Splitting the costs per the agreement & medical coverage

[athene1399]

We have this problem a lot and I think others do as well so wanted to start a new thread. In another thread, Penny mentioned:

[H] sends [BM] a message saying how much the kids are enjoying their lessons and he's sure they would love it if she signed them up on her time as well. Instead she signs them up for daycare on his time (that he doesn't need? like she's just wasting money? and she wants him to pay half for this even as she hasn't paid for lessons)...

We experience similar situations as well. Has anyone found an effective way to deal with this?

The courts have only ordered the parents to split medical costs, but that is an issue. The most recent example was when BM asked if she could buy SD glasses, then bought her glasses, prescription sunglasses and contacts. SO didn't want to split all that since he only agreed to the glasses. it was an argument for months until SD needed some teeth out. SO paid for the surgery and BM's reason to not pay for half was the glasses from before. He was fine with that, but fast forward to that summer and SD needs glasses. We couldn't use the Medicaid insurance she has because when BM took her, she used her work insurance, gave SO that receipt, then sent the same receipt into Medicaid for reimbursement. Turns out she paid nothing even though she demanded half. SO had to pay for the new glasses for SD out of pocket. Every time he asks BM for her half, there's always an excuse why she can't pay. The last excuse was she was going to buy glasses this time around with her flex money (but it didn't work out because she was fired and the company took the money back). But she does something similar to what Penny mentioned, where she buys something SD doesn't need and expects SO to pay for half or it to eat the cost of what she owes SO. She's been trying to get out of paying SO for the glasses since he bought them. We're going on a year now and still haven't seen a dime towards the cost of the glasses. I think going forward if she has insurance through work we will have to ask for the Medicaid denial letter first (and just assume she's sending the receipt to them). That will cause a blow out, but whatever.

I really want to cut her out of the process. First off, we would have to change the agreement so SO is in charge of the insurance. Does anyone know what evidence you need to show the other parent is incapable of handling the insurance? I have evidence BM lapsed SD's insurance three times and she never supplies SO with the explanation of benefits even though he requests it multiple times. Is that enough?

Second, does anyone know if you can legally take on the responsibility for the medical payments and say you don't want the other parent to pay half and if that parent buys anything themselves they have to eat the cost? Like can we make an agreement where SO pays for all medical costs himself and SD should have SO take her to the doctor, and if BM takes it upon herself to take SD to the doctor she has to be responsible for the costs since she didn't go through SO? We haven't had the chance to get a hold of SO's lawyer yet, so I was wondering if anyone knows if there is a legal option to do this. If not, any suggestions on how to try to keep the medical costs split? Or do we just have to deal with the headache until SD turns 21 (which is when the agreement ends in our state)? 

[Penny Lane]

Haha! Glad we're not the only ones! H has been tearing his hair out over this whereas I've been trying to do radical acceptance and just accept that we're just going to pay for more things than she will.

DH's experience was that when BM let the kids' insurance lapse once, and then lied about it, he immediately took her to court. For us, it felt like it was too important to let little kids go without insurance and to deal with the uncertainty on our part of whether the kids did or didn't have insurance. But the major issue never got in front of a judge. Instead she settled by letting him put the kids on his insurance and reducing child support, in large part because H showed her how much cheaper that would be to her than to put them on her more expensive insurance.

A question, are you saying your SO would just pay for insurance without asking BM to contribute? Or does he want her to pay for half of the premium? If it's the first one, I think that actually could be pretty easy. As I see it your SO has three options here: Try to work out a deal with BM, try to get a judge to change the order, or just do what you want to do and tell her what you are and aren't willing to do.

If he goes the trying to work with her route, he could say "now that SD is an adult I think it makes sense to revisit the insurance arrangement. I'd be happy to put SD on my insurance at no cost to you and pay for any doctors visits I take her to. My open enrollment is (XX month) - let me know if you'd like me to add SD." It never hurts to try - all you lose is emotional energy so just limit the amount of it you spend.

In terms of court, I honestly think it's not likely that a judge would mess with the arrangement. You'd need to ask the lawyer to be sure. But also even if they do - H's case dragged out for more than a year at which point you'd be halfway to the time when the order doesn't apply anymore. That being said, maybe you could get BM to agree to let SD go on H's insurance as part of a settlement. Like, if she's supposed to be providing insurance and it lapses again, file a contempt motion and/or some kind of motion to get SD on SO's insurance. Then offer BM a good deal for her - H is in charge of insurance, she's no longer responsible for it. Maybe she'd sign it? That's an expensive gamble though.

