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Insurance Issue Covering Step Child

One Life Once Chance's picture

I apologize in advance for the length but I am just so angry right now. My DH was ordered to cover SS on insurance until he was 18. He just turned 18 and is now cancelled. So not a problem. The problem lies within the fact that he took a new job 2 years ago that didn't offer insurance, so out of the spirit of being a trooper, I put my SS on my plan, since DH, BS and myself were covered under it.

Of course, there have been a lot of issues with the insurance and doctor visits and miraculously SS has 20 different diagnosis and 10 medications to cover them all. BM, wanting to maximize the secondary insurance before it stopped started dragging him all over. MY insurance company has been frustrated as she's tried to call and demand info, not to mention excessive claims, etc.

In order to stay out of legal issues because of her behavior, my health and dental insurances now send me a check for eligible benefits on him when a claim is filed. Me, Step Mom, Non Custodial. OK, so the EOBs aren't really self explanatory and sometimes they send lump checks which cover other visits for myself, our son, or DH. When I call MY insurance company, because of SS's age - they ask if I am legally able to speak on his behalf - I tell them no. Trying to work out billing issues a year ago - she accused me of trying to get info I shouldn't have legally - at one of DH and her court hearings. Since I was accused, I guess I'm not allowed to try to figure this out and don't want any more legal crap with her. When I call his doctors or dentists they won't discuss anything with me or DH due to SS age and the fact that BM has told them not to talk.

Recently, I have a dentist office calling me indicating the insurance company sent me a check for $201.80. Not being able to track anything real well, I went into our online bank account and I have no deposits for that amount. I asked the office to tell me what date's of service, can they give her smaller amounts that equal that - and once again I was told she couldn't discuss with me. I told her to take it up with BM then - if something is owed - BILL HER! Since no one will break it down for me. BM can send a bill to DH at the end of the year like she always does (and is ordered to handle that way) and we'll pay his portion.

Last night I got a bill in the mail from the dentist office, in MY NAME for $201.80 due for SS. I called the dental office and explained I never signed anything and I am not financially or legally responsible for him. HOW BALLSY!!!!! She indicated she called Bio Mom and she told her to bill me (glad BM can make me a guarantor - good luck in court with that one). The lady said she'd switch it back but I needed to pay the full amount because insurance confirmed they sent me the money, but neither of them can help me get to the $201.80. So this bill, that has no dates of service, is not a dental office that I or my immediate household family go to and I'm just supposed to pay that amount. With all the over billing and crooked drs now a days, I don't send anything to anyone unless I can verify who paid what and the amount is correct.

Anybody ever been through this? Can dentist office come after me? Insurance company said they paid me, they did what they were supposed to and they don't get caught up in legal issues. HER dental office seems to think I'm committing fraud. I don't think so, I'd gladly pay if someone would tell me what it is for.

Well, at least now he's 18 and there is end in sight. Just wanted others opinions. Thanks!

Totalybogus's picture

Your insurance company should be able to give you the information regarding the payout. Go through them. They ARE obligated to discuss YOUR insurance issues whether they are personal or for someone else you cover.

The dentist office cannot come after you, but it could be considered insurance fraud. Make sure they give you all of the information you need.

One Life Once Chance's picture

I've tried talking to the dental insurance on several occasions (have documented each time just in case). They tell me once he turned 17, in the state of Michigan - I need his permission to discuss his billing - even though I'm the subscriber.

My DH tried to contact him a couple of times, but we really have had no contact in about a year. He's left messages with the 800 number to call, sent him something in the mail. No response.

The insurance fraud thing is what I'm worried about. I told Delta I would just send checks back and then them pay amounts directly to the dentists involved. They said they'd send the check back to me, because they've done what they are supposed to.

theboysmom's picture

This happened with my SD, BM told dental office to bill me. I called Dental office and asked who signed financial responsibility (which everyone signs at every Dr) said it was BM....ummmm hello ur calling me why???? Bill BM and BM can turn around and request funds.

One Life Once Chance's picture

Did you receive money from the insurance company for it up front? I'm getting checks from them, but because they're lumping in with my son's, my DH's, and myselfs claims - I can't make heads or tail.

I've had 2 counselors bill me as well as she's listed me as guarantor. She's a piece!

theboysmom's picture

I work in the insurance dept for a hospital and it all comes down to who signed the paperwork, I can easily say strawberry shortcake is my guarantor doesnt mean anything unless she signs.

One Life Once Chance's picture

Since you deal with insurances, can BM or dentist office come after me for fraud if I don't pay bills based on, them just telling me to pay it, without any explanations - invoice just says "Previous balance". How do I not know this is not for BM as she is a patient there and they only have account number on it, and she verbally told me it was for SS. I do not know this dentist office or billing lady - and only interactions with BM are her trying to constantly get more money out of DH. So I feel like they are insisting I just take their word and hand over money. My biggest worry is the fraud thing.

theboysmom's picture

the only thing they can do and its a stretch is send you to collections for payment. Even if you already got reimbursed by the insurance because that reimbursement is between you and the insurance. tell them u want an itemized list containing dates of service. if they choose not to provide you with one then tell them to deal with BM

LostInTheMess's picture

If they did send you to collections, read the Federal Fair Debt Collection Act and DISPUTE THE BILL accordingly. The collection company would have to establish that YOU are the responsible party and it does not sound like that is the case.........

LostInTheMess's picture

Agreed!

Ultimately, his bills are not your responsibility. BM wants to be custodial parent, then she gets the custodial responsibility.

We don't pay ANYTHING until we see the actual bill from the provider and the statement of benefits from the insurance carriers.

