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Question a bout medical copays and court orders

sickofitall's picture
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I have an 18 yo SD and a borderline personality disorder BM that have been abusing our medical plan for years and years. My DH has to pay half of all copays which he has always done. We average about 100 dollars every couple of months in unnecessary appointments,prescriptions etc. this girl has had about 5 or 6 different "diseases" over the years and has been to tons of specialists.Each sickness goes by the wayside. Honestly theres nothing wrong except they want the attention.My DD has a chronic incurable disease and this is about when it all started.

Anyway we just got the next batch of bills and there is a bill for a NUTRITIONIST ($125) so SD could get a special diet to lose weight because they told her she MAY become diabetic sometime in the future if she doesnt lose weight and exercise. Sigh. It was not covered by insurance because they felt it was not necessary. Do you think we have to pay it?Dh's papers just say half of all unreimbursed medical and dental.

Just to show what a biotch BM is she mails us a bill for $80 worth of copays a week before Christmas,nags and harrasses us to pay them and has now held on to the check for 3 weeks! Now the next batch came in for over $100.

My DH has been paying since SD was 18 months old and we now have less than 48 months to go!! Beyond excited. I am so tired of being dollared to death besides paying child support!

Totalybogus's picture

I wouldn't pay it. It will cost her more to take you to court to enforce payment than what she will recover if the court does grant it. There is a good chance the court will not make him pay it. She obviously didn't discuss going this route with your husband and just unilaterally made the decision. Nope, I wouldn't pay it.

JustAnotherSM's picture

I wouldn't pay for this. A nutritionist is not considered a medical professional.

Jsmom's picture

Don't pay it. If she saw a need and the insurance didn't cover it tough. Let her take you to court, by the time it gets there it won't have been worth what she paid in Attorney's fees.

I certainly hope you do not have to have coverage for this girl after 18. This is yet another reason why that crazy clause in obamacare for kids until 25 is insane...

sickofitall's picture

BM does not pay the first $250. We just pay half of all copays.This divorce was written up in 1994 and DH didnt have his own lawyer.Not too swift.LOL We have to pay until 21 or 22 if in full time college-I hate my state!! Our insurance will allow her on until 26.Pisses me off to no end. I have 2 children with medical needs-one has a chronic disease which is pretty serious and the other has other issues not as serious Thank God but we would be in big trouble without the insurance.I hate the way they abuse it.

She doesnt care about spending the copays even though shes broke because it gives attention to them. My DH has stopped asking and showing concern because it is bogus and they have stepped up their game.I dont know where they find these doctors.I really dont.I would give anything NOT to have to see the specialists for my kids that I have to!! Sick,mental people. Sad

But we only have 3 to 4 years left! I can. not. wait. }:)

GoodbyeNormaJean's picture

I'm pretty sure you don't have to pay it. If it's important to BM that younpay it and she thinks you owe her, she can take you to court and you both can present your case to a judge. Personally, I think asking a parent to pay for elective things should be agreed upon prior to using the service. I think that goes for cosmetic braces, anything relating to diet that isn't medically necessary due to an existing disease, vitamins, any cosmetic procedure, etc.

Ssamantha's picture

If BM has BPD, you probably have more than enough experience to know that she loves the chaos and drama she is creating. That's what it is all about. The more you fight back, the more she thrives on it. Expect during the last year or two for her to really step it up.

Sorry to say...but people with this disorder are an absolute nightmare to deal with. You're almost better off just paying it without saying one word. That would deny her the satisfaction. I know it's horrible advice and I probably wouldn't follow it myself, but it's probably the easiest way. If you go to court, she'll work her brain to find some other loophole to cause a problem. That's what they do.

sickofitall's picture

Thanks for the advice everyone. Ssamantha -that is what we have been doing for 15 years because everything you have stated is absolutely true.Part of me wants to fight her but that is what she wants. As it is we have a no contact thing going on right now. We have had no contact for about a month and it is killing her.Im absolutely exhausted by it all and I cant stand her or my SD anymore.Im sad to say that because Ive been in her life since shes 2 but its true. I spoke to a therapist about the situation and it is a very real condition called emmeshment betweeb Sd and BM.We may end up paying it-even though we are broke beyond belief-to avoid anymore stress and turmoil. Sad

babedow77's picture

Wow. what state do you live in?

