Co-workers discussing getting a legal divorce just to qualify for Peach Care

[ccgirl]

I applaud these folks. I got married "in sickness and in health" but maybe it should be "unless I can get cheaper benefits."

I do know my children's pediatrician stopped taking PeachCare. I think as another PP said, the grass may look greener but there are things that may offset any perceived savings.

I would also imagine if they have children you cannot get a cheap $500 divorce. I've always heard that was for people with no kids and no assets but not having been down that road, I really don't know.

I know for me the "emotional" and "ethical" cost would be too high.

Great post. As you mention, there are many doctors that do not take state run health insurances because they are reimbursed at a much lower rate than the private health insurances.

They probably could get a cheap divorce because there's nothing really to fight over. The way I read it is that they are still going to "act" like they are married, it's just they are getting rid of the piece of paper in the hopes of getting "free" benefits.

 

[jgreco]

It sounds to me like one of those things that people grumble and shoot their mouths off about but almost none of them will actually do it in practice, and like has been mentioned they really don't understand the details that make it unworkable anyway.

I have to wonder though .... with regular doctor office visits heading into $50 range at what point will people start offering their Doctors just a cash payment and skip the insurance billing altogether? I've seen some health clinics around here that will charge a $65 cash payment up front fee for a minor problem office visit like a strep test and prescription. It's getting awfully close to that.

We have a "concierge" doctor also known as a private doctor. We pay an annual fee and it covers all of our visits, blood work drawn in his office, neck and back adjustments. He will also call on his friends to get us a "cash price" for any outside tests we need done. We have a $10k deductible, so he does not even bother with our insurance and I pay nothing else out of pocket to him. He also spends TIME with us, we don't feel like we are being herded through to make up for volume.

 

[Anjelica]

Great post. As you mention, there are many doctors that do not take state run health insurances because they are reimbursed at a much lower rate than the private health insurances.

Or they don't take the state run health insurance because the state doesn't even reimburse them in a timely fashion (think up to 6 months here in Illinois).

 

[wishing4PA]

Ethical questions aside, OP's co-workers may find that married people aren't "getting screwed" as badly as they think while they are on that side of the fence. I spent a great many years as a single working adult, and even then, I would look at my tax returns, and realize that the humongous marriage penalty the TV talking heads were screaming about did not apply to everyone. Not to mention that marriage has other benefits that have nothing to do with taxes.

Now I'm married, 1 kid, and I am most certainly benefiting from the "system" overall more than I was as a single. Sure, they may save on the medical, but have they looked at all the angles? I doubt it. This one thing seems unfair and favors the other side. Other things may favor them, but somehow it's harder to notice the things that are favoring us than the things that are favoring others, lol.

I'll stay married to my DH, even if he doesn't love WDW as much as I do, thank you.

Good luck to the OP's co-workers.

 

[mrsbornkuntry]

My sister was living with me for a short time while she was looking for a job and she applied for state health benefits (not sure what it's called here) and they asked on the application how many people were in the household/she was supporting so really unless they got divorced and didn't live together it would be fraud.

 

[Colleen27]

So they are thinking of getting a divorce just in case something goes wrong and they have to pay $50-$65 out of pocket for a doc appt?

I'm willing to bet that these people have cable or a cellphone they could cut back on first. Besides, let's say a divorce costs $500, put that in the bank for a "medical fund" instead and you've got 10 visits covered right there,

No kidding. I can understand it in some situations - a friend was talking about it for a time because coverage for herself and the kids through her husband's job was over $800/mo and his full time job plus the two minimum wage jobs she had just couldn't afford that and still pay rent and put food on the table. But over co-pays? You could cover dozens of $50 co-pays with what the legalities of a divorce would cost!

 

[OLT2004]

I thought all Health Care would be completely Free next year.
No?

Judging by the responce - I think my attempt @ Political Satire Fell Flat...
I will have to try to Move Forward...

 

[ceecee]

I thought all Health Care would be completely Free next year.
No?

Judging by the responce - I think my attempt @ Political Satire Fell Flat...
I will have to try to Move Forward...

Saying you are divorced to get govt help, is just another way to abuse the system and the reason it is already a mess.

 

[badblackpug]

I think that might vary from state to state. PA can require one parent to cover the children's health insurance but the state cannot force an ex to cover the former spouse. It's how the state skirts placing the kids on the CHiP program.

