Post-marriage financial quandary - who should pay this bill, me or her?

February 14, 2018 12:36 PM

My wife and I separated. I thought she was covered under my employer's health insurance until the end of the year. She wasn't. Who should pay her doctor's fees?

My wife left me in August. We agreed to keep her covered on my employer's health plan until the end of the year, and have her switch to her new employer's plan in January.

She emailed today to say she has been sent a bill for $2000 for a doctor's visit she made in November. I spoke to my insurance company and it turns out when I made the changes during open enrollment they kicked in immediately, not in January as I thought. She was therefore uninsured. I made an honest mistake.

One part of me feels I should pay the bill (or offer to pay half). She isn't in the best financial situation. I could afford it (though it would take a good chunk out of my savings, which have been diminishing rapidly in this scary post-marriage world I find myself in.)

But another less charitable part of my mind, clouded with mid-divorce animosity perhaps (she didn't treat me the best towards the end of the marriage) thinks she should pay it.

Please help me think clearly on this. I want to do the right thing, but my moral compass is spinning wildly these days.

posted by anonymous to Human Relations (29 answers total)

We agreed to keep her covered on my employer's health plan until the end of the year

You literally cut her off of your insurance plan. You violated the agreement. You pay. 100%. There's no question here.
posted by saeculorum at 12:37 PM on February 14, 2018 [92 favorites]

Pay it. You made her a commitment, and, accidentally, failed to live up to it, subjecting her to significant costs.

I know there's an emotional block. But it's the right thing, and, later on, you'll look back and be glad you did it. Really.
posted by praemunire at 12:37 PM on February 14, 2018 [29 favorites]

Pay it, in part because you can, and in part because it was your responsibility to understand what was happening with your insurance and when these changes would take effect. Since you messed that up, you should make your soon-to-be-ex whole.
posted by chesty_a_arthur at 12:38 PM on February 14, 2018 [22 favorites]

So, I thought this was going to be a question of whether you pay it, or you work with your benefits team, or the insurance company to see what went wrong. I am not sure why there would be a question of her paying this, if there was the previous agreement that you mention.
posted by kellyblah at 12:40 PM on February 14, 2018 [6 favorites]

I hate to say it, since she left you, but I agree that you should pay the bill. It's the right thing to do and I think you'll be glad you did it.
posted by schroedingersgirl at 12:53 PM on February 14, 2018 [5 favorites]

you should pay the bill but also, she should follow up with the doctor's office if she paid a co-pay at the time of the visit; if so, that should be refunded to her by them in full or applied to the cost of the bill.
posted by poffin boffin at 1:00 PM on February 14, 2018 [8 favorites]

Please help me think clearly on this.

+1 that the mistake was yours, whether by accident or not. You're responsible.

Also, by the same reasoning, you should cover additional applicable consequences (e.g., like tax penalties for gap in coverage) that come out of her not being insured.


clouded with mid-divorce animosity perhaps (she didn't treat me the best towards the end of the marriage)

Consider also that trying to stiff her on this cost would invite more animosity, more wounds to get over. If someone made a mistake that cost you $2000 and they refused to make amends, would you feel like dealing with them in good faith? Even if you're divorced, things will probably come up where you still have to interact. Pay it and move on. Not paying is just going to add to the fire.
posted by Sockin'inthefreeworld at 1:01 PM on February 14, 2018 [15 favorites]

From someone who has worked on HR web applications in the past, something sounds off here. Typically open enrollment changes go into effect in the new year. Immediate removal from a plan at another time, which is what seems to have happened, typically has a reason attached.

