The statute does not specify the type of documentation needed when requesting reimbursement of medical expenses incurred by a parent. Typically, the court order, or the agreement adopted as the court’s order, specifies how expense reimbursement process is going to work and that is the first place to look to find out what the rights and responsibilities are for both parents.
The statute defining the medical expenses that are usually required to be reimbursed is C.R.S. 14-10-115 (10)(h). Subparagraph (h)(II), defines the medical expense subject to reimbursement as “Extraordinary Medical Expenses”, and reads: “Extraordinary medical expenses are uninsured expenses, including copayments and deductible amounts, in excess of two hundred fifty dollars per child per calendar year. Extraordinary medical expenses shall include, but need not be limited to, such reasonable costs as are reasonably necessary for orthodontia, dental treatment, asthma treatments, physical therapy, vision care, and any uninsured chronic health problem. At the discretion of the court, professional counseling or psychiatric therapy for diagnosed mental disorders may also be considered as an extraordinary medical expense.”
Pursuant to Subparagraph (h)(I): “Any extraordinary medical expenses incurred on behalf of the children shall be added to the basic child support obligation and shall be divided between the parents in proportion to their adjusted gross incomes.”
Note that it says “added to the basic child support obligation.” On the support worksheet there is an area for adding extraordinary medical expenses. The problem that you are dealing with, however, are medical expenses that were probably NOT taken into account when the court filled out the child support worksheet (i.e., the court did not estimate the amount of expenses that would be incurred and add the monthly average amount into the worksheet). You are dealing with expenses that were incurred AFTER the court made the child support order and this is a topic that the court’s order or the parties’ agreement adopted as the court’s order typically addresses in addition to the basic monthly amount of support to be paid.
If the Court did not specify how the uninsured medical expenses were to be paid, then you have an enforcement problem and probably should go back and ask the court to address this in a modified or amended order. The Statute does not specify how you deal with these type of expenses when they were not included in the child support worksheet calculations.
Typical expense reimbursement provisions specify:
- The parent receiving the child support pays the first $250 per year, per child, of unreimbursed medical expenses (this is calendar year);
- After the initial $250 has been paid, then the parent incurring the expense provides the other parent with proof of the expense and requests reimbursement;
- It is good practice to include wording in the order that the request for reimbursement must be made within a certain period of time after the expense was incurred (30 days works well), or the right to request reimbursement is waived, AND that the other parent must make reimbursement within a specified period of time (30 days works);
- The expense reimbursement request should be made in writing, dated, signed, and a copy kept.
Also, it may also be helpful to specify what the request for reimbursement entails. Logically, since it is REIMBURSEMENT that is being requested, there must be proof that the expense was incurred and paid for – otherwise, how can someone “reimburse” when it has not been paid? Requesting a copy of the doctor’s bill and proof of payment is not unreasonable. The EOB (Explanation of Benefits) by itself is usually NOT sufficient, BUT should be included with the reimbursement request. The EOB typically sets forth the date and nature of service, the provider’s charge, the amount the insurance company allowed as a charge, the amount the insurance company will pay and the amount the insured is responsible for. It does not specify or provide proof of how much was ACTUALLY PAID by the insured. It is the amount that was actually paid that is subject to reimbursement, and this is why proof of payment is needed before reimbursement is made. The initial doctor’s bill alone is really not enough either: it shows the pre-insurance charges, what the service was for and probably how much was paid (co-pay usually); it does not always show the charge adjustment made by the insurance company, how much the insurance company paid, and how much was ultimately due from and paid by the parent who is seeking reimbursement from the other parent.
Other points to note:
- The statute defines extraordinary medical expenses to include counseling or mental health therapy ONLY if the court includes these expenses within those to be reimbursed.
- The ability of the parent ordered to pay child support to take the income tax dependency exemption may be barred if the ordered expense reimbursements are not made and the court considers those expenses as part of child support to be paid.
C.R.S. § 14-10-115 (12): Dependency exemptions:
Unless otherwise agreed upon by the parties, the court shall allocate the right to claim dependent children for income tax purposes between the parties. These rights shall be allocated between the parties in proportion to their contributions to the costs of raising the children. A parent shall not be entitled to claim a child as a dependent if he or she has not paid all court-ordered child support for that tax year or if claiming the child as a dependent would not result in any tax benefit.
Note: The information above regarding Dependency Exemptions only applies to income tax returns for tax year 2017 and prior. The dependency exemption for 2018 and later years was repealed by Section 1003 of the 2017 Tax Cuts and Jobs Act, H.R.1.
The information provided above is general in nature, is not intended as legal advice for your particular situation and should not be relied upon without first consulting with legal counsel. Martin Law Firm provides legal representation in child support matters in the Denver Colorado metro area and will tailor its services to your particular needs and unique circumstances.