Most parenting plans will state that the custodial parent has to notifythe non custodial parent before seeking treatment. The noncustodial parent can then agree or disagree.. If the custodial parent still wants to pursue it, then she needs to get the court to say that it's reasonable and necessary.

For example in our case:
DH pays cs plus pays for health/dental insur.
the x is responsible for the deductible plus the first $250 per year.
After that, if the treatment is "reasonable" and necessary then she has to contact DH. He then can say yes proceed with treatment or can say no.
But if he says no and she pursues through court, they would have to go to mediation to come to an agreement.
If he says yes then he simply pays after she gives receipts.
If she proceeds without getting him to agree or without getting the court to interven then the cost is on her. So.... I would suggest you look at the parenting plan to see what it says.

I personally never ask my x to help with the extra costs. I don't have the energy to argue with him and as long as he pays the child support I'm happy and guess what??? the kids are extra happy. (but if I really needed the financial help I'd ask but I don't need it so I'd rather have the peace.

My DH's x on the other hand.... wow. He was paying an extra $200 a month just to create a peaceful environment so she would not have to ask for anyting more. But...... that failed. She still managed to demand more way beyond the courts ordered. To the point that we want to get a new parenting plan in place so that we have something that defines everyting to the t. Of course she will find something to complain about especially since we reduced the amount we were sending because she was ungrateful. So now we pay exactly what the court says we pay. I would just be careful to not catch contempt charges so definately look at the parenting plan and ask for a modification if need be.

unbelieveable's picture

uh you just do whatever your paperwork says you have to do but IF she is abusing this - you should get a hold of a lawyer or something - if a judge thinks she is just doing this to be an annoyance and rob you of more money he will most likely say welp - she is just going to pay in full everytime she takes her to an unnecessary appt. This happens all the time. We had this issue too. If she has to pay with her own money you can bet she will quit abusing the appts.

sickofitall's picture

Well we didnt pay it. Mailed the check off 2 days ago.Should be getting a really nasty text or phonecall anyday now.Honestly we just didnt have the money. We just paid for half of her AP course at school( which she is barely passing and never gets to school on time to go to) plus other things. Just looked online and she found another specialist to take her to.More copays in the works.

There is no parenting plan in place and there was no stipulation for her to pay the first 250 in copays. They divorced in the early 90's and she has sole custody and he had visitation only. He didnt have a lawyer during the divorce and signed everything they said to.I didnt know him at that time or I DEFINATELY would have talked him into his own lawyer.

We have always paid half and it used to be somewhat reasonable. But for the past 3 years she has taken SD to hematologists,urologists,endocrinologisrs,gastro dr.,ent,gyn,pulmonists,rheumotologists. I think thats all of them not counting the pediatrician monthly.I honestly dont know why they havent flagged the account or why these doctors dont see whats going on. We cant get any info anymore becasue she is of age and they have their privacy policy and wont tell DH anything without her approval.They have never found anything wrong except I-dont-want-to-get-up-early-in-the-morning-itis. She moves from specialist to specialist.The nutritionist was the newest but it wasnt even submitted to insurance. We were wondering if it was for supplements or something.No idea.

We dont have the money for courts and lawyers right now but we'll see what happens. I wont get into anything with her and DH has been having blood pressure problems and I dont want him getting too upset.Thanks for the advice. It probably would have been easier to pay it but we just couldnt swing it. I like to feed my kids once in a while too Smile

ETA-we do pay her almost 1000 month child support which she call peanuts! Wish I had it lol