Ottawa Divorce .com Forums


User CP

New posts

Advertising

  Ottawa Divorce .com Forums > Main Category > Financial Issues

Financial Issues This forum is for discussing any of the financial issues involved in your divorce.

Reply
 
LinkBack Thread Tools
  #1 (permalink)  
Old 08-27-2015, 11:22 PM
Maggie82's Avatar
Senior Member
 
Join Date: Oct 2008
Location: Toronto
Posts: 183
Maggie82 is on a distinguished road
Default Section 7(1)(c) - Health-related expenses that exceed insurance reimbursement

Special and Extraordinary Expenses - Section 7.(1)(c) states that "health-related expenses that exceed insurance reimbursement by at least $100 annually..." are considered special and extraordinary expenses to be shared proportionately between the parties.

What does this mean?

Does it mean that the first $100 that isn't covered by insurance is not shared, and anything above and beyond that amount is to be shared? What if the amount is exactly $100?

Scenario: Mom orders glasses for Child totalling $500 without Dad's consent to the expense. Dad's health benefits cover $400 of the expense, forcing Mom to pay the outstanding $100. Mom sends Dad the receipt for the outstanding $100 she had to pay, and says "pay your share!" Dad tells her that his share of the expense is covered in his child support, and that any other health-related expenses not covered by insurance that should arise between now and year's end will be shared as the $100 limit has been reached. Mom says that as per the Guidelines, the $100 expense must be shared because it exceeds the insurance reimbursement by "at least $100."

So.... how does this work exactly? Any light shed on this particular S7 provision would be greatly appreciated. TIA
Reply With Quote
  #2 (permalink)  
Old 08-28-2015, 12:04 AM
Senior Member
 
Join Date: Aug 2010
Posts: 110
ele110 is on a distinguished road
Default

The way I understand it is that the C/S recipient pays the non reimbursed medical expenses up to $100.00 and adds them up. Once over the $100.00, they become extraordinary and have to be shared. So for the glasses, it would all depend on wether you have reached the $100 mark yet or not. If there has been no expenses exceeding the insurance payment so far this year, mom needs to pay the $100 for the glasses.
Reply With Quote
  #3 (permalink)  
Old 08-28-2015, 03:58 AM
Maggie82's Avatar
Senior Member
 
Join Date: Oct 2008
Location: Toronto
Posts: 183
Maggie82 is on a distinguished road
Default

Quote:
Originally Posted by ele110 View Post
The way I understand it is that the C/S recipient pays the non reimbursed medical expenses up to $100.00 and adds them up. Once over the $100.00, they become extraordinary and have to be shared. So for the glasses, it would all depend on wether you have reached the $100 mark yet or not. If there has been no expenses exceeding the insurance payment so far this year, mom needs to pay the $100 for the glasses.
That is our understanding as well. Thank you. Unfortunately because the charge for the glasses was $109 exactly, Mom is claiming that it needs to be shared because the S7 provision states "AT LEAST $100" - hence she believes the entire $100 needs to be shared. Dad has already told Mom that the first $100 is covered by her and the child support she receives, and confirmed that any additional health-related expenses not covered by insurance will be shared between now and the end of the year, but Mom is still demanding $$$. So we thought we'd double check what is understood by this particular guideline. (Mom is also claiming that if she doesn't get reimbursement of Dad's share by month end when her credit card bill is due, she will at the interest charges to the total of the expense.)
Reply With Quote
  #4 (permalink)  
Old 08-28-2015, 07:48 AM
Senior Member
 
Join Date: Mar 2014
Posts: 2,886
rockscan will become famous soon enough
Default

I want to add a question to this one. My partners agreement says "health related expenses including eye care". To me eye care is glasses and contact lenses that are required. To ex its lens cleaners, cases, red eye drops etc. She even claimed prescription swim goggles that werent agreed to (kid isnt a champion swimmer and could wear contacts under regular goggles as eyes change all the time). Would just the glasses and contacts be subject after the $100 or is he on the hook for all the extras too?
Reply With Quote
  #5 (permalink)  
Old 08-28-2015, 08:10 AM
Maggie82's Avatar
Senior Member
 
