One of the more nuanced issues involving child support is reimbursement for medical expenses. When one parent is ordered to pay child support, the monthly amount they pay includes a contribution to ordinary medical expenses of the child or children. The Michigan Child Support Formula (MCSF) states that “ordinary medical expenses include the support recipient’s co-payments and deductibles, and uninsured medical-related costs for all children in this case.” (2017 MCSF 3.04(A)(3)). However, issues arise when the parties’ child incurs substantial medical expenses that are greatly in excess of what is considered “ordinary”.

Looking again to the language of the Michigan Child Support Formula, we see that “additional (extra-ordinary) medical expenses consist of the support recipient’s out-of-pocket expenses that exceed the children’s ordered annual ordinary medical expense amount and any uninsured medical expense paid by the support payer.” (2017 MCSF 3.04(A)(4)). The annual ordinary medical expense amount is set by the State and serves as a baseline that can be used in the majority of cases. Courts are permitted to add amounts to the State’s standard amount ($403 in 2017) when it is known at the outset that a child will incur higher expenses. Once a child’s medical expenses exceed the annual amount, the parents share the cost of those expenses based on each parent’s share of the family income. Each parent is responsible for a certain percentage of extraordinary medical expenses.

So what is the remedy when one parent refuses to pay their percentage of extraordinary medical expenses? The parent who is seeking reimbursement for medical expenses should submit a request for health-care expense payment to the other parent within 28 days of either the date the insurance provider has paid on the expenses or the date the insurance provider denies payment. It is important to note that we are talking about reimbursement. That means that the parent must pay the entire amount of expenses themselves and ask the other parent to reimburse them for the portion they are obligated to pay. If the non-paying parent agrees to pay their portion, the parties should make an agreement in writing that lists the expenses to be paid, the total amount to be paid, and the schedule for payment. The agreement must be signed by both parties. If the other parent fails to pay according to the agreement, the parent seeking reimbursement must submit the bill to the friend of the court within six months in order for the friend of the court to enforce payment of the expense.

If the non-paying parent refuses to make an agreement to pay their portion, the parent seeking reimbursement can request that the friend of the court enforce payment of the expenses. To do this, the parent must show that they requested payment within 28 days of the date notified of the balance due after insurance payments and the other parent failed to pay their portion. Bills must be presented to the friend of the court within 1 year of when they were incurred, or six months after the insurer has made a final denial of coverage for the expense. As such, it is essential that a parent requesting reimbursement be aware of how much time has passed since the expense was incurred.

When the parent seeking reimbursement makes a complaint with the friend of the court for enforcement, they must also give notice to the non-paying parent that they have made the complaint. The non-paying parent has 21 days from the time that notice is sent to file a written objection with the friend of the court. If the non-paying parent does not object, the unpaid expenses will be added to that parent’s support account as a healthcare support arrearage.

It is essential that parents be diligent record keepers regarding health care expenses as documentation is required both to secure payment directly and to request the friend of the court to enforce unpaid health care expenses. Parents should make sure that they keep a copy of all medical bills and keep track of the total amount owed by the other parent. Because the parent seeking reimbursement must pay the bill in full first, parents must also be sure that they have proof of such payment. A good way to keep track of bills is to create a spreadsheet that includes columns for the name of the child receiving service, the name of the medical provider, the date of service, the type of service, the total medical cost, the amount paid by insurance, the balance due, the percentage to be paid by the other parent, and the amount owed by the non-paying parent.

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