The last option is the one I think is the most feasible for you. What if SO just ... paid for stuff, and let BM pay for stuff without reimbursement? She would definitely find a way to make sure the balance is in her favor. But at this point SD is an adult. What would he be willing to pay for if BM wasn't in the picture? Just pay for that and when she requests reimbursement for stuff be like, no at this point you owe me ("$X amount" or "hundreds of dollars" or whatever), you can take it out of your debt to me. My H keeps a spreadsheet so he can say exactly how much BM owes him at any given time. But I'm not even really sure you need to document this - is BM really going to take your SO to court over this? If not, you can just ... set the boundary of "I'm not going to give you any money unless I see the Medicaid denial letter." Even if she DOES take SO to court, she'd have to show the Medicaid acceptance or denial and my guess is it wasn't denied. So she has no case anyway. She won't like it, but she doesn't like anything that he does, right?

SO could even just put SD on his insurance (unless he needs BM to contribute financially in order for that to happen) the next time SD's insurance lapses. This might not be a great option because you don't want to have two insurances (in case they both say the other should cover something and neither one does). But he doesn't need BM's permission to put his daughter on his insurance plan.

I would say, overall, SD is an adult now and I think your SO can way, way pull back on how much he talks to BM and what topics he discusses with her. He should be able to work most things out with SD herself. Like, maybe SD is responsible for making sure she has insurance and SO says "You need to always have insurance otherwise you could end up owing tens of thousands of dollars if something goes wrong. You always have the option of going on my plan, let me know if you want me to add you." And then she can work it out with BM, or not, but that's up to her.

I know how frustrating this all is so I would say, what solution can you live with and also afford? Do the one that causes you the least stress.

[athene1399]

I really think we will end up doing the last option you suggested. The thing is, SO is self-employed so he is on Medicaid. BM was putting SD on her insurance when the agreement was first made (that she's in charge of putting SD on her insurance and SO pays half the premium and splits the copays or whatever medical costs come up). A month later, BM quit (put in her two weeks), yet didn't set up SD with any insurance.  That was the first lapse. It was so quick after the original agreement and we were still in court over custody we had no money to do anything about it. So since then, SD's been on Medicaid off and on. With every one of BM's job switches she puts her on that insurance and was canceling the Medicaid (because if she went from temp to permanent she would "make too much money for medicaid"). Sometimes she let the insurance lapse because she's convinced the place will hire her and they don't. So then SD went through a couple times where she needed insurance and didn't have it. BM was able to get the Medicaid back date, but services had to be paid for up front.

My problem is this has been going on for four years. Most of the time SD's been on just the Medicaid since BM works for maybe three months then is off the rest of the year trying to find work. SO's on Medicaid and he's the custodial guardian so I don't see why SD wouldn't qualify to stay on it. Maybe we can talk to SD and see if she can access her account on line now that she's 18. Maybe walk her through how to make sure her coverage is still active and identifying when she needs to renew it to stay on (because BM had it lapse once for that reason too). Then maybe ask BM if we can just keep her on that instead of switching her every five seconds BM gets a new job (I won't word it that way of course. I'll have to figure something out). And let her know SD should still qualify since SO is the custodial guardian and he qualifies. And if he needs to report his income to sign her back up for it he can. Maybe say we are willing to pay for anything up front without asking for half as long as BM does the same (like if she takes SD she has to pay, and if she's not okay with that to let SO take her). It's really only the glasses we have had to pay out of pocket for. And that was because you can only use Medicaid once every two years for them. So it's not terrible.

But as you said, we'd need BM to agree to that. If she doesn't, we could do the one you suggest where we just say "we're taking SD to get glasses, I'll let you know what you owe...", tell her what she owes, then just leave it at that and keep it in a sheet. When she asks for something, remind her what she owes.  If she threatens court we will have the documentation to back up what we are saying, especially that we asked her for what she owes and told her about it up front.

