it was that DH refused to pay for anything he did not agree to first, which was allowed under their CO. Since BM never consulted with DH, so there were a lot of expenses he refused to pay...surprise, Skids don't really do much. One supposedly goes to "golf lessons", but I think MIL pays for most of those (shouldn't that count towards DH's portion of payment?). When I met DH, BM would just give him a handwritten list of her supposed expenses....I asked him, "why are you paying these with no proof?" He then asked for proof and you would have thought he ran over BM's puppy (because she was using this tactic to get hundreds of additional dollars from DH each month). Then she sent copies of checks as proof, but they were only the front of the check, no proof they had been cashed and one that was supposedly for the golf coach was written out to the wrong name (made only more obvious by the fact that another picture was of a check with the correct name). Mind you, when BM and DH were married, BM had to go to a special court-ordered class because she was caught writing bad checks, so not exactly the most honest person. Now, because BM refused to pay for skiing, even though skids were in lessons...at their request...we just pay for what they do with us and we haven't gone skiing in a few years because of covid and we now have a toddler. I'm also not interested in paying for something so expensive for a couple of ungrateful skids....they also demanded to take their skis to BM's this year, assuming BM would take them skiing (which she didn't), so no skiing while the skis are at BM's house.

CastleJJ's picture

Yeah, the judge never specified that BM had to clear anything with DH. DH does not have to pay for extra-curriculars or extras, but he cannot dispute medical expenses. He has to pay for whatever medical expenses BM incurs for SS. 

strugglingSM's picture

This makes the "need" for the OT and the OT "prescription" of sports all the more clear. Did you say BM was a social worker? Is this OT a friend of hers?

At the last mediation, BM claimed she was paying $600 a month to have skids on her health insurance, even though DH is the primary provider of health insurance. This was her ploy to raise DH's CS. In return, I think her lawyer added a clause that BM would pay all extra health care expenses, so joke was sort of on BM. She tried to claim that the one SS who didn't have braces "might" need them and DH pointed back to the clause in their agreement to remind her that she was responsible for the cost. She had a fit and never took skid to the orthodontist. We paid for DH's share for the other skids braces and his teeth are now crooked again since he doesn't wear his retainer. I also don't believe that BM has them on her health insurance, esp since she is now divorced from former stepdad and doesn't have to have him on her health insurance...but at my suggestion, DH also got a clause added saying that if he lost his health insurance or it changed, he didn't have to cover skids anymore.

CastleJJ's picture

Sometimes I just need a reminder that we aren't the crazy ones. When DH decided to email BM about the medical expenses, I told him to leave it alone because we were clearly the ones in the wrong. DH and I have been abused by BM so bad that we have anxiety every time we have to confront her, because she is so good at gaslighting and crazy making. I can't tell you how many times over the last 9 years I have questioned if we are the ones at fault even though everything contradicts that. She is a major narcissist and very good at abusing people. It sucks, but until she has no legal power over us, we can only set our boundaries and try to enforce them. Only 8 more years and she will have no more power over us. 

dragonfly878's picture

Do you ever save her communications with your DH and throw it back at her when she contradicts herself? Slightly off topic... but your BM sounds like a real gem and I really feel for you... 

My DH will only communicate with BM through email unless it's an emergency. She will be quick to point out something that we did wrong- soemthing that she herself does routinely. Often we quote her and say, "in an email on December 4th you stated XYZ was wrong, YET today you're doing the exact same thing... help me understand the difference?" I suppose it's poking the bear in some ways- but my god the double standards with these people are amazing... 

CastleJJ's picture

We have done this on numerous occasions. It gets us absolutely nowhere and causes BM to explode with narcissistic abuse. 

When SS was 3, DH did all transportation for all visitation. We did not have overnights at the time because BM claimed that SS wasnt comfortable (probably because BM withheld all visitation from birth to age 2). BM couldn't be bothered to do one leg of transportation for visitation. Why? Because BM drove SS to daycare, activities, etc. everyday and never let DH do anything, so she argued that she shouldnt have to do visitation transportation. So per the CO, DH exercised 8 hours of visitation every other Sunday, doing all transportation for years. One visitation, SS left his coat in DH's car. Not a big deal, it was spring and 50°. DH was seeing SS that next day for something and would give it to him then. Oh no, BM flipped out in a 3 hour text rage claiming that DH was neglecting SS by not returning the coat right then at 9 pm (even though we had purchased the coat because BM's coat for SS was too small). BM raged about DH, his job, me, our relationship, the fact that DH was living with his Dad because he couldn't afford his CS and student loans, that he was a deadbeat who never paid CS (not true, he paid full CS every month on time), etc. She threatened to call CPS, the police, her GF at the FBI, etc. After that, we forced BM to go to email only. 

