covered insurance providers

[gimmeabreak]

I am court ordered to provide insurance for my child. I have changed insurance carriers due to changing jobs. My ex is rufusing to take our child to a network provider because she says that it would upset our child to change dentists. What do I do? I have to pay all of uncovered medical bills, but can barley afford the monthly insurance premiums. I can't afford this.

[CollegeDad]

What does your divorce decree say about how you and your ex are going to pay for medical expenses?  Does it say that you and your ex are going to split all medical expenses that are not covered by health insurance?  If so, then your ex-wife is costing herself more money.

Also, who is given charge of the medical care of your child?  Does the divorce decree grant your ex total control over medical decisions for your child or do your both hold that jointly.  Most likely if your ex has primary custody of the children, then she can decide which doctor the children see.  And you may only be allowed access to your child's medical records but not any control over your child's medical care. 

If you are not happy with how decisions are being made concerning your child's medical needs, then I believe you would need to demonstrate how your involvement would improve the care your child is receiving before you could convince a judge to change your divorce decree.  I believe, unless you can show that your ex's handling of your child's medical care has been on the extravagant side with unnecessary procedures and such, a judge is not going to be inclined to change your decree to give you more control over the situation. 

[livealittle]

college dad, let me play devil's advocate here....


we all know health insurance is tied to employment. gimme is maintaining employment by taking a new job - and sometimes the employer changes plans when you stay with them. The insurance says which doctor you get to see. I think gimme should explore having his attorney write a letter telling x that gimme is upholding his part by providing health and dental insurance. she needs to uphold her part by going to preferred providers.

gimme says he has to pay 100% of the unpaid medical bills. I think he should at least explore getting x to see in-network providers.

I don't think that's unreasonable.

there are lots of pediatric dentists and they all should be familiar with dealing with new and maybe nervous patients. due to ins. changes my kids have seen several different dentists. While they like some more than others, none of them were insensitive to the needs of a child.

[gimmeabreak]

This is what I have decided. First of all, we are talking about braces, not brain surgery. The ortho is putting braces on my child's teeth, my child is not moving in with the ortho. In fact the Dr. that my child has seen for 8 years is not the one you see for braces
 (made a few phone calls)so my ex's concern is a mute point. The difference in a consultation between in network and out is over $500. This is just another way for my ex to try to punish me. I will not pay it. My decree says necessary & reasonable. I am not sure that braces are necessary at this time, however I do think it is reasonable to expect my ex to use providers covered by the insurance I provide. That is why I pay for insurance in the first place. 

[CollegeDad]

You must have pretty good insurance because I had to pay for my son's braces out of my pocket.  Granted it was only half of the 10K that it cost but still, it would have been nice if my insurance would have paid for this.  I guess you have to have a dental plan which costs extra with my insurance offerings. 

Here again, the necessity of braces is something that you really need to talk over with your orthodontist.  Hopefully your decree does allow you direct access to medical records for your child and possibly consultations with your child's doctor so that you can decide for yourself.  There really are situations where braces are needed like cross bites or severely misaligned bottoms to uppers or vice versa.  The earlier you can start orthodontic treatment, the easier the whole process is on the child and the more that can be corrected.  If the pallet needs to be widened, it is very easy if treatment is started at an early age.  If the treatment is started later, widening the pallet is no longer an options.  About the only thing that can be done for teeth that are crowding a narrow pallet is to just pull the incissors. 

It really all depends on how much you care about your child's smile and how much you think its worth sacrificing for.   I believe that decision is best made with a professionals opinion.  I don't believe there is anything stopping you from getting your own independent assessment with a doctor of your choice.  This goes back to your divorce decree and what it will allow.

[gimmeabreak]

Collegedad.....Even if the braces are necessary, I think it is reasonable to expect my ex to use a provider of the dental insurance that I do pay extra for. If she wants to go out of network, she can pay for the braces herself.