Ask A Lawyer: When A Health Provider Is Not Listed, Do I Still Pay?

Question:

I am carrying insurance on my son as was ordered in my divorce decree. If his mother takes him to a doctor that is not a provider listed in my insurance plan, do I still have to pay the co-pay and the bill?

 

 

 

 

Answer:

Most states require that the court orders for child support include provisions as to the health insurance for the children.  The health insurance provisions may be in the divorce/paternity judgment but may also be in a separate Uniform Order for Support or a Medical Support Order.   Usually such orders contain language as to the responsibility for payment of expenses not paid by insurance.  However, unless you had an attorney who is experienced with the ways in which such orders can be misapplied, the out of network provider issue may not have been addressed.  

One consideration in the splitting of uncovered expenses is to assure that neither party runs up avoidable extra expenses by using out-of-network providers or urgent care services instead of office visits.  If your court orders do not address these issues and the opposing party is unreasonably running up uncovered expenses, you may wish to consult a qualified domestic litigation firm to pursue a modification of the court order.  However, be prepared for opposing party to assert other issues or seek a child support increase in response to your effort to address the uncovered expense issue.

The court orders only address the obligations for payment of expenses between you and opposing party.  The health care providers will pursue collection from either or both parents for the care of minor children regardless of which parent requested the services, unless restricted by applicable law or by a specific contract with the provider as may be the case for elective procedures such as orthodontia.

 

Richard Coffee is a Litigation Manager in the Belleville Illinois office of Cordell & Cordell. He is an experienced divorce attorney whose practice is devoted to domestic litigation. He is licensed in the State of Illinois and is admitted to practice law in the U.S. District Courts for Northern, Central and Southern Illinois.

Mr. Coffee has extensive domestic litigation trial experience representing clients in courts throughout Illinois on all aspects of domestic litigation, including the representation of clients who are current or retired military personnel with issues under the Soldiers and Sailors Civil Relief Act and the Uniformed Services Former Spouses’ Protection Act, clients involved in state court jurisdictional disputes due to the relocation of one or both parties from or to Illinois, and clients with government or private pension benefit valuation and division issues. 

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