Part of my brother's divorce decree includes this stipulation. It is independent of the child support agreement and the custody agreement. However, the agreement also stipulates that his ex has responsibility for half of all medical copays and deductibles. So, she doesn't get out of also paying for the kids' healthcare completely.

Right, this is what I meant. In the case of divorce the parent who has medical insurance or is more financially able to pay is generally required to cover their minor children. They are not required to cover their ex-spouse. Usually the divorce agreement stipulates that the parents split the out of pocket expenses based on their incomes. 50/50, 60/40, 70/30 etc.

 

[badblackpug]

Your second statement is true and I would never do it BUT, the first one is dependent upon the state you live in.

Here, one parent carrying insurance on the children is only a stipulation if it is put in the divorse papers. Its not automatic, the custodial parent has to ask for it (and the judge can rule in favor of the non-custodial parent on this). And even then, if that parent becomes unable to carry insurance for some reason, then there can be a change in the papers.

Same thing with child support. The custodial parent can refuse it unless he/she gets on welfare or food stamps. The CHiP program would not be in the same category.

And if child support is given, none of it goes back to welfare, food stamps or medicaid.

Also, for the cheap divorces, you can get them as long as everything is agreed upon by both parties. If there is any disagreement then it will cost more.

Are you in PA? Because now they require at least one parent to provide health insurance for the child. Common sense would dictate that if only one parent had health insurance he/she would be it. If both parents carry health insurance then who would carry the insurance would either be an agreement between the parents, or a court order, if they couldn't agree, but just like child support, someone is going to be ordered to pay for it. I would think the child would only be eligible for CHiP if neither parent was insured privately.

You are right, though, child support is not considered income, and a non custodial parent can refuse support if they aren't on public assistance.

I don't know the laws regarding health insurance and living with the child's parent, but I do know to receive AFDC you have to disclose everyone who is living within your household. I am not sure how that affects the amount one would receive, though.

 

[cornflake]

Are you in PA? Because now they require at least one parent to provide health insurance for the child. Common sense would dictate that if only one parent had health insurance he/she would be it. If both parents carry health insurance then who would carry the insurance would either be an agreement between the parents, or a court order, if they couldn't agree, but just like child support, someone is going to be ordered to pay for it. I would think the child would only be eligible for CHiP if neither parent was insured privately.

You are right, though, child support is not considered income, and a non custodial parent can refuse support if they aren't on public assistance.

I don't know the laws regarding health insurance and living with the child's parent, but I do know to receive AFDC you have to disclose everyone who is living within your household. I am not sure how that affects the amount one would receive, though.

Support is only ordered if there's a disparity though. If there's an equitable time division, or other major disparities, there's no support order. Insurance isn't automatic if there's an equitable division of everything else, because as you say, has to be decided by someone.

 

[lorax123]

Getting divorced to beat the system and get out of high co-pays? Seems like dubious logic to me. Is this a low tier plan? Our company offers a similar plan for the low option. A few dollars more and you can opt up. Depending on your financial situation, the low option may be a good plan for most adults. Our low end covers 80% and has a maximum oop of $2500 a year, with $30 copays and $45 specialist. If it were just myself on the plan, I'd have spent only $90 for copays at my doctor this year. Since I have two kids that always seem to be going to the doctor, I go with the high option. $2500 of out of pocket expenses in top of copays and prescriptions is a bit too rich for me at this time.

Don't forget to use your FSA account! You can put $2500 pre-tax dollars into that. That is a great way to set aside money for those doctor visits. As long as none of your coworkers are suffering serious health issues, they will barely feel the sting of your rising copays.

 

[lorax123]

No kidding. I can understand it in some situations - a friend was talking about it for a time because coverage for herself and the kids through her husband's job was over $800/mo and his full time job plus the two minimum wage jobs she had just couldn't afford that and still pay rent and put food on the table. But over co-pays? You could cover dozens of $50 co-pays with what the legalities of a divorce would cost!

Has your friend looked into paying completely oop for insurance for his spouse? Our company has a similar pricing structure for covering a spouse. Right now I pay about $250 a month for myself and my children for our health insurance. If I added my spouse, my annual contribution to our health care plan, for the low end is about $9k per year. The high end is $12k per year. No one in our company is able to afford that to cover their spouse. But living with a spouse with no insurance is too risky.

Many of my coworkers, with uninsured spouses, pay for private insurance. My wife is covered through Aetna, with a policy that covers 80% of our costs and