Another time, DH contacted SS' school to be added to the school email list. This was right after BM and SS moved out of state and DH was trying to get the new school info. The school informed DH that he could not be added because BM's GF of 6 months had taken up the "Parent #2" spot, blocking his access. The CO didn't clearly outline access to records so it was a grey area. DH told the school to remove GF as Parent #2, but keep her on the emergency contact list, and add DH as "Parent #2." DH notified BM that he did this and has rights to access information and encouraged BM and GF to get a joint email account to add under BM's profile so they can both access the information. BM again freaked out, this time for 4 days. She contacted the school, reverting it back to GF as "Parent #2" because BM has sole custody. BM told the school to block DH from making changes to SS' academic profile and to notify her if he tries. BM filed contempt on DH. BM email abused DH for 4 days, claiming that because SS was living with BM and GF, removing GF from the information list put SS at risk. After that, DH and I legit thought we were wrong. 

For years, BM would send DH "report card emails," scoring him on his parenting during his parenting time. She would express her concerns of SS staying up too late, SS having too much sugar, SS being around family BM didn't like, SS getting a scratch, sunburn or bug bite, SS hearing someone curse around us, us supposedly eavesdropping on SS' phone calls with BM (we never did), etc. She would tell DH that he needs to do better to stop or prevent these things from happening and if he could not, then she would force him to make corrections via court action or visitation withholding. If BM didn't get the answer she liked, she would have a tantrum. Yet, BM does all of this with SS. He is literally never with her. GF does everything and he is spending the night at friends (even on school nights) or he is at friends or daycare after school, etc. SS has told us that he drinks Mountain Dew on the regular and stays up until midnight at BMs, but having an ice cream and staying up until 10 during our summer visitation is forbidden. We finally stopped caring what she says and during one court stint, the judge told her that our parenting time is off limits and what occurs is none of her business. Now she just accuses us of abuse to be able to discuss our visitation without getting in trouble with the courts. 

SS once got sick during his summer visitation with us. We asked BM for the insurance card to seek medical attention. BM refused to provide it, telling DH to take SS to BM's parents so they could take him to the doctor. DH refused and BM sent like 4 email responses about how she didn't trust him and she was worried he would lie about SS' illness or treatment. Finally, she accused DH of committing medical insurance fraud with her insurance card and said that he would access her health records because he had the card. BM works for a hospital and clearly doesn't know hoe HIPAA works. We had to go to court to get medical care added to the CO since BM lived 6 hours away and couldn't get care for him. Oh and BM also wouldn't let us use daycare at all. She said if DH couldn't be with SS for 6 weeks per year, then there was no point in him having visitation. DH only had 2 weeks of PTO per year. BM also disputed having family or myself babysit while DH was at work. We had to go to court to get childcare added as well. 

If you contradict or question BM on anything or use her words against her, you are asking for a narc tantrum. She will abuse, gaslight, and diminish our role to nothing. If she does it, it's acceptable. If we do it, we will pay for our mistake. 

strugglingSM's picture

We have very similar BMs. My favorite contradiction of hers was she had it written into the CO that SSs were not to "be exposed to video games rated MA", because DH plays video games, but then husband #2 was a gamer, so BM bought grand theft auto (the one where you can have sex with a prostitute and then kill them to get your money back) for SSs when they were 7 and they played in their room without any supervision. DH objected and she told him it was "none of his business!" what went on at her house. Meanwhile, every visitation weekend, he would get a list of things that were strictly off limits for SSs while they were with DH. 

She also railed at DH whenever he asked her for any information about skids that he was "just trying to get her to do all the work" and he should have that information or he could "get it himself!" And then she would send DH texts or emails asking if he could send SSs' SSNs or birth certificates because she needed them for something. 

She also railed against any time that DH had Skids that DH was not taking off from work to be with them. She said that having me watch them while DH was at work or class on a weekend was child neglect, even though SSs were regularly babysat by BM's 14 year old SS (now former SS) who basically stayed in his room and didn't come out. She also insisted that DH take his two weeks over the summer when she wanted him to take those weeks, but then if he signed SSs up for camp, because he couldn't get the time off work, she would berate him and tell him he needed to "learn to be a parent." 

I haven't really followed the Johnny Depp trial, but listening to Amber Heard is super triggering for me, because BM is the same way. She even accused me of "possibly being a child abuser" at some point because I didn't accept a friend request from her on FB. 

CastleJJ's picture

Yes, they sound alike. Last night I was in a full blown panic waiting for BM to respond. Its like PTSD. My mind kept racing and I was shaking. Once she responded and it was resolved, I was fine. 

dragonfly878's picture

Hopefully you've saved all of these exchanges... someday SS will be older and this is all the proof you need that you were dealing with an impossible human in his mother... all about control with her that's wild!!!

CastleJJ's picture

Oh we have. We have thousands of pages of documents, emails, texts, court motions, etc. in a filing cabinet. It takes up an entire drawer. SS is welcome to it when he is older and can decide for himself.