Health Care

The medical enforcement clerk in our office is available to assist you and answer your questions concerning the health care provisions in your court order.

The clerk’s job is to enforce the health care portion of the order. The clerk can help you obtain information about the health care coverage available to the other party to your case. The clerk can help you obtain reimbursement for health care expenses for the minor children. Finally, the clerk can calculate the “reasonable” cost of health care coverage in your case.

Procedure for Collection of Health Care Expenses

The Friend of the Court will assist in collection of health care expenses in certain circumstances.

Step 1: Verify Order Eligibility

Your support order must provide for the other party to pay a portion of the health care expense. For orders since 2005, those expenses exceeding the annual ordinary health care expense amount in your order are eligible for reimbursement. For orders before 2005, only non-routine expenses are enforceable. (Ask the office for a copy of “Routine health care expenses.”)

Step 2: Notify the Other Party

You must send a Request for Health Care Expense Payment form with a copy of the bills, including proof of any payments and the explanation of benefits from your insurance company to the other party. For orthodontia, you must also send a copy of the signed contract, proof of the down payment, and proof of the total insurance coverage.

Timeline: Must be sent within 28 days after insurer’s final payment/denial (1 year if no insurance).

Allow the other party 28 days to respond and keep a copy of everything sent.

Step 3: File FOC Complaint

If after 28 days no arrangements for payment are made, request a Complaint and Notice for Health Care Expense Payment form from the Friend of the Court office. Fill it out and return it to the office with a copy of the bills, an explanation of benefits, and the Request form from #2.

Deadline: Complaint must be received within 1 year of expense OR 6 months after final insurance denial.

Step 4: Enforcement Review

The Friend of the Court only takes enforcement action twice per year, in June and December. Bills must be paid in full, though exceptions are made for orthodontia and major hospital expenses.

Step 5: Objection Period

After the Complaint form is mailed by the Friend of the Court, the payer has 21 days to file a written objection. If no objection is filed, the amount becomes a support arrearage subject to enforcement. If an objection is filed, the matter will be set for a referee hearing and both parties must attend.

Please ensure all forms are filled out completely and all required proofs (bills and insurance explanations) are attached to avoid delays in processing.