Join Date: Oct 2008
Location: Toronto
Posts: 183
Maggie82 is on a distinguished road
Default

Quote:
Originally Posted by rockscan View Post
I want to add a question to this one. My partners agreement says "health related expenses including eye care". To me eye care is glasses and contact lenses that are required. To ex its lens cleaners, cases, red eye drops etc. She even claimed prescription swim goggles that werent agreed to (kid isnt a champion swimmer and could wear contacts under regular goggles as eyes change all the time). Would just the glasses and contacts be subject after the $100 or is he on the hook for all the extras too?

I would assume eye-care to mean vision tests, optgomologist visits, eye glasses and contacts. Cleaners and drops would not be special and extraordinary unless the drops are prescription.

I don't know if your partner's order for eye care would be subject to the $100 clause as it's slecifically added to the order. Perhaps I'm wrong. For example, S7 states extracurricular activities. But we have an order restricting the number of activities to 6 mutually agreed upon shared activities per year. Otherwise Mom would sign Child up for everything under the sun and send Dad the bill. As much as going to court sucks, it is often necessary to get clarification and set needed boundaries. Generic sayings like "eye care" can be interpreted so many ways.
Reply With Quote
  #6 (permalink)  
Old 08-28-2015, 08:18 AM
Maggie82's Avatar
Senior Member
 
Join Date: Oct 2008
Location: Toronto
Posts: 183
Maggie82 is on a distinguished road
Default

Quote:
Originally Posted by Maggie82 View Post
That is our understanding as well. Thank you. Unfortunately because the charge for the glasses was $109 exactly, Mom is claiming that it needs to be shared because the S7 provision states "AT LEAST $100" - hence she believes the entire $100 needs to be shared. Dad has already told Mom that the first $100 is covered by her and the child support she receives, and confirmed that any additional health-related expenses not covered by insurance will be shared between now and the end of the year, but Mom is still demanding $$$. So we thought we'd double check what is understood by this particular guideline. (Mom is also claiming that if she doesn't get reimbursement of Dad's share by month end when her credit card bill is due, she will at the interest charges to the total of the expense.)
Correction: The extra charge for the glasses was exactly $100 - not $109.
Reply With Quote
  #7 (permalink)  
Old 08-28-2015, 09:00 AM
Senior Member
 
Join Date: Mar 2014
Posts: 2,886
rockscan will become famous soon enough
Default Section 7(1)(c) - Health-related expenses that exceed insurance reimbursement

Quote:
Originally Posted by Maggie82 View Post
I would assume eye-care to mean vision tests, optgomologist visits, eye glasses and contacts. Cleaners and drops would not be special and extraordinary unless the drops are prescription.



I don't know if your partner's order for eye care would be subject to the $100 clause as it's slecifically added to the order. Perhaps I'm wrong. For example, S7 states extracurricular activities. But we have an order restricting the number of activities to 6 mutually agreed upon shared activities per year. Otherwise Mom would sign Child up for everything under the sun and send Dad the bill. As much as going to court sucks, it is often necessary to get clarification and set needed boundaries. Generic sayings like "eye care" can be interpreted so many ways.

Heres where its tricky. Its actually a clause that says "the current expenses are..." And list out what they had agreed to for that year when the divorce was signed. Then it says "future extra-ordinary and extra-curricular expenses will be agreed to..." Theres nothing in there about future medical expenses so it goes by the federal guidelines correct? In which case the over the counter eye care is covered by CS correct? Then the medical expenses not covered by benefits is subject to the guidelines. Which means that if glasses were $200, they would split the $200? Or $100? Thats the other part I dont understand. Amounts over $100 are considered in the entirety or the amount over $100 is considered?

P.S. His ex interprets that part of the order and the law so its in her favour. She tried to claim feminine products and other drug store items as a school expense. Setting clear boundaries is what my partner has been trying to from day one!

