Step-Parent Carrying Children on His Health Insurance

My question involves child support in the State of: IL

As it turns out, my ten year old kid needs braces. Ex husband doesn't have insurance coverage for this, but step-dad is able to cover the child on our insurance. I have sent this information to my attorney and my ex. I expect my ex-husband not to be thrilled about this but he came to me asking of I had insurance to cover the kids under my insurance ... so we did.

Does this affect child support? If so, how would it impact child support?

Why would it affect child support? At most, you may be entitled to reimbursement for half of your out of pocket expenses. However, some courts (maybe someone more familiar with IL law will pipe up? I don't have time to research it right now) consider braces purely cosmetic and won't require reimbursement unless deemed medically necessary.

Does your order address orthodontia?

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Quoting EA1070a

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Why would it affect child support? At most, you may be entitled to reimbursement for half of your out of pocket expenses. However, some courts (maybe someone more familiar with IL law will pipe up? I don't have time to research it right now) consider braces purely cosmetic and won't require reimbursement unless deemed medically necessary.

Does your order address orthodontia?

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Health insurance does factor into the child support calculation in Illinois. There are no courts that consider ALL braces to be purely cosmetic. All courts recognize that some braces are medically necessary.

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Quoting EA1070a

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Why would it affect child support? At most, you may be entitled to reimbursement for half of your out of pocket expenses. However, some courts (maybe someone more familiar with IL law will pipe up? I don't have time to research it right now) consider braces purely cosmetic and won't require reimbursement unless deemed medically necessary.

Does your order address orthodontia?

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Yes, our divorce decree addresses all medical necessary expenses be split 50/50. The child's braces are medically necessary as the bottom teeth are cutting into the upper palate. The child was a thumb-sucker.

One factor of our child support arrangement includes costs for medical/dental/vision insurance.

Thank you

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Thank you,

But how will this affect the child support. Unless the father removes the child from his insurance (strangely enough I couldn't even do that with my policy) the fathers insurance will, most likely be considered primary with sdads as secondary. It won't alter the cost to the father other than both parents may enjoy the benefit of a secondary policy resulting in less out of pocket costs for both parents b

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Quoting llworking

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Health insurance does factor into the child support calculation in Illinois. There are no courts that consider ALL braces to be purely cosmetic. All courts recognize that some braces are medically necessary.

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Yeah, you didn't read what I wrote. I said SOME courts consider them to be cosmetic unless otherwise demonstrated to be medically necessary.

If MOM carried insurance and DAD carried insurance then those figures might have an impact. But generally NOT the cost of insurance under step-dad's plan.

Go back and read the original post.

ETA: having just looked at The CS guidelines for Illinois they calculate on a straight up percentage of NCP's net income unless a deviation can be justified based on a few limited circumstances. OP states that the monies paid for support take the cost of health, dental and vision into account. That would be the amount the parents pay. And step-dad isn't in that category.

Insurance companies usually apply policies in order of the Birthday rule. Whichever parent or step-parent having the earliest birthday in the year, their policy covers first and it works through the policies applicable. The net remainder, is usually covered by the custodial parent in the absence of a court order. For example, when my step daughter needed braces, her dads policy paid according to its terms and mine according to its terms, which happened to be awesome because mine paid the entire coverage amount up front. The remainder due, we paid our half by court order up front. Dad had to go to the dentists office and sign up for a payment plan. When he missed some payments, they did not suspend treatment. When the dentist determined her braces were ready to come off at the next visit, her dad was notified he had to have is portion paid off before the dentist would remove the braces. If he missed the appointment deadline, they would extend it until he did pay. Hope this helps. BTW I had free insurance but covered my son also. It is petty to try and seek step parent insurance reimbursement especially if there is another kid it is covering.

A court order being vague can be advantageous in these situations. The State of OH wanted my wife to sign a paper so they could modify the order which said insurance was to be provided by dad. It currently said as reasonably practical by one or both parents specifically. She told them if they forced this issue on her, it would have the effect of causing a loss of coverage because my daughter had 3 health insurance policies on her.

Yeah, it's nice having coverage under more than one policy until the insurance companies start pointing fingers.

When my step-son had his wisdom teeth removed the oral surgeon's office up where his mom lives submitted the bill to our insurance company, which denied coverage stating his step-father's dental insurance was primary. She resubmitted to step-dad's insurance company and they said ours was primary.

His mom called me and told me to sort it out. <_< I spent three months working with the surgeon's office, calling our insurance company and his insurance company. I even faxed the divorce decree to both which set forth the provision that my husband's insurance was primary and any coverage that mom had would be deemed secondary.

It took three letters from my husband's HR Department directing them to pay plus a final call from me telling them that if we ended up back in court with my husband's ex over their refusal to pay that we'd haul them into court to pay our attorney's fees.

In the end the entire bill was covered but I wanted to set someone's hair on fire it was such an enormous PITA.

Fortunately the billing gal at the oral surgeon's office was a doll. I swear, I spoke to her more than a dozen times when we were trying to sort this out.

And before anyone asks why my husband didn't do it, he was working 80 hours a week and traveling overseas for business. Mom didn't work it out because, quite frankly, she just didn't want to be bothered with it so it fell on me. And admittedly, I'm much better at stuff like this than she is.

Fun times.

Take it from someone who has worked with employer-sponsored benefits for some 35+ years now.

Unless the secondary plan is considerably better than the primary plan, and there is either a court order or a VERY clear rule as to which is primary and which is secondary, it really is not worth the bother of having two plans. Unless the secondary plan pays a significantly higher percentage than the primary plan, you're essentially paying for nothing.

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Quoting cbg

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Take it from someone who has worked with employer-sponsored benefits for some 35+ years now.

Unless the secondary plan is considerably better than the primary plan, and there is either a court order or a VERY clear rule as to which is primary and which is secondary, it really is not worth the bother of having two plans. Unless the secondary plan pays a significantly higher percentage than the primary plan, you're essentially paying for nothing.

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Yep, I've specifically turned down health insurance through my employer because it's a small company and the insurance was through an HMO (I have several chronic diseases and have to have a PPO because I see a ton of specialists) and ungodly expensive and my husband has always had great insurance (knock on wood).

You must have the patience of a saint!!!