Husband's ex collecting medi-cal on step-son behind our backs

AdMom0129 · September 2014

I'm wondering if anyone has any experience with this. I have heard that in this instance, we may have to go to court and that the state could make us pay back premiums and could even put a lein on our home.

Several years ago my husband lost his job prior to our marriage. We tried to get a private health insurance policy for my (soon to be at the time) step-son, but unfortunately he was deemed un-insurable on private insurance due to a medication he had been taking. His biological mother supposedly put him on her policy at her then employer and we began giving her a check each month to cover the premiums. Once she lost that job, she communicated to us that she was able to find a similar policy for my step-son and that we could continue to pay her the money.

Yesterday, it came out that she had signed him up for medi-cal all those years ago and has been cashing the checks we send for insurance premiums from us although no premium was due from her. We pay court ordered child support and nothing has come up yet, but my fear is that the state will come after us for insurance re-payment even though we've been paying her to supposedly fund a policy every month for the past couple of years.

I have looked all over on the state of California's Medi-cal site and also on the child support services page and cannot find any information. Has anyone ever encountered this before?

ambrvan · September 2014

I don't doubt about California, but in TN, on rate occasion the state may intercept partial child support payments to pay back state assistance. So the payer is ok, having paid their CS, and the receiver receives a lesser amount, some of it going to the state, until x amount is paid back.

Not sure how it works in other states, it is rare for such action to be taken in TN. There are guidelines set ti figure how much the state can take out of CS so that they aren't taking all of it.

daystardreams · September 2014

My brother was a possible father to a baby. The mother received temporary assistance for needy families and medi-caid for the baby. When he was proven to be the father, they told him that a portion of his child support would go to paying back the state. He didn't have to pay any more child support than he would have had she not gotten the assistance. We live in Missouri.

AdMom0129 · September 2014

Thank you both very much for the insight. Here's hoping things don't waiver all that much state to state.

Mkherren12 · September 2014

Did she supply yall with his insurance information when she signed him up? If not then in tx that's a violation too. If you would have known it was state ins then you could have had the ins amount tacked onto you CS amount. You might could pull bank records to show that while she had ins to now you've been giving the same amount in addition to the CS, to show history. But in tx they tell noncustodial parents to never pay money without going through the states channels and that if you do its just a gift. I hope it all works out for you.

Ilumine · September 2014

Actually who is court ordered to cover the child? The ONLY issue would be if your DH was ordered to cover the child and you refused. But since you can show checks equalling the premiums that BM had SS covered at one time (this information can be obtained from the first HMO if the court orders is), and that you have never STOPPED those payments, then you should be covered.

Second, while YOU have a case to get the money back (and I think you should contact a lawyer about that), I am not sure that Medi-Cal does. There are so many variables. Let's be honest, YOU couldn't get your SS on an Individual Plan due to the pre-existing condition, so if BM couldn't and Medi-Cal found BM and SS eligible, then it is not quite fraud.

Now, if she lied on the application, you have her. But some states do not include child support in their fiscal eligibility calculations. And if your DH was ordered to cover Health Care...she could almost squeak by. Again, you need a lawyer.

Ilumine · September 2014

But here is my last comment. WHO IS COURT ORDERED TO COVER HEALTH CARE?

It has been two years. Are you telling me that your DH still does not have health care? Because if he has coverage and has not included SS, then you may not want to open this can of worms.

AdMom0129 · September 2014

I drudged up the court order to see how it is specified because DH has always just said it was his responsibility to pay 1/2 and her responsibility to pay 1/2. Apparently, he was just being gracious -- his paying 1/2 is not actually in the court order, the order spells it out as she is supposed to supply DH with a copy of the health insurance card and that is it (Plus all the other court mandated support amounts and custody arrangements) she hasn't supplied us with a card and just kept saying "take him to kaiser...you don't need to know the numbers. They can look him up." for years. Strangely, when we were covering him on our policy, we were actually going above and beyond when looking against the court order.

My husband has always had insurance for himself, but was self-employed. Before the healthcare reform people could be denied coverage based on pre-existing condition which is what happened to my SS. BM doesn't want to put him on DH's plan now because she like Kaiser and wants to keep SS on Kaiser.

I'm just gathering everything -- correspondence, cashed checks and court orders to make sure we cover our butts. Hopefully we can sufficiently cover ourselves.

Thanks for asking the questions and helping out with this. I appreciate the perspectives.

Husband's ex collecting medi-cal on step-son behind our backs

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