Parents who have a child with special needs or a mental illness know that the costs for providing effective therapy to support their mental well-being can be staggering. Even when health insurance coverage is available for appropriate services, co-pays and deductibles can add up to significant out-of-pocket costs. Often, providers charge a higher cost for specialized care or may not take insurance at all, leaving parents with few options but to pay when they are unable to find the mental health services their child needs at a lower cost or within their health insurance network.
This situation is daunting enough when co-parents are on the same page regarding their child’s needs. However, when an ex-spouse refuses to pay for a child’s mental health cost, the other parent can be left with mounting bills and a sense of despair.
In California, the law makes parents responsible for the “reasonable uninsured health care costs” of their shared children as an additional mandatory child support obligation after divorce. Parents have the right to pursue reimbursement in court if their ex fails to pay the share of such expenses they’re responsible for, but they should be prepared to make the case that the care provided was necessary for the child’s well-being. A family law attorney experienced in child support disputes can provide essential guidance in presenting a thorough and effective argument.
- California Law and Unreimbursed Medical Expenses
- What Happens When One Parent Refuses to Pay
- Proving Mental Health Treatment Costs are Necessary
- When Does the Obligation for Unreimbursed Medical Expenses End?
Is your ex-spouse refusing to pay for your child’s mental health care through child support?
California Law and Unreimbursed Medical Expenses
A regular child support order typically addresses which parent will be responsible for providing medical insurance coverage for the children and factors the cost of such insurance into their support obligation. This order doesn’t usually cover costs aside from premium payments such as co-pays, deductibles, prescriptions, or other healthcare expenses that aren’t covered by insurance. The obligation for parents to pay the reasonable unreimbursed health care costs for their children as additional child support is explained in Family Code § 4062.
A child support order will usually give a general guideline on how these costs are to be split between the parents when they arise; for example, they may be required to split them evenly or proportionately based on their relative incomes. Each parent should strictly follow any specific procedures for requesting or reimbursing such expenses as laid out in the original child support order.
This obligation is not a license for either parent to run up medical bills on the child’s behalf. Family Code § 4063 details the timeframes for parents to request and provide reimbursement for unreimbursed costs, respectively, as well as their right to go back to court if payment is not made and what the court considers if there is a dispute over the request for payment.
In general, there is “a rebuttable presumption that the costs actually paid for the uninsured health care needs of the children are reasonable,” meaning that it is up to the party disputing the charges to prove they were unnecessary. As a practical matter, however, the parent incurring the costs for mental health treatment should be prepared to support their contention that the therapy provided was appropriate to their child’s diagnosis, recommended by their healthcare providers, and subsidized to the extent possible with insurance coverage.
What Happens When One Parent Refuses to Pay
If the reimbursing parent—the one paying their share of the cost to the parent who incurred the original expense or paying the remaining share of the bill to the provider—does not agree with what they’ve been asked to pay, they are supposed to pay the requested amount and then seek judicial relief under the terms of § 4063.
Of course, that may not happen, especially when parents are at odds over their child’s care. In that case, the parent requesting reimbursement can file a motion with the court to enforce the terms of their child support order that apply to unreimbursed medical expenses. If the court finds that payment was withheld without cause, it can also award reasonable attorney’s fees and filing costs in addition to enforcing payment of the disputed bills.
Proving Mental Health Treatment Costs Are Necessary
It’s not unusual for a special needs child to need mental health support as a result of their diagnosis. For example, neurodivergent children, such as those on the autism spectrum, may need to see a psychologist to cope with anxiety. But what can seem obvious and necessary to one parent can appear excessive to the other.
When a dispute arises, and an ex-spouse refuses to pay for their child’s mental health costs, it is prudent to have records that support the position that mental health treatment is appropriate. Any parent seeking payment for unreimbursed health care costs should keep copies of the bills, explanation of benefits (EOB) statements from the insurance company, and proof of payment. They should document their actions to inform their co-parent of the requested reimbursement within the required timeframe.
In disputes centered around whether mental health services were necessary, they should also provide a current diagnosis from a licensed mental health professional that specifies the type of therapy needed, as well as a detailed treatment plan that outlines the frequency and duration of sessions and treatment goals.
If treatment was provided by a professional not in the child’s health insurance network, or who does not take insurance, the parent should provide documentation of their efforts to find appropriate care in-network as well as efforts they took to obtain any insurance coverage for treatment that was available (for example, submitting a superbill for reimbursement). A family law attorney can provide specific advice on what further information may be needed to help the court decide on the reasonableness of mental health costs.
When Does the Obligation for Unreimbursed Medical Expenses End?
As with regular child support, the obligation for a parent to pay unreimbursed medical expenses, including mental health care costs, may extend into a child’s legal adulthood under certain circumstances. While ordinarily, child support ends in California at age 18 or when a child graduates high school, if a child is mentally or physically disabled and unable to support themselves that obligation can continue throughout their life. The courts will weigh both the child’s needs and the parents’ relative ability to provide financial support in awarding support under these circumstances.
Expert Family Law Representation for Child Support Disputes in the Silicon Valley
If your ex-spouse won’t pay for mental health care you know is vital for your child’s well-being, you may feel caught between the threat of financial ruin and the nightmare of having to discontinue essential therapy. The family law attorneys at Hoover Krepelka can provide the vigorous legal representation you need in enforcing child support for mental health expenses. We’ll help you fight for their mental wellness and your own peace of mind. To schedule your consultation, fill out the form below today.
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