The other issue is BM sometimes makes appointments for SD then the day before/day of asks us to take her because she can't. We used to rearrange our schedules when this happened, but this week we said we both have too much going on and can't. We just started the "if BM makes an apt she will have to be the one to take SD (or we reschedule)". SO and I discussed it last night because it came up. It's too stressful to have to hear about it last minute when we weren't expecting to have to take SD anywhere. If it was an emergency that would be one thing, but in this case it was not. It was scheduled months ago (ortho) and we're just being told now BM can't take SD (when we didn't even know the apt existed). I think if we set up boundaries with this it will get better. We told SD we can schedule apts when it's a good time for us then we can take her, but if it's a surprise and we don't know about it, we really can't take her. I used to do the ortho stuff but really can't this year. Luckily she's not had to go in for a while, but it's still irritating that BM makes appointments for SD then can't take her. BM's done it with doctor's appointments in the past. At first she did it to get SD for more time (she would put the apt on SO's time then say he couldn't see SD for this reason), but now that BM has SD all the time she does it then can't take her. I think she does it because she wants to be a good mom, but then is so disorganized she realizes at the last second she can't do it. We just don't have the time right now to bail BM out. Is that unfair of us?

[Penny Lane]

Could SD just enroll herself into Medicaid, since she's 18 now? With your SO's help it seems like that should be something she can do? Then it's HER responsibility, not BM's.

And on doctors visits, I know she doesn't have a license but I hope you guys can encourage her to find ways to get herself to the doctors office. That'd be a good way for her to exercise her independence, I think. I was taking myself to the doctor basically as soon as I could drive and it was a really good thing for me to learn how to do. I do NOT think you should drop everything to take SD to a non-emergency appointment that BM tries to dump on you at the last minute.

[Associate of Daniel]

The health things seems to be problematic with many pd parents.  My own dramas with uNPD exH regarding ds's health have been dragging on since he left nearly 7 years ago.

Our country's health insurance system is different from others'. 

Private health insurance is optional. Everyone has access to Medicare.

Private cover is exhorbitantly expensive and only worth it if you have the most expensive cover.

UNPD exH has ds covered on his family private insurance but refuses to give me access to it.

Initially we had it that I would pay the entire gap.  But after a long time I realised that uNPD exH was not paying any higher premium for having ds on the policy.  So I said I'd pay half the gap instead.

UNPD exH chucked a tantyand refused.

We have been around in circles so many times but his latest demand is that we each pay for appointments that happen on our times with ds.

This seems to be working.

My problem is that uNPD exH doesn't inform me of appointments he's made until after they've occurred.  Not only that, he doesn't usually attend any of those appointments. His uNPD wife does.

He also doesn't attend any of the appointments that I've made, even though I give him plenty of notice.

Instead, he takes ds to another practioner for a "2nd opinion" who always has a "better" report. A report that says exactly the same thing as the first one.  No doctor that I take ds to is good enough. They're all terrible.

So poor ds gets dragged to unnecessary appointments.

My suggestion is that you are unlikely to succeed in having BM play fair, or even logical.

So, as another poster suggested, try to have SD set up her own account. If that's not possible, just pretend that BM doesn't exist and arrange and pay for all appointments yourself. Radical Acceptance is the way to go.

Even though it can be expensive, it is very worth it to have less contact with the pd, and therefore less drama.

The health thing is confusing without pds.  Their presence turns the whole thing into a mind boggling unsolvable, frustrating, relentless mess.

Hopefully you can come to a "solution" soon.

AOD

[athene1399]

he takes ds to another practioner for a "2nd opinion" who always has a "better" report. A report that says exactly the same thing as the first one.

haha yup. This is generally the type of reason BM takes SD to the doctor herself, she didn't like what SD's pediatrician said about something. Then the specialist or emergency room (yes.. the emergency room) says the exact same thing.

I would love to just pay for what we pay for, but I know the second BM takes SD to a bogus apt she will ask for half even though we've been paying for everything else (which it really only ends up the glasses aren't covered in full, everything else generally is aside from some prescriptions). I think maybe the idea of letting BM know what we paid and keep a ledger a when she asks for half we can say "no because you owe us for x". At least for now until we figure something out.

But after a long time I realised that uNPD exH was not paying any higher premium for having ds on the policy.

That's terrible! SO just has to pay half the difference between the single and family plan (for when BM gets insurance through work). We had an argument because she thought we were supposed to pay half the plan, not half the difference. It's seriously been one headache after another since this stupid agreement was put in place. 

