Medical Reimbursement - Watch the clock

The worst part about getting your mail every day is the prospect that it contains bills – and if you or your children have health concerns, it can make walking to the mailbox more like walking the plank. 

Most divorce judgments and child support orders contain a provision where the parents have to divide the cost of unreimbursed medical expenses for the children.  Typically, the parent who receives child support has to pay a certain amount of money out of pocket, called an “ordinary medical expense,” before the other parent’s percentage towards the unreimbursed costs commences.  At present, the 2013 amounts are:  $357 per year for one child, $715 for two, $1,072 for three, $1,430 for four, and $1,787 for five or more children.

If an ordinary medical expense is included in your court order, the parent paying support is actually contributing to this annual amount each month in his child support based on a percentage determined by the child support formula.  Even if you don’t reach the out of pocket amounts, you don’t have to return the money to the parent paying support.

Let’s say you pay the ordinary medical expense before the year runs out, and you now want your ex to pony up his percentage towards unreimbursed medical costs for your child.  How do you go about doing this the right way?

Naturally, there’s a form for this, called “Client Demand for Medical Payment” (SCAO Form FOC 13a) and instructions as well – you can conveniently find these on the Jackson County Friend of the Court’s webpage.  Fill out the forms appropriately, and be sure to attach all supporting documentation so there’s no question that your ex owes that amount or that you have paid your portion.

One of the biggest problems people face is waiting too long to ask for the reimbursement – there are of course time limits on basically everything in the law.  The magic number is 28 days – you have to request the payment from your ex within 28 days of the actual expense or within 28 days of your insurance company finalizing its claim.  Once you’ve done so, your ex has 28 days to respond to your request for payment.  If he doesn’t, you can ask the Friend of the Court for enforcement (assuming you utilize the FOC’s services of course).

In order for the FOC to assist you, there are time frames yet again, conveniently listed at the bottom of the form for your reference.  In addition to the 28 day limitations described above, you must also submit your enforcement request to the FOC no later than one year after you paid the expense, and within six months after your ex defaults in paying the amount required.  If you have health care insurance, you have to submit your claims to the insurance company within two months after the expense was incurred. 

Being organized and keeping good records is a must in ensuring reimbursement for your children’s health care costs.  Failing to follow any of the time frames means you may end up paying these costs on your own – let’s face it, the doctor’s office is probably not going to be sympathetic to you missing a deadline.