If you were asked for a reason, and it was divorce or legal separation, it should have triggered a process where she'd have been offered COBRA coverage. She (or you) would have to pay out of pocket for it but it should have been offered. Talk to HR.
posted by mikeh at 1:01 PM on February 14, 2018 [76 favorites]

I would ask for a copy of the bill so you can pay it for her, do not give her the money directly.
posted by NoraCharles at 1:03 PM on February 14, 2018 [11 favorites]

Pay it for the good reasons noted above, then take it up with hr to potentially be reimbursed, for the good reasons noted above.
posted by davejay at 1:03 PM on February 14, 2018 [6 favorites]

it should have triggered a process where she'd have been offered COBRA coverage

Excellent point. Also, COBRA can be continued retroactively to day 1 of losing coverage. You'll have to pay the full subsidized premiums, but that is likely less than $2000.
posted by saeculorum at 1:07 PM on February 14, 2018 [12 favorites]

Pay half. Ask for a copy of the bill to make sure there isn't something else going on here such as a mistake in billing. Make it clear that you will not be paying for any more medical bills (unless they come from the period during which you had agreed to have her on your insurance, then pay half of the bill.)
posted by WalkerWestridge at 1:09 PM on February 14, 2018

I'm inclined to agree with Mikeh -- open enrollment is very clear about when the starting date of coverage is, and for most places, it is 01-Jan. I can see if being the last day of open-enrollment (and/or "next business day") for some companies.

Regardless, check your confirmation of benefits selection email and see what it says about when the elections become active.

(I mean, did your Nov/Dec paycheck have an extra $200 in it because you were having the new "just me" medical coverage taken out ?)
posted by k5.user at 1:12 PM on February 14, 2018 [4 favorites]

(Rather than abuse the edit window)

To be VERY CLEAR - did you make these changes as part of your companies annual open enrollment ? Or did you sign up as a "qualified life event" ?

Because in a qualified life event (eg have a kid/adopt kid, get married/divorced/spousal death) etc -- those changes are immediate (because things like babies have immediate medical needs).

Perhaps you weren't clear to the rep (they thought you were changing as a qualified event, not open-enrollment), or you made the changes under the wrong auspices (checked the wrong box in the HR web form to change your benefits). That's what could also lead to the "immediate" situation.

(This is all to say: if you accidentally picked qualifying event, the $ is on you, pay it as agreed. Otherwise, the insurance co isn't playing right, and you should talk to HR about it)
posted by k5.user at 1:17 PM on February 14, 2018 [20 favorites]

Yes, pay the bill, then seek reimbursement as described above.

It would be legit to ask her nicely to postpone any optional expenses until she has her own insurance. if possible.

I hope you'll update this interesting thread when you find out what went wrong.
posted by JimN2TAW at 1:41 PM on February 14, 2018 [1 favorite]

If you did check with the wrong box you might have the opportunity to correct the mistake. I had a weird thing happen where our insurance plan flips on 12/1, but the annual deductible doesn't reset until 1/1. So I was out $1000 that I thought was applying to my new high deductible plan, but in fact, wasn't because it wasn't 1/1/2018 yet. When I was trying to sort all this out last month our company insurance rep said I could switch back to the PPO retroactively if I wanted to. I didn't, but I was kind of shocked I even had the option. You may have options too.
posted by COD at 1:58 PM on February 14, 2018 [1 favorite]

Just call HR. I was able to unenroll myself and my baby from next year's coverage despite missing the open enrollment period by weeks. Nthing that there may be more options than you realize.
posted by peacheater at 2:01 PM on February 14, 2018

If it turns out you can't fix this with the insurance company or your employer, you should probably pay the whole amount. I can see an argument for paying just half, too. I mean this was a surprise to the both of you and neither thought to check the coverage.

Either way, as has been mentioned, it would be in your interest to pay the bill directly rather than just sending a check.
posted by FakeFreyja at 2:03 PM on February 14, 2018 [1 favorite]

Get a copy of the doctor's bill. Follow up with your HR dept and the health insurance company to find out what when happened, explain the issue, and see if they can help. If there's nothing they can do, see if the doctor has an uninsured, cash rate that they'll charge you. If not, maybe you can work out a payment plan.

Pay the bill, though.
posted by studioaudience at 2:08 PM on February 14, 2018 [2 favorites]

I would say it is your responsibility, but I would not blindly pay it. First I would see if there is a way to get retro COBRA, then I would negotiate with the doctor, then I would assume the liability.
posted by AugustWest at 2:15 PM on February 14, 2018 [1 favorite]

I mean, if your soon-to-be-ex-wife had known that you had cancelled her insurance, she could have gotten her own insurance; if she had known she wasn't covered under your plan, she would presumably have gotten on her work insurance either (losing insurance is generally a qualifying life event) or gotten on a marketplace plan, or even delayed that doctor visit if it wasn't for something urgent.

