Out of network insurance repsonsibilities


#1

Our custody order states that the parties “shall first seek treatment from approved medical providers and will choose generic prescription brands when they are available”. The ex wife has chosen an orthodontist that is out of network and our additional cost will amount to almost $800. We have requested that she seek treatment from an in network provider however she has said the closest one is 30 minutes from her residence and is an inconvenience she is not willing to bear. My question is, because of this being her choice and the court order being ambiguous about what “available” means are we on the hook for the added $800 or are we only required to pay the in network costs?


#2

Does the order say anything about who would have final decision making power on issues related to the child’s health and wellness? Do you share legal custody or is legal custody vested in one person. If you have joint legal custody, does the order state what will happen in the event that you cannot agree on something? If so, that may help you determine the answer.

You could always refuse to pay your portion of the orthodontics bill and see what she does. She could file a motion for contempt and then you could defend by stating that there are available in-network orthodontists and therefore you shouldn’t have to bear the added cost of the out-of-network orthodontist. At the end of the day it would be up to the judge to determine if you’ve truly breached the order, but the order states you will look to in-network physicians first and it seems as though she hasn’t done this. Alternatively, you could always file a motion for contempt stating that she violated the order by not using the in-network physician.