If you watch or read the news much, you know that one of the most frequently recurring topics is the matter of paying for healthcare and healthcare insurance in this country. If you are a parent going through a divorce or a paternity action, health insurance for your children is going to be an important issue. A collateral aspect of that often can be insurance “networks” and what happens when an “out-of-network” doctor is used. This all may leave you with many questions like… “Who gets to pick the doctor?” and “Who has to pay for those out-of-network costs?” To make sure you’re not left footing a very large medical bill after having had no say-so in the provider selection process, be sure you have an experienced Fort Lauderdale child custody attorney representing you in your case.
In a divorce with minor children, or a paternity action, the court’s judgment will often order one parent to maintain health insurance for the minor child (or children) at all times. Of course, for most people, that means including the child or children on their employer-sponsored plan. And, if you’re like a lot of folks, that means an HMO or other plan that declares some doctors to be “in network” (and therefore much cheaper for you) and other to be “out of network” (and therefore much, much more expensive for you.) In many divorce cases, the judge will order you and your ex-spouse to split the costs of your child’s healthcare that are not covered by insurance, so it is very important to make sure that you have the necessary control when it comes to the decision-making process in selecting a doctor for your child.
As an example, there’s this recent case from Tallahassee. T.N. and K.N. divorced in 2015. They had two minor children. The spouses worked out a marital settlement agreement that said, among other things, that the father would maintain health insurance coverage for the children and that the parents would split all of the children’s uninsured healthcare costs 50-50.
A marital settlement agreement provision requiring approval in writing
The agreement contained another very important provision, though. It said that if either parent used “a ‘non-approved provider’ for medical care with respect to one of the parties’ minor children, then that party is solely responsible for any resulting expenses unless the other party has provided written consent for the treatment.” In other words, if one parent wanted to take the child to an out-of-network provider, that parent either had to get the other parent’s OK in writing or else foot 100% of the bill herself/himself.
That was a very important provision for these parents as the couple’s daughter had a “serious medical malady.” Right after the divorce was finalized, the mother began taking the daughter to a clinic near Clearwater, even though the clinic clearly told the mother that its fees were not covered by insurance.
The total bill for the daughter’s treatment at the clinic was more than $60,000. After the mother’s family paid the entire bill, the father’s insurance did agree to cover some of the costs. The mother went back to court, asking to “enforce” the settlement agreement and make the father pay half of the clinic bill. Although the trial judge ruled for the mother, the appeals court decided that this was incorrect. The clinic the mother used clearly was not an “approved” provider. The mere fact that the insurance company paid some of the costs after-the-fact did not convert the clinic from an unapproved provider to an approved one. Because the clinic was not an approved provider and there was no evidence that the father approved the daughter’s treatment in writing, the agreement did not require the father to pay half the bill.
Whether your child dispute involves who will pay the medical bills, where the child will attend school, what religious training the child will have or some other issue… you need a skilled advocate in your corner. Turn to the South Florida child custody attorneys at Sandy T. Fox, P.A. Our experienced attorneys have many years of representing parents in family law cases and know how get our clients the positive results they need. Contact our attorneys online or by calling (800) 596-0579 to schedule your confidential consultation.