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Dental over 2K - Section 7?

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  • Dental over 2K - Section 7?

    Our kids have expensive mouths. They both require dental work, which combined is over 2K. Would this be considered S7 due to the high expense in one shot?

    No issues with regular check ups, paid by me up front. However, the treatment required is out of the ordinary, IMO. Their baby teeth are not budging and the adult teeth are already significantly coming in, which is causing all sorts of dental issues that will require treatment once the adult teeth are in.

    Over 2K is a huge amount for one person to carry. I asked their dad attend to pay his portion now to help cover this and have been met with a big fat no. I am not arguing with him and am robbibg Peter to pay Paul so-to-speak. But am curious if this would be considered S7.

  • #2
    Any medical expenses over $100 are section 7.

    Do you have any benefits? Does he?

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    • #3
      He does; I unfortunately don't. As mentioned, I have no issues with regular check ups. I pay, he reimburses .e when he feels like it. The insurance, on top of saying this is not a S7 expense, is his reason/excuse for not helping up front. I asked for help, he said no, and I am doing what I must to keep our kids dental health in good order.

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      • #4
        His insurance covers it?

        It is a section 7 expense whether he likes it or not. I would simply send him an email advising that these are section 7 expenses and should he refuse to pay his share you will seek court assistance and costs to recover it.

        His reason for saying no is that its not necessary?

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        • #5
          Yup, his insurance covers it; we sent in a request for an estimate. He's a "No-Man"; just says no to everything, even dental work that is most definitely required. My lawyer sent a letter to his at the beginning of June when he refused to help; no response. Its just what he does. His initial email refusing to help with the costs up front was word salad making an attempt to call me unfit for the umpteenth million time because I can not afford the full amount on my own. I do what I can to work around him to get things done for our kids. His refusal to help is centered around his belief this is not S7 and implying I am unfit as mentioned on the previous sentence.

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          • #6
            There is no use trying to argue with logic against someone that didn’t use logic to decide their position. When someone is so emotional like your ex it is a waste of time to negotiate. Tell them what is happening (the way you did with your lawyer sending an email to his lawyer) and then file in court. Meanwhile you can start treatment (most dentist offices have payment plans) and file for reimbursement from his insurance.

            It is stupid and a waste of money and time to go to court on a slam dunk issue but you have to defend your kid’s right to support. I have read cases on Canlii where the recipient parent did not pursue the section seven they were entitled to beyond a request, so future claims of the section 7 were disallowed. Ugh, judges really need to smack people like your ex upside the head with huge cost awards to show them how dumb they are being.

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            • #7
              I have had to split the appointments up over the next three months; its the only way I can afford to do this. Keeping my fingers crossed the remaining teeth slated for extraction fall out on their own. If not, am also keeping my fingers crossed that no further damage is done in the meantime. We had some extracted today. When the lower one was extracted, it was discovered that the adult tooth was fully erupted but pointing down his throat. And, one of the teeth beside it has been pushed out of place. His mouth is a mess. I am seeing major $$ signs for braces in the near future. As for reimbursement, yes his insurance will pay me back. I just have to wait for him to decided to pass the money on to me. Waited six months once for a regular cleaning reimbursement! Oh the joys.

              I will check CanLii for S7 like this to make sure my butt is covered for future expenses.

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              • #8
                2 k for all your kids is nothing. Wait till you are looking at braces (which by the sounds of things you probably will).

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                • #9
                  I was going to say same thing about wait until braces time. I just got a quote at $5500 per child.

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                  • #10
                    Turn the unfit parent back on him. Tell him to take the kids for appointments and hear what the docs say!

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                    • #11
                      Originally posted by Helpmyspouse View Post
                      I was going to say same thing about wait until braces time. I just got a quote at $5500 per child.

                      Braces are s7 every time. So is the current dental work. The ex should simply run it through their insurance and then you split the remainder proportionally to income.


                      My kid just got braces. I know it is s7, and was on board from the get go. Luckily my ex, my wife and myself all have coverage. Given all 3 insurers, we are looking like we won't be out of pocket a cent.


                      I would recommend that your ex educate themselves on what is and what is not s7.

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                      • #12
                        Is it possible the dentist can direct bill he insurance? You would just need the number off the card and then you would only have to worry about reimbursement for the proportional portion not covered by insurance. In my experience the orthodontist does not direct bill, but my regular dentist does. I agree with others, just state it is a section 7 and then move to have this taken care by court if ex won’t agree as it sounds like this is only the very beginning of many years of orthodontics. My own child had some baby teeth not come out, and needed pulling and the permanent dud come out in a row behind baby teeth. Had 2 rows of teeth. was told at the beginning would need braces twice at different stages of growth of the jaw as a child and again as a teen. Have spent a small fortune. Typically each insurance company pays 50% to a max amount per lifetime so if you have only 1 insurance plan it is unlikely it will cover whole cost

                        Comment


                        • #13
                          Originally posted by denbigh View Post
                          Is it possible the dentist can direct bill he insurance? You would just need the number off the card and then you would only have to worry about reimbursement for the proportional portion not covered by insurance...

                          Definitely section 7 expense.


                          I agree with denbigh here, in that it's always better to find a dentist that can do direct billing with insurance. It's always a pain to claim reimbursements through your insurance for the larger amount, then add a problematic "ex" into the situation, and it's just frustrating.



                          If you anticipate large dental expenses coming up, in the next few years, it would also be good for you to find insurance as well, so that the expenses can be coordinated between the two plans. (yours and ex's)



                          What is the section 7 split between you guys anyway?

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                          • #14
                            Thanks everyone! Ya, we are definitely heading into very expensive braces in the near future. Am already mentally preparing myself for that battle. He keeps quoting and sending me the link to the Justice Canada website specific to S7 telling me to seek better legal advice on and to educate myself regarding S7 expenses. He's on ignore 😉

                            I have been going to the same dentist for almost 25 yrs. He does not do direct billing. Its my choice to stay with him, so I guess one could say my choice to have to wait for him to send me the reimbursement. However, he is definitely in the wrong for withholding the reimbursement.

                            Our split is 65/35; it is what it is. My budget simply does not allow for private
                            insurance.

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                            • #15
                              Send him section 7 of the guidelines SPECIFICALLY the words “the necessity of the expense in relation to the child’s best interests” and “health-related expenses that exceed insurance reimbursement by $100 annually”.

                              If you have an agreement it should be in there too. You can send him that.

                              Your ex sounds like an asshole and eventually the kids will see it and ignore him too. Hope he enjoys that!!

                              Comment

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