Health care can be very expensive, especially if the treatment is not covered by insurance. A child support order will generally set out how uninsured medical expenses are allocated, but what happens when one parent seeks treatment for a child who is not covered by insurance? The Washington Supreme Court considered this issue in a recent case.
The child developed a kidney stone. The condition grew worse while she was visiting her aunt, and she had a temporary stent installed at a hospital in the Cincinnati area. She was also referred to a group in the area for lithotripsy, which would break open the stone by ultrasonic waves.
The child was covered by her father’s insurance, which was not available in the Cincinnati area where her aunt lived. The nearest facility covered by the insurer was in the Cleveland area. The wife contacted the husband, who said the aunt should either drive the child to the in-network facility or wait to see if the insurer would approve an out-of-network provider. The wife felt the daughter needed immediate treatment. The aunt took the child to the physician group in Cincinnati, and they treated the stone with lithotripsy. The medical expenses totaled about $13,000. The insurer determined that the treatment was non-emergent and out-of-network and denied payment.
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