If BM wants you to pay it, then she can get a copy of the billing statement from the provider and give it to you. Otherwise, she can eat cudd.

You can also write your insurance company and ask for an explanation of benefits for services from date X to date Y as well to see if this bill was included. You can also ask for an itemized statement of all payments made to YOU.

also, if a creditor was telling me to pay a bill, but refusing to provide me with proof of the debt, I would tell them to get bent!

MoreWorkThanPlanned's picture

I cover SD on my insurance, but knock on wood, have not had to deal with these issues! Even though I hate the idea of giving handouts to adult children, health insurance is the one thing I don't mind too much. DH and I realized that, if something happened to her and she didn't have insurance, we wouldn't be able to sit by and let her health suffer and would break down and pay her medical bills anyway, so we might as well cover her insurance.

Can you get SS a separate policy for himself, in his name (not connected to yours, DH, and BS)? I've always had insurance through work so I'm not sure how difficult it would be to get a separate policy, but, before I married DH, he could not carry his daughter on his work insurance and just got a separate policy through BC/BS for her and then gave her money to pay for it. It might be more expensive that way, but it might help cut down on the finances getting mixed up.

Alternatively, you could just tell SS that unless he gets on phone with insurance co. and authorizes you to be able to talk to co. about his claims, you’ll drop him and he can get his own insurance. SS and BM do sound pretty ungrateful for your assistance, which is generous of you to provide.

One Life Once Chance's picture

I cancelled him when he turned 18. His mother has primary coverage on him, all be it crappy.

He has not had anything to do with his father and I in approx a year because we don't agree with his drug use. BM has enabled him. He was arrested at 16 for being a dealer on school grounds. BM and attorney starting throwing out bipolar and suicidal from the get go to get him out of trouble. He went back to using and selling when probation was up. His father tested him when he came to our house and he started refusing to take tests. We have a now 2 year old at home - sometimes you have to protect younger ones from older ones - SS was showing up either strung out or with stuff with him. My insurance company has been getting fed up to begin with because of the multiple diagnosis. Medical claims average 10 a month as BM is grabbing at straws to keep him out of trouble, plus I think she wants any excuse to have contact with my DH still.

One Life Once Chance's picture

Well, I'm sure the $200 isn't the end of it because of all of his other appointments we're getting wind of - seems like he's been at a dr. 3 times a week for the past 3 months (per his aunt that we ran into). Haven't seen anything come in for those. I'm afraid that if I just go ahead and pay this, what else is she going to say - just bill her. And how many hundreds of dollars will we have overpaid.

She needs to pay the Dr's - per the court order - bill my DH. He'll pay his percentage gladly. And it's funny is - we can't have the info right now, but when she sends the bill at the end of the year - it will be broken down LIKE IT ALWAYS IS - and that is what I am asking for right now. I'm not just going to pay her dentist what everyone says without explanation. It could be a bill for her for all I know.

She always sends statements, copies of everything when she bills him for his portion of what insurance didn't pay. SO why can't she provide this now to get it taken care of.

MoreWorkThanPlanned's picture

Didn't realize he wasn't on your insurance anymore.

If this is the only bill outstanding and there are no more bills on the horizon, I'd be inclined to just pay it and chalk it up to a lesson learned and not help him out with money/insurance again. Sounds like he has enough serious problems (like drugs) that it would be best to disentangle yourself from him as quickly as possible in any event.

One Life Once Chance's picture

We have - about a year's worth of distance. Kept on insurance until he was 18, unfortunately - more bill's are coming - she was dragging him everywhere up to the day of his 18th birthday.

We've definitely protected our household from this. It's been hard on my DH, but he knew he had to. He couldn't go along with everyone else's "Its OK baby, you're a child of divorce, you're depressed - do meth" mentality. Regardless of a divorce that happened about 9 years ago - he HAD to be his Father.

One Life Once Chance's picture

I've called them multiple times to try to resolve. They won't give me anything because in Michigan, when a patient is 17 - they have to give permission for you to talk to doctors OR Insurance Carries, even if I'm the fricking one carrying insurance on him. It's MY insurance - I thought they HAD to talk to me!!

When he was 16 - they gave me answers. He turned 17, my own insurance won't speak to me re: details of what should be paid to who when it comes to him. When I log onto the insurance system - I only have access to me, my DH (he had to even sign a form) and our minor son.

I'm sure when our son turns 17 - he'll need to sign something as well. I'm not sure when children started to get so much adult status, but it's wrong.

One Life Once Chance's picture

Rendered when he was 17. Although you are considered adult at 18 in Michigan, with healthcare in Michigan - 17 is the age where you need patient permission to get info (even with my own insurance that I have on him)

It's crazy!

12yrstepmonster's picture

If you are asking opinions here is what I waould do. Gather up ALL your EOB's for DH, yourself and your child which will breakdown what was billed to insurance. What insurance covered what was paid out to you and what you owe. Total up what was paid to you. They should reference check date And maybe number match to date funds were deposited. What you can't account For is For SS.

12yrstepmonster's picture

If you are asking opinions here is what I waould do. Gather up ALL your EOB's for DH, yourself and your child which will breakdown what was billed to insurance. What insurance covered what was paid out to you and what you owe. Total up what was paid to you. They should reference check date And maybe number match to date funds were deposited. What you can't account For is For SS.

hbell0428's picture

What a horrible thing to go through.......that doesn't make any sense; I would call my insurance company and file a complaint w/ them for her and make sure that they don't use the insurance unless you are aware. I don't but SD on my insurance - just for these reasons......because with co-pays and such you have the option at some Dr. offices to pay then or mail it........and it comes to my house!! No thank you!!