Who is responsible for the insurance co-pay on medical visits?

Question:

My children are now covered by my health insurance after my ex-wife lost her insurance. Now that they are covered by my insurance, my ex is taking them to the doctor for anything and everything claiming that I am responsible for the co-pays. Are co-pays considered uncovered medical expenses, and would I be responsible for paying them?

Do I need to modify the court order to specifically state that if she takes my children to the doctor, emergency room, etc. that she has to pay the copay for it since I provide the insurance?

Answer:

Co-pays for doctor visits typically fall under the category of “uncovered medical expenses.”  Your divorce decree should have a provision regarding uncovered medical expenses.

This provision, if it exists, should establish who is responsible for those expenses. Often, these expenses are shared equally between the parties, i.e., if you have a $20 copay, then you would each be responsible for $10. Just because your ex-wife is not covered by your insurance does not mean that she is not responsible for co-pays.

You may want to modify your judgment if the language regarding uncovered medical expenses is not set forth in your divorce decree. You could propose to the court that she pay the co-pays because you cover the premiums.

Whether the court will agree with your proposal depends on several factors, including placement, child support, and other expenses for the children that are covered by the respective parties.

Your question does not indicate whether or not you pay or receive child support, but you may also want to modify the court order to recognize that you pay for all the insurance premiums, which could potentially qualify for a decrease in any child support you may pay or increase in any child support she may pay to you.

The likelihood of modifying your judgment as you desire depends on the facts of your case and the laws in your jurisdiction.

I suggest that you seek further advice from an attorney. Cordell & Cordell has divorce attorneys in 18 states throughout the country that would be happy to speak with you about your case.

 

Trisha B. Festerling is an Associate Attorney in the Milwaukee, Wisconsin office of Cordell & Cordell where she practices family law exclusively. Ms. Festerling’s practice is focused on men’s divorce, child support, child custody, paternity and modification. She is licensed in the state of Wisconsin. Ms. Festerling received her Bachelor of Science degree in Criminal Justice with a focus on Political Science, Magna cum Laude, from the University of Wisconsin – Milwaukee. She received her Juris Doctor from Regent University School of Law in Virginia Beach, Virginia.