Is this considered insurance fraud and can BM get in trouble?
DH receives a insurance statment in the mail with his ex wifes name on it. He called her to ask what the heck was going on. She explained to him that she had no idea that had happened and that she had gone through health and welfare for medicade (I think) in order to get the portion that was not covered by DH's insurance taken care of.
DH called his insurance company and they explained that her name was still on his plan and that he had to fill out a form in order to get her removed. Now this insurance is through his work so if you are not a dependent then you can't use it.
Is that considered insurance fraud? I would assume that she would of had to give the insurance info to medicade correct? And just because DH didn't remove her from his insurance, they have been divorced for three years, she is no longer considered a dependent and would no longer be eligable to use the insurance right?
- Unhappy's blog
- Log in or register to post comments
Comments
If DH did not remove her,
If DH did not remove her, it's likely the fraud charge would fall on him. Maybe both of them, if she used it.
She's getting Medicaid for herself? Or kids?
For herself.
For herself.
Yes I am on his insurance.
Yes I am on his insurance. But I was just added recently. He didn't know that he had to fill out a form and submit it to his work in order to get her removed until he called his insurance company when he received the statement in the mail.
If she used an old card or
If she used an old card or claimed to be his spouse, it's on her. If he hasn't updated his policy, then it's on him.
He needs to talk to his insurance company and employer ASAP.
I thought about this
I thought about this possibility too. But everytime I've had to take my daughter to the doctors they always ask if I'm still covered under the same plan. It seems standard practice that they just don't assume that your still covered under the same insurance plan if you haven't used it in three years.
Agreed .. I think she
Agreed .. I think she definitely pulled something a little shady .. unless she didn't know she wasn't on his plan anymore? How likely is that though?
Hmm, thats an interesting
Hmm, thats an interesting one. Unfortunately, its your DHs duty to inform his Insurance carrier of the divorce, and to have her removed. They simply do not have the knowledge or resources available to know when Insureds divorce & whatnot.
Your DH needs to provide documentation to the Insurance Co to have her removed. Technically she still has Insurance under the plan, until your DH provided them with what they need. I do believe the coverage will then cease. So, therefore she is able to use said Insurance until the Insurance Co cancels her coverage. They wont be legally able to cancel it back to an earlier date- as she was still om the policy. It sounds like she realized she was still covered & used the policy to go to the Drs.
It sounds like she is obtaining Medicaid coverage, and that may help to cover the costs that the other policy may not cover. You may want to have your DH contact his HR person at work & check to make sure he removed his ex on other things as well, such as group Life Ins, 401k & Pension accounts.
Edited to add: Are You listed as an Insured on your DHs Health Ins? If so, that changes everything & then would be fraud if she used DHs Ins
Wouldn't she have to provide
Wouldn't she have to provide her proof of insurance to health and welfare in order to get them to pay the remaining balance?
Yes, she would & in my State-
Yes, she would & in my State- you cannot obtain Medicaid if you have any other in-force Health Ins Policies.
Although, if she would be obtaining Medicare- then she can get it as well.
She would not necessarily
She would not necessarily have to provide it. Well, I know of some kids who were on Medicaid and apparently their NCP got some kind of insurance on them through work but did not inform the CP. That insurance company started showing up as a co-provider and it was a real headache for the CP.
Don't know if it might be different for adult medicaid but probably it's the same.
I'm not sure, but you need to
I'm not sure, but you need to have your husband get a copy of ALL of the things he has from work, ie pensions, insurance, etc...to make sure he changed those.