And then we tried to get around that by saying "Why don't you just keep SD on Medicaid instead of changing insurances all the time?" and she said "she'll make too much money if she gets hired permanently." It's like why don't we cross that bridge when we get there? But eventually we realized she did keep the Medicaid and was being reimbursed for things without telling us (yet asking SO for half n top of that). She just uses it as a scam to get money. She really is s scam artist. The last place she worked at she gave us a number of what we're supposed to pay in a text without documentation. SO said we wouldn't pay without documentation, and the documents were never sent. So assuming she didn't really have to pay for insurance but was trying to get money anyway?

I think you are right though, AoD. I just need radical acceptance. She's always going to scam SO out of money and there's probably nothing we can do about it. I think the best first step is to talk to SD about seeing if she can sign herself up and be in charge of Medicaid herself. Maybe we can talk her through the process since we've had to do it ourselves for SO. Maybe we could let BM know as long as SD is eligible for Medicaid, we aren't paying for secondary insurance. The order doesn't say we pay for secondary insurance.

I also like your idea about the parent who takes the child to the apt pays for it. We generally always take SD unless it's a bogus "i didn't like what the doctor said" appointment. And sometimes the ortho. I don't know what it is, but sometimes BM just wants to take SD there. Then I think she remembers she owes them money so tries to get out of taking her last minute.

And Penny, i think the "making sure you can get to appointments yourself" could be good too. That way she can learn to be responsible for finding a ride places instead of her mom scrambling at the last second because she can't take her. Maybe if SD does this, we will hear about appointments we didn't already know about. Like everything is always fine when we make the apt, it's when BM makes the apt that chaos happens. So maybe SD can make the connection that when BM makes the apt she should work on finding a  ride right away so it isn't last minute.

Thanks again everyone. And if you think of any other ideas, please let me know. There's just so many parts to the insurance problem; it's really like 10 separate problems.

[HotCocoa]

Athene - I feel for you. 
My ex had the insurance on our children.
He would get angry and threaten to remove them at certain times, sporadically, whenever he wanted to hold something over our heads.
So, even though he makes more than me, considerably more, I took them on my insurance to guarantee they would have medical.
The court agreement stated he was to carry the insurance.  I'm not saying ever go against a court order, however, I felt it necessary to make sure they were insured.
Then, he was ordered to pay for like, 90% of all out of pocket medical expenses.  He always and consistently shorted it, went to attorneys to fight it, complained about how my insurance is horrible and he has the best.  He wants to take them back now because he can be reimbursed for all medical expenses, however, still expects me to pay up front for all costs, but he gets reimbursed.
So, yeah.  I've been shorted plenty of times and unless I have to speak to my attorney, I've given up.  Between him just wanting to pick and pick at things and argue and harass and then decide he wants attorneys involved, its too much and messes with the peaceful way of life I have created without him.  My children are happier and I am happier. We are at peace and in my home we are free to be ourselves.
This probably won't be solved until DD is older, and by solved I mean, it either goes to court, or DD takes insurance on her own, or you guys take her under your insurance and live with the added costs.  Wish there was an easy answer, there's not.  You just have to find the answer that brings you peace and not dealing with this woman, however that may happen, is the right choice.  Good luck.

[athene1399]

Thank you, Hot Cocoa.

The main reason I wanted to open this can of worms so we could get a court document or agreement that removes BM from the process so we don't ever have to speak with her again. If SO and I split everything, things are fine. It's when BM tries to go out and do stuff when problems are caused (believe it or not). That's why I want to just remove her from the equation if we can.  That will involve weighing if we want to deal with whatever drama it may cause while trying to remove her vs things remaining as they are (which is also drama at times). If she didn't go through so many job changes I don't think it would be as bad, but that is not our reality. And what compounds the issue is she goes on long spans of being unemployed yet unable to collect unemployment, so gets stressed over money. The stress affects us because she tries to start stuff or scam her way into more money. She uses the current medical agreement as leverage for her scams. I've never hated a piece of paper more in my life. I think we've almost mastered every loophole she's found,but there's push back from her when she can't win at a scam. Which we expect every time,but I just want to never speak to her again or have to try to figure out what she's planning next. I know we're all there too. So maybe there's no way to erase her until SD is 21. Maybe I will have to accept that (but for now I'm happy to be stubborn and try to think of a way around that and try out some things before I accept that). I know there is no magical solution, but I'm ready to try something other than what we've been doing to see if things improve.