Talk to your benefits/HR office to see if they can fix this, but if not I think you have a moral obligation to pay it - your mistake cost her $2K.

(Also FWIW at my current place of work the benefits year runs September to August and our enrollment period happens right around September 1. I've previously worked at places where the benefit year started in July or June.)
posted by mskyle at 2:19 PM on February 14, 2018 [6 favorites]

The only certain thing is this is not her liability. You do whatever you need to on your side to figure out who pays it, but it stops with you ultimately.
posted by I'm Not Even Supposed To Be Here Today! at 2:19 PM on February 14, 2018 [4 favorites]

You do whatever you need to on your side to figure out who pays it, but it stops with you ultimately.

Yep, possibly not your fault but definitely your responsibility. Your agreement with her was straightforward and it got messed up for $REASONS. Now it's on you to figure out those reasons and either you can fix it (yay, no one pays!) or you can't (boo, you pay the thing that was your responsibility). Also in a general sense, divorces are terrible and removing as many "entanglements" as you can helps everyone move on sooner. I am sorry you got left, it's a terrible feeling, However it has nothing to do with this situation, which is basically math.
posted by jessamyn at 4:06 PM on February 14, 2018 [6 favorites]

One other thing; if you and/or your former wife have to pay that bill out of pocket, that $2000 can probably be negotiated down. Medical bills for uninsured Americans are generally inflated 2-3x and if you agree to pay it off immediately they will discount it.
posted by Nelson at 4:49 PM on February 14, 2018 [7 favorites]

Seconding what Nelson just said. Bills, especially medical bills, can be negotiated, apparently it's like buying a car, who knew?
posted by BoscosMom at 5:59 PM on February 14, 2018 [1 favorite]

You agreed to keep her covered and it is not her fault this happened. On the other hand, Cobra information should have been sent because that is required by law. If it wasn't, you could have a case (though I'm not sure how you'd prove it) but if her coverage ended in August it's well past the 90 day deadline. Didn't your paycheck increase due to decreased deductions? If your employer continued to charge you for her portion of the health insurance then your employer could be liable for these charges. (Unless your employer pays 100% for you and your spouse which is not a universe I am familiar with.)

Definitely find out if your insurance rep can help. If you honestly believed she was covered until January, find an email or something that may have suggested it?

In re-reading your question I noted one other thing. Why is she just getting billed in February for a November appointment? If she had known in November I believe she would have been within the window to sign up for Cobra. What a mess. I am an office manager (so default HR) for a small company and it seems I am constantly apologizing for our terrible health insurance.
posted by Glinn at 7:34 PM on February 14, 2018

Just a data point - I've been able to get on COBRA near the end of the enrollment period, and then have doctor's offices resubmit the bills for retroactive coverage. The doctor's offices are used to this; it should be no problem to do this, if COBRA becomes an option. Once on the COBRA, just call the doctor's office and explain the situation to them.
posted by spinifex23 at 10:15 PM on February 14, 2018

Why is she just getting billed in February for a November appointment? If she had known in November I believe she would have been within the window to sign up for Cobra. What a mess. I am an office manager (so default HR) for a small company and it seems I am constantly apologizing for our terrible health insurance.

Doc probably billed insurance, insurance kicked it around a bit before confirming no coverage. Odds are, the ex received a first bill, and ignored it. (The first bill probably even said "pending with insurance"). I'd be curious if OP or the ex got an EOB from the insurance company saying "you are no longer covered" (OP - I'd look for that .. ). So when the dr (practice and/or their outsourced billing and insurance folks) finally get the determination from the insurance company, voila, it's February, and a harshly worded "past due" bill is sent.
posted by k5.user at 5:58 AM on February 15, 2018

Why is she just getting billed in February for a November appointment?

I don't know where you are, but this is a regular occurrence where I am; places beleaguered by health care costs will sometimes save 2017 bills and deal with them first thing 2018 so they balance correctly on the books. This aspect of it should not be your issue but may affect how to manage retroactive COBRA.
posted by jessamyn at 6:11 AM on February 15, 2018