Worried about having to pay more on medical expenses for my children

Right now, my two kids with my ex-wife are on Medicaid. My children with a previous non-marital relationship are on my health insurance which costs me close to $600 a month and with Child support for both sets of kids close to $800 comes out of my income for the month. It is more than 50% of my income as an EMT.

That may seem like alot, but my net is around $400 a paycheck after everything has come out. I don’t get much to live off of at all and still be able to provide for my kids when I have them.

My ex-wife is redoing the food stamps and medicaid because she is disabled and doesn’t work. This time they may ask if I have health insurance as she has redone the application.

It is in our divorce decree that we are to split the cost of co-pays and out of pocket health costs. Neither one of us can afford to pay for medical things and with my five year old going to school for the first time at the beginning of the new year, I can see lots of doctor visits in the future for her and her younger brother as she’ll be bringing home lots of nasty illnesses.

Copays are sixty dollars a visit for non-well visits. The prescriptions are ten dollars each. We really cannot afford to even split that amount as I know I live paycheck to paycheck and she does as well. I’m struggling now making ends meet and I do not qualify for benefits as I make too much.

I know the common answer is to get another job. That is not an option as I work three days a week, but work 15 -17 hours a day for those three days and then I get my kids every day for the rest of the week. I do not want to lose time with my kids by getting another job and taking away their time with me that they deserve.

Just not sure what to do.

Have you looked into Medicaid for all your children?

Medicaid in most states offers free or low-cost appointments and even transit. Also, children’s Medicaid is different than adult Medicaid. My friend (a single mom) has health insurance for herself but her daughter is on state Medicaid because she meets the qualifications. The state looks at the cost of having a “family” health plan and determines if it is “onerous” and a child can be eligible despite being able to be on a family plan. She also has a “split” expenses divorce decree. Her ex is a layabout who has been “trying” to get disability for years.

I would meet with your state’s benefits office and bring your pay stubs, tax documents and other information as well as what your ex can give you.


They are on Medicaid right now.

The State is looking to get them off of Medicaid and because I have health insurance they are going to want them added to it.

New York where my other kids are forced me to get health insurance so they would get off of medicaid knowing that the health insurance would be a burden to me. The only difference is that there is nothing stating that I have to pay half of the copays. Their mom handles them.

I do not qualify for Medicaid myself as I make too much and don’t have the kids more than half the time. I get them three nights and three and a half days. The nights is what counts to the state.

Have you actually talked to a professional?

Like sat down, face to face and made an appointment?

It’s all well and good to say the “state is looking to get them off medicaid” of course they are. They don’t know the entire story. Many people try to play/cheat the system.


I have not admittedly talked to anyone, but having had food stamps with my wife as I stayed home to take care of her and our children and did not work, I do know how the system works.

My premium will not go up adding them, but it’s the costs afterwards that’s the issue.

I understand that.

In my state (not NY) my friend went to the office. She showed them her cost (minus deductibles) with her daughter (about $500 a month) and the cost of insurance for her alone. (under $200) a month.

They looked at her monthly income, her expenses, her assets and debts she owed to others–including her college loans. They would have also factored in child support payments had she had any. They determined that the burden of maintaining insurance was much too high.

So her daughter was granted Medicaid, even though she was not eligible for food stamps, heating assistance, etc.

You may actually be able to get your premium down, in regards to your obligations to your other children.

But again, you need to gather all your financials and make an appointment with a real, live professional who can look over your information and find out what the state can do for you.

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I’d also look to see if a non-employer based health plan might be more cost effective. I’m not sure what the ACA will look like in coming years but for now you would likely qualify for premium credits which would reduce the insurance cost for all your kids.

Pre-ACA me and the kids had our own policy as it was MUCH less expensive than to go on my husband’s work plan.

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I had looked into that. When I went through it, the kids had to be with me more than half the time for them to be put into my plan. Since they are, not it doesn’t work for me.

What about them having their own plan?

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That would have to be their mother’s doing that. All I know is the child support order for New York and the divorce decree say that once I get healthcare for myself I must put them on it.

You might do well to have a lawyer look over the divorce decree. They may be able to change the wording so the children can get back on medicaid.

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The state (any state) requires children to be on a parent’s insurance plan if one is available. It sounds as though the OP has health insurance and they would require him to add the younger two. With the mother being disabled they may be able to get help with medical bills through different programs of medicaid. The OP would have to talk to the social worker at the medicaid office to know what the options are.

The wording of your divorce decree is pretty standard. To get it changed would include hiring an attorney, going to court, and taking a huge chance nothing would change.

The only way you are going to know what happens is if you ask the people who know, like those who work in the medicaid office.

No, that’s totally not true.

Some states DO take into account if the health insurance is burdensome to the parent/family, especially for children’s Medicaid. It’s totally different than adult Medicaid. My state is pretty strict, but my friend is a prime example of what the state allows. Her child could be on her insurance but it is so burdensome they allow her child to be on Medicaid. The paperwork was done by an official so I very much doubt it’s illicit in any way.

Agreed. He needs to talk to someone who is in charge of these funds.

Again, not true. If you have willing and amicable parties you can amend the wording of a divorce decree with a lawyer and without without a court visit.

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With my name being listed on her bi-annual reappilication as an absent parent (hate the wording as I am not absent) do I even have the ability to do something like that or is it something only my ex-wife can do?

That’s a really high copay for basic pediatric visits. Can you get a better insurance plan?

With any luck, it might be “some” rather than lots.

The bigger they get, the more they’ll be in school anyway.

It’s in her best interests to be helpful.

According to the insurance agent that my company used they compared the three insurance plans in the area and that was the best they could find. My premium went up $200 with the insurance company because not enough people at my job has the insurance so they cannot spread the risk to others is what we were told.

I understand the older they get, the more they’ll be in school, but I still want to be home on the days that I get them. My youngest has at least another two years before he goes. I need to be able to be home for when they get home on the two weekdays that I get them.

Is that choice really on the table for you right now?

You are correct, but in her defense and I do this quite a bit in defending her, she herself has alot on her plate and her doing this would just be one more thing added to it and she is already beyond overwhelmed.

You mean staying home on the days that I get them?

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