Demands for Reimbursement of Unreimbursed Medical Expenses Due March 31

The Pennsylvania Domestic Relations Code defines unreimbursed medical expenses as out-of-pocket expenses that are not covered by insurance companies or any third party, and these types of expenses are usually considered “extraordinary” expenses because they exceed the cost of basic health care that is normally included in one’s insurance plan.  While these expenses will include things such as co- payments, deductibles, dental services, vision care, and much more, they will usually not include psychiatric, cosmetic, chiropractic, and psychological services, unless the Court deems these expenses to be reasonable.  In order to comply with the applicable Rules of Civil Procedure, these unreimbursed medical expenses must be annual expenses in excess of $250 per person named as a dependent in the applicable support order.  Only medical expenses in excess of $250 per dependent are subject to allocation under the rules because expenses less than $250 per year per dependent are the responsibility of the party receiving support.

How does it work after the initial $250 of unreimbursed medical expenses are paid by the person receiving support?  The additional expenses above that $250 threshold are divided in terms of each parties’ percentage of both parties’ combined total income.  Each party in this situation has the responsibility of keeping track of his or her expenses for the year and reporting those expenses to the other party during the first quarter of the following year.  Under Pennsylvania law, any unreimbursed medical expenses that a party wishes to have allocated must be documented and provided to the other party no later than March 31 of the year following the calendar year which the final bill was received by the party seeking reimbursement.  Any allocation of unreimbursed medical expenses where documentation is not given to the other party in a timely manner will be handled by the Court subject to its discretion and therefore may not be collected.

How does the allocation of unreimbursed medical expenses work?  As previously discussed, after the initial $250 of expenses per dependent is exhausted the additional expenses in excess of that amount will be divided between the two parties based on their respective percentages of their total combined monthly net income.  Although this is the standard way to do this, there may be issues that arise and timing is an extremely important piece of the allocation of unreimbursed medical expenses.  Looking again at the date of March 31, this is when all documentation needs to be given to the other party in order to ensure that expenses can be allocated and reimbursed appropriately.  In cases involving unreimbursed medical expenses, one of the parties must get into contact with the other in writing and demand that party to contribute within a reasonable period of time, which is generally 30 days.  Here are some tips to help you or someone you know keep track of unreimbursed medical expenses:

  • Keep all bills and receipts together at all times.
  • Always provide notice to the other party in writing.
  • Make several copies of bills and receipts for your own records.
  • Formally reach out to the other party if necessary.

Failing to pay for unreimbursed medical expenses can result in the enforcement of arrearages.  Arrearages simply are the amount of money that should have been paid at an earlier date and will be enforced at a later date to ensure payment occurs.  The party who has not received his or her allocated unreimbursed medical expenses can bring enforcement proceedings upon the other party if necessary.  These expenses can be collected from a party in many ways if he or she is uncooperative and does not agree to payment when the demand is first received.  On the other hand, if the two parties disagree with one another that certain medical services were necessary and therefore should be reimbursed – such as providing their child with eyeglasses – a court will then be given the opportunity to consider the reasonableness of such expenses and determine whether a division of the responsibility for payment should then occur.

As we begin the month of March, it is important to keep in mind that if you or a loved one is responsible for the documentation and collection of reimbursement for unreimbursed medical expenses, March 31 is the deadline for that demand to be provided to the other party.  At Musi, Merkins, Daubenberger & Clark, we have collected and organized unreimbursed medical expenses demands for clients, we have moved forward with demands for reimbursement, and we have litigated both the reasonableness and collection of these expenses.  Therefore, Lucas A. Clark, IV, Esquire and the rest of our family law division are ready to help you with any unreimbursed medical expense needs you may have.

Call us today at 610-891-8806 to schedule an in-person or virtual appointment.