Uninsured Health Care Costs
Divorce Lawyer in Covina
In addition to basic
child support costs, parents are required to pay for uninsured or unreimbursed medical
expenses, or health care services not covered by insurance. This includes
co-pays, deductibles, prescriptions, and any other cost incurred as a
result of necessary medical treatments or procedures. Uninsured health
costs are addressed in California Family Code section 4063 which states that:
- The court should advise each parent, in writing or on the record, of his
or her rights and liabilities, including financial responsibilities
- The court should include in its order the time period for reimbursement
of additional child support costs subject to the requirements of this section
If a parent paid excessive uninsured heath care costs, he or she must provide
the other parent with an itemized statement of the costs within a reasonable
time, but not more than 30 days after accruing the costs. These costs
shall then be paid as follows:
- If a parent has already paid all of these costs, that parent shall provide
proof of payment and a request for reimbursement of his or her court-ordered
share to the other parent.
- If a parent has paid his or her court-ordered share of the costs only,
that parent shall provide proof of payment to the other parent, request
the other parent to pay the remainder of the costs directly to the provider,
and provide the reimbursing parent with any necessary information about
how to make the payment to the provider.
- The other parent shall make the reimbursement or pay the remaining costs
within the time period specified by the court. If no period is specified,
they should pay it back within a reasonable time not to exceed 30 days
from notification of the amount due, or according to any payment schedule
set by the health care provider for either parent unless the parties agree
in writing to another payment schedule or the court finds good cause for
setting another payment schedule.
If the reimbursing parent disputes a request for payment, that parent shall
pay the requested amount and thereafter may seek judicial relief. If the
reimbursing parent fails to pay the other parent as required, the other
parent may seek judicial relief.
Either parent may file a noticed motion to enforce an order issued. In
addition to the court's powers under Section 290, the court may award
filing costs and reasonable attorney's fees if it finds that either
party acted without reasonable cause regarding his or her obligations
pursuant to this section.
There is a rebuttable presumption that the costs actually paid for the
uninsured health care needs of the children are reasonable, except if:
- The health care insurance coverage, including, but not limited to, coverage
for emergency treatment, provided by a parent pursuant to a court order,
shall be the coverage to be utilized at all times, consistent with the
requirements of that coverage, unless the other parent can show that the
health care insurance coverage is inadequate to meet the child's needs.
- If either parent obtains health care insurance coverage in addition to
that provided pursuant to the court order, that parent shall bear sole
financial responsibility for the costs of that additional coverage and
the costs of any care or treatment obtained pursuant thereto in excess
of the costs that would have been incurred under the health care insurance
coverage provided for in the court order.
- If the health care insurance coverage provided by a parent pursuant to
a court order designates a preferred health care provider, that preferred
provider shall be used at all times, consistent with the terms and requirements
of that coverage.
- If either parent uses a health care provider other than the preferred provider
inconsistent with the terms and requirements of the court-ordered health
care insurance coverage, the parent obtaining that care shall bear the
sole responsibility for any non-reimbursable health care costs in excess
of the costs that would have been incurred under the court-ordered health
care insurance coverage had the preferred provider been used.
When ruling on a motion made pursuant to this section, in order to ensure
that the health care needs of the child under this section are met, the
court shall consider all relevant facts, including, but not limited to:
- The geographic access and reasonable availability of necessary health care
for the child which complies with the terms of the health care insurance
coverage paid for by either parent pursuant to a court order
- The necessity of emergency medical treatment that may have precluded the
use of the health care insurance, or the preferred health care provider
required under the insurance, provided by either parent pursuant to a
- The special medical needs of the child
- The reasonable inability of a parent to pay the full amount of reimbursement
within a 30-day period and the resulting necessity for a court-ordered
The essence of California Family Code section 4063 is that if either party
incurs a medical expense not covered by insurance, the party incurring
the expense must send confirmation of payment to the other parent whereby
there is an expectation of re-payment within 30 days. Again, although
a greater time may be allotted, the norm is a 30 day window for which
to send these expenses to the other parent and an additional 30 days for
which any amount incurred should be paid. The court does not want a parent
holding receipts for an inordinate period of time and then sandbagging
the other parent with a huge medical bill.
In addition to timing, please keep in mind that the above code section
does not apply to such luxury items. For example, braces, which are not
mandatory, may not be reimbursed, particularly if one parent does not
agree to incur the cost for such an expense.
Finally, if insurance is available, but a parent opts to not utilize the
insurance or obtain services from an out-of-network provider, then that
parent may be solely responsible for the cost incurred and cannot request
reimbursement from the other parent.
Call Us at (626) 788-9864
If you’re being targeted with extraneous medical costs, or your ex
has refused to reimburse you for uninsured child health care, contact
us as soon as possible. Our
experienced Covina divorce attorney has worked for many years assisting people pre- and post-divorce. We understand
how difficult managing separate lives is, so trust us to represent you
in negotiations and in court.
Call us or
fill out our online form to schedule a free case consultation today.