In a Texas divorce, the court addresses the matter of your children’s healthcare costs in the context of child custody and child support. Typically, the parent who has better employment-based health insurance coverage keeps the children on his or her policy, and the cost of doing so is included in the child support calculation process.
Often, however, children generate out-of-pocket healthcare expenses. If you are the primary custodial parent (or the parent who covers these expenses), you will need to seek reimbursement from your children’s other parent, which can be a daunting process if you do not have a system in place.
If the unreimbursed medical expenses are piling up, do not wait to reach out to an experienced Killeen child support attorney.
In order to obtain reimbursement for your children’s out-of-pocket medical expenses, you will need to do some serious documenting for each expense.
You will need a physician’s statement for each visit that leads to an out-of-pocket expense. The receipt provided to you by the doctor’s office at the time of service will generally suffice, but it must include your child’s name, the date of service, and the payment method.
You will also need to supply proof of each subscription you fill that leads to out-of-pocket costs. A printout of each child’s patient history from the pharmacy will generally suffice.
Explanation of Benefits
If the insurance company’s explanation of benefits (EOB) is accessible to you, it reports the patient’s portions of each medical bill, but it will not serve as proof of payment. As such, you will need to attach specific proof of payment for each expense.
If any of your children have any ongoing expenses, you will need to compile these charges and related payments. A common example of ongoing expenses is braces, which require keeping all the following information together:
The dental contract, including the down payment amount and the monthly payments
The physician’s statement (or printout) given to you at each visit
Proof of down payment
Proof of each monthly payment
Surgeries and Hospital Stays
If any of your children require surgery or need to be hospitalized for any reason, the billing is often quite complicated. Categorizing each expense into the following basic categories can help to ensure that you are reimbursed appropriately:
Physician fees, including surgeon fees, anesthesiologist fees, and any others that apply
Lab work expenses
All EOBs and proof of payment should be kept together
Proof of Payment
A significant portion of ensuring that you are properly reimbursed comes down to proving payment, which can be accomplished with each of the following forms of documentation:
Credit or debit card receipts
Canceled checks (but not with the carbon copies they generate)
Bank statements that break down automatic payments and clearly identify who is paid
Proof of payment must be attached to the corresponding medical bill from each specific healthcare or insurance provider.
In other words, being reimbursed for out-of-pocket medical expenses requires considerable effort on your part. Because these expenses can be considerable, having a system in place can prove invaluable. If this responsibility seems overwhelming, remember that your experienced child support lawyer is standing by, ready to help.
Compiling the Information
It is not enough to gather all the required documentation – you will also need to compile it in a way that clearly demonstrates how much reimbursement you are entitled to receive and that allows you to keep careful track of the matter over the course of time. Typically, the best approach is with a basic spreadsheet (for each child) that includes columns for the following information (in chronological order):
Each medical visit and its cost
Each prescription medication and its cost
Any ongoing medical expenses
The number of times each expense arises and the date it is incurred
The reason for the medical expense
The amount that you paid out of pocket for each (and the full cost, if different)
The amount of reimbursement that is owed to you by the other parent
The date you sent documentation of your out-of-pocket expense to your children’s other parent
The reimbursement you receive, including the dates you receive it
Keeping your records up to date helps to ensure that you do not lose track of your children’s out-of-pocket medical expenses, that you have the documentation you need to back up your requests for reimbursement, and that you are well prepared to file legal action if the need arises.
Sharing the Information
Generally, parents share records related to reimbursement electronically. You are required to provide your children’s other parent with proof of out-of-pocket healthcare costs (as discussed above) by the 30th day of receiving said proof. This means that your medical payment and your reimbursement report to your ex are generally due on the same day.
The best approach is to compile your out-of-pocket medical expense reports as you go and to deliver them to your ex monthly – along with a dated cover letter that includes an overview of the details contained within. It is also important to keep hard copies of everything you send.
There is no deadline for getting your reimbursable healthcare expenses to your ex (in terms of your right to reimbursement). However, if your notification is outside the allotted 30 days, you lose the option of having your ex held in contempt of court for failure to reimburse.
You can, nevertheless, seek reimbursement for your out-of-pocket expenses regardless of how much time has elapsed.
Contact a skilled child support attorney right away if you need help obtaining reimbursement for out-of-pocket medical expenses.
A Note about Payment
If your children’s other parent is obligated to reimburse you for out-of-pocket healthcare costs (or for a percentage of these costs), you can only seek reimbursement for the healthcare expenses that you have already paid. The reimbursement requirement does not extend to those healthcare costs that are outstanding or unpaid.
