Who Gets Your Child’s Healthcare Reimbursement?

Several months ago I  was searching for a counselor for my 15-year-old daughter. She was about to have major back surgery and was having a lot of anxiety about it. I knew I didn’t have the skills to deal with her emotions (heck I barely have enough skills to deal with her normal 15-year-old self).

Luckily for both of us, my daughter has excellent medical insurance. Her father is employed by Apple and thereby is able to cover all of his children under his insurance without costing him anything extra. I, on the other hand, as a Founder who bought back SupportPay after being fired ( am in bootstrap mode and am self-funding the company. Therefore, medical/ mental health/ dental insurance is not a luxury I can afford at this time … but I digress!

As I sought out a therapist for my daughter to help her through the next few months of her life I ran into a few surprises.

Good luck finding a child therapists/counselor that takes insurance

  • Good luck finding ANY mental health professional for your child(ren) that takes insurance – its a sad reality that it seems no one is talking about.
  • Actually, good luck finding ANY mental health professionals for your child at all. In a world where mental health is finally being talked about the number of professionals focused on children is severely lacking. In my case, I was given a list by my daughter’s school, looked on her insurance’s website and searched on yelp. After 27 phone calls, I received 4 calls back. 3 told me they didn’t have openings. 1 called back and said she didn’t either but knew of another place that might and gave me their number
  • I called and luckily her therapist did have an opening. However, she warned me she didn’t take insurance. In fact, there was no one in our area (Sacramento, California), focused solely on children, that took insurance.
  • The reason for this is something I can understand. First, most therapist work in a small practice. They don’t have the administrative overhead available to deal with the very difficult insurance companies. On top of that, with children, it is not simply a 1 to 1 conversation between therapist & patient. The therapist has to coordinate between the parent (or parents), the school, medical professionals and the child. The amount of time to do this is already incredibly burdensome. If they then have to worry about billing insurance, and wondering if they will even get paid at a reasonable rate, would make it nearly impossible to provide a service.
  • So its either deal with the system as it is and be lucky we have the limited number of providers we have or deal with this and bill insurance after you have paid out of pocket. And just to remind you, my daughter has one of the TOP insurance coverage in the country yet finding her the mental health she needed was hard, very hard!

However, I was told that I could submit the bills for reimbursement to her insurance and they would pay at least a portion of it. Therefore, I ended up paying $150 / session out of pocket.

After 8 sessions I submitted the claim to her insurance for reimbursement. The process was fairly simple but as I was submitting the claim there was no place to update the address/person to send the check to. In the system, it defaulted to my ex-husband’s name/address. I sent a note along with the submission asking them to send me the payment/reimbursement as I was the one that paid the session fee and therefore the one to be reimbursed.

Wait What? You aren’t sending me the check?

I submitted the claim and waited a few days. The total claim was $1200 – after her $300 deductible, the reimbursement was $900. After a few days, I logged back into the system and it showed the claim had been processed and a check had been sent out.

I then got on the phone and called the claims department to make sure they received my note and that I would be getting the check. it was then that I learned the rules. Insurance reimbursements can only go to the Insured. I was shocked. I even asked if the check was being written in my name and send to my ex-husband’s address as it was clear on the bills that I was the one that paid for them. The answer was no. The check was sent in my ex-husband’s name and sent to his address. I asked the nice gentleman, “So you are saying I just gave my ex-husband $900?” Of course, my question was not meant for an answer. However, it does surprise me that 50% of our children do not live with both of their biological parents yet the insurance companies are not set up to support the new “modern family”.

Reimbursements go to the person that hold the insurance, NOT the person that pays!

I learned the hard way that healthcare / medical reimbursements do not go to the person who pays it goes to the person who holds the child’s insurance. Even though the bill had my name, showed I was the one who paid for it and the bills come to my house the insurance company would not send the reimbursement check to me.

Lucky for me my ex-husband and I have a fairly amicable relationship. So I simply called him up and explained the situation. Of course it conveniently took him another 3 weeks to send me the $900 – after I logged it as an expense in SupportPay and it was part of his monthly payment. But I will say I am lucky as I am sure not all parents would have an amicable outcome.

I’m sharing this information so other parents are prepared in case they face a similar situation.  This is not something I had ever thought about before but now I know that it is critical to clearly agree, and document, who pays and who should receive healthcare / medical reimbursements. And if there is a reimbursement how does that affect the regular base support or other expenses that may be incurred at the same time?

Do you have a different experience? Is this something that you have experienced a divorced parent? Any suggestions or advice you would like to provide?

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