Last edited by rockscan; 08-28-2015 at 09:02 AM.
Reply With Quote
  #8 (permalink)  
Old 08-28-2015, 09:43 AM
Maggie82's Avatar
Senior Member
 
Join Date: Oct 2008
Location: Toronto
Posts: 183
Maggie82 is on a distinguished road
Default

Quote:
Originally Posted by rockscan View Post
Heres where its tricky. Its actually a clause that says "the current expenses are..." And list out what they had agreed to for that year when the divorce was signed. Then it says "future extra-ordinary and extra-curricular expenses will be agreed to..." Theres nothing in there about future medical expenses so it goes by the federal guidelines correct? In which case the over the counter eye care is covered by CS correct? Then the medical expenses not covered by benefits is subject to the guidelines. Which means that if glasses were $200, they would split the $200? Or $100? Thats the other part I dont understand. Amounts over $100 are considered in the entirety or the amount over $100 is considered?

P.S. His ex interprets that part of the order and the law so its in her favour. She tried to claim feminine products and other drug store items as a school expense. Setting clear boundaries is what my partner has been trying to from day one!
Since the order in your case says that future extraordinary expenses will be agreed to, I think the best thing to do is to share the clearly listed S7 expenses (after the first $100 for health-related expenses not covered by insurance) and for other expenses that are not clearly listed in S7 but that *could* be considered special and extraordinary, to mutually agree upon them prior to incurring the costs. It will be a give and take... pick your battles type of dance. That is exactly what, in our case, Dad trying to put in place, and has been trying to for the last 12 years. But Mom feels she can just spend, spend, spend and send Dad the receipts for reimbursement. And when Dad says no... well you can imagine what happens then!
Reply With Quote
  #9 (permalink)  
Old 08-28-2015, 11:13 AM
Senior Member
 
Join Date: Mar 2014
Posts: 2,886
rockscan will become famous soon enough
Default

Yep thats my partners situation too. His ex figures she'll just spend the money and he will have to pay. Her benefits cover medical expenses for one year and then max out the second. This year is the "second" so he should receive something in the next few months. Although, the last time she didnt send him anything and he told her she needs to send a report from the benefits co. Outlining what wasnt covered. That was crap as there were no receipts. He contacted the service providers directly and got the receipts. He wont be doing that leg work again. Plus she now submits stuff to FRO so she will need full receipts AND he can reject them if she pulls it again.

I know it sounds bitchy but he is dealing with someone who refuses to tell him whats happening medically and then refuses to provide proof of payment.
Reply With Quote
  #10 (permalink)  
Old 08-28-2015, 11:40 AM
Maggie82's Avatar
Senior Member
 
Join Date: Oct 2008
Location: Toronto
Posts: 183
Maggie82 is on a distinguished road
Default

Mom is claiming that she spoke with a lawyer who told her that any health-related expenses that cost at least $100 are to be shared. Since the eyeglasses cost exactly $100, she is "promising" court papers if she doesn't receive reimbursement by month's end. And then the $100 will continue to increase as she will add her 19% credit card interest to it for every month that Dad doesn't pay.

Thoughts?
Reply With Quote
Reply


Currently Active Users Viewing This Thread: 1 (0 members and 1 guests)
 
Thread Tools

Posting Rules
You may not post new threads
You may not post replies
You may not post attachments
You may not edit your posts

BB code is On
Smilies are On
[IMG] code is On
HTML code is Off
Trackbacks are On
Pingbacks are On
Refbacks are On


Similar Threads
Thread Thread Starter Forum Replies Last Post
Section 7 Expenses Question blendedinsanity Divorce & Family Law 14 05-25-2015 04:41 PM
Insurance Premiums Deducted from Paycheck for Chidren's Health Care ross_toronto Financial Issues 13 03-27-2015 11:29 PM
FRO - section 7 expenses Coop Financial Issues 5 10-22-2012 01:19 PM
Question on CS and Section 7 Expenses decent fellow Financial Issues 4 11-15-2011 12:59 AM
Actually GETTING the Payment for Section 7 Expenses dazedandconfused2049 Financial Issues 4 10-20-2011 10:15 AM


All times are GMT -4. The time now is 09:08 AM.