The same applies to partially paid medical bills. For example, if your ex is required to pay 50 percent of your children’s out-of-pocket medical expenses, you can only seek reimbursement for 50 percent of what you have paid.
This means that if your child had $1,000 in out-of-pocket medical costs one month, your ex would need to reimburse you $500 – but only if you paid the full $1,000. If you only paid $200 of this outstanding expense, your ex will only be required to reimburse you 50 percent of this amount – or $100.
In Texas, child support is calculated according to state standards that take all the following factors into consideration:
The age of each child who is covered
The physical and mental health of each child who is covered
Any special needs any of the children have
Each parent’s financial situation – including the ability of the payor to pay and the degree to which the payee needs the support
The cost of childcare if the custodial parent were to work outside the home
The income and other financial resources of the payee
The amount of time each parent spends with the children
The children’s health insurance expenses
Each child’s education expenses
Any extraordinary expenses incurred by any of the children, such as tutoring or extracurriculars.
Any other factors that the court finds relevant to the case in question
The court will address the matter of who will cover the cost of the children’s health insurance (often through employment-based coverage) and the matter of out-of-pocket healthcare expenses. If you are the primary custodial parent, your ex may be required to reimburse you for all (or a percentage) of the out-of-pocket medical expenses you cover.
If You Are Not Reimbursed
If your ex is not reimbursing you for the out-of-pocket medical expenses you cover on behalf of your children, it can leave you in a considerable financial bind. If your reasonable efforts to obtain payment do not get the job done, it is important to recognize that the law is on your side and that a trusted child support attorney can help.
FAQ about Reimbursement and Child Support
Reimbursement and child support are important and often-complicated legal matters, and the answers to some of the questions that are asked most frequently may help with your own concerns. For more FAQ about child support, read “Texas Child Support FAQ.”
If my ex does not pay child support or reimburse me, can I decrease visitation?
This is a very common question that is important to address clearly.
The state makes decisions that pertain to children in accordance with the best interests of those children. As such, child custody and child support are separate matters. It is in the best interest of children to see their parents according to their court-ordered visitation schedules and to benefit from court-ordered child support.
In other words, if your ex is not reimbursing you or is not paying you child support in accordance with your divorce decree, you can address the issue through legal channels, but you cannot retaliate by withholding visitation.
The same is true when a parent refuses to follow the court-ordered parenting time schedule. The other parent cannot cut off child support in protest. Instead, he or she must seek a legal remedy.
If you find yourself struggling with your ex’s noncompliance with your child support order, contact a child support attorney right away.
Can child support be changed?
The court can issue child support modifications when the financial circumstances of either party involved – or the expenses incurred by the covered children – change significantly.
To be considered a significant change, you will generally need to demonstrate that it amounts to at least a 20 percent change in the current child support amount (or a change of at least $100). Further, every child support order is entitled to review every three years.
Are child support payments taxed?
Child support represents funds that the payor would have spent on the covered children if the parents had remained together. As such, the parent who pays child support does not get a tax deduction, and the parent who receives child support does not pay tax on it.
When does child support end?
Child support is typically ordered until the child in question reaches the age of 18 or graduates from high school (whichever comes later). If a parent is paying child support for a child with physical or mental special needs, child support may continue indefinitely.
Speak with a skilled Killeen child support attorney to learn more about how the duration of child support will play out in your case.
Who pays child support?
Generally, the noncustodial parent has the child support obligation. This means the parent with the visitation schedule usually pays child support, and the other parent provides the children with their primary home. Even if you and your ex split your time with the children equally, however, the parent with more considerable earnings is very likely to be the parent who pays child support.
How is basic child support calculated?
The child support calculation process is complicated, and many factors can play a role. However, the basics involve determining the payor’s net monthly income, which refers to his or her gross monthly income minus specific allowable deductions. From here, child support is calculated in accordance with the number of children being supported.
Consider the following common calculations for child support:
For one child, the parent pays 20 percent of his or her net income.
For two children, the parent pays 25 percent of his or her net income.
For three children, the parent pays 30 percent of his or her net income.
For four children, the parent pays 35 percent of his or her net income.
For five children, the parent pays 40 percent of his or her net income.
If the payor is supporting six or more children, the percentage cannot be less than it would be for five children.
An Experienced Killeen Child Support Attorney Is Standing by to Help
Brett Pritchard at The Law Office of Brett H. Pritchard in Killeen, Texas, understands the financial significance of reimbursement for your children’s out-of-pocket medical expenses and is well prepared to skillfully advocate for your case’s most favorable resolution. For more information, please do not hesitate to contact us online or call us at (254) 781-4222 today.