Disputing unreimbursed medical expenses
Does anyone have experience with this? Last year BM decided that ss10 needed braces based on recommendation of his dentist....she asked him at that time of he was gonna pay half fdh told her he couldn't afford it. She told him this 6 days before the procedure was to take place. No discussion about it, just this is gonna happen it's gonna cost X and I want you to pay half.
Now she has taken it to domestic relations claiming unreimbursed medical expenses. We live in PA. From what we have found online orthodontics is able to be claimed as an unreimbursed medical expense unless it was medically necessary. She also has medical assistance for the boys plus fdh cover their insurance (which paid over $1000 for the braces). We have found that medical assistance will pay for braces IF the diagnosis for braces fits certain criteria, ie making it medically necessary. Since it was clearly a cosmetic issue, medical assistance would not cover. So why does fdh?
They just went back to court because she requested and increase and she got it, another $250/month. Currently the CO states he is responsible for 64% she is responsible she 36%. Even in the even that he is required to pay is there any way he can have that revised to 50-50?
We are disputing the case for the reasons stated above, plus the ortho was to have a signed consent from both parents AND a signed financial contract from both parents, which fdh did not sign because BM just went ahead and had it done. They have shared legal custody. Any thoughts, advice? Thanks.
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Hey MarieJeanne, why are you
Hey MarieJeanne, why are you bashing the op for her lack of a marriage certificate? I agree with most of what you say, but if her partner has any kids that makes her a step parent, perhaps she is just wiser than those of us who got married already and doesn't want to be legally tired to this man yet because of all the shit that comes with it.
OP, MarieJeanne makes some good points it isn't your job to research everything, though I know how you feel in wanting to get all the options for your fiance. The best person to talk to would be a lawyer or perhaps your fiance could take your ss to an orthodentist for a second opinion and get it in writing, even though it is a bit late it could be used in court maybe?
ETA: woops just seen the OP's name.....ok MarieJeanne I completly missed that and can see why you said what you did, that makes way more sense to me now, I must learn to read everything first!
I don't have any experience
I don't have any experience with this issue but it seems that if BM did not follow proper procedure as far as the consent form and financial contract, your FDH can fight it. I would make copies of anything you find that supports why your FDH is not responsible for this particular medical expense.
If they just went back to court, he should have tried to get the medical revised to 50/50 at that time. Sure, he can try now but it would have made more sense to do it then.
Fdh needs to see a lawyer to
Fdh needs to see a lawyer to clarify the CO and try to have the CS regarding medical adjusted.
As to the insurance, very few pay for cosmetics, so if they paid some of it, it will most likely be deemed necessary.
Most orthodontist have payment plans available. If fdh has to pay to the dentist he can inquire about payment plans for his part of the cost. It would be unusual, where I live, to pay the full cost upfront.
She has already paid the full
She has already paid the full amount, as a matter of fact two months after the procedure was completed, so she did not afford fdh the opportunity to set up a payment arrangement with the dentist. FDHs insurance pays for cosmetic ortho up to a certain amount, which is what was paid. He has talked to his lawyer and is waiting for further instruction. I just wondered if anyone else has been through this sort of thing.
Ss's teeth were not that bad before the Braces, not to mention that he still does not have all his adult teeth and recently had to have the braces removed and 4 teeth extracted because the braces were preventing them from falling out. FDH did not have the opportunity to take his son to get a second opinion because she scheduled the appointment for brace placement 6 days after she informed him that it was going to be done. She basically said I'm doing this and you're gonna pay for it.
Not too long ago she informed fdh that ss6 would need braces soon as well....I don't understand this because he's still losing teeth. Why would you put braces on a child and put them through unnecessary pain before they even have all their adult teeth? It seems to me that BM simply sees all of FDHs income as her disposable income. He pays his support, on time every month. Has never missed a payment. Covers their medical insurance. We provide for the boys when they are here as well. he's not a deadbeat, he he's the boys as scheduled and extra time if she allows. I just don't understand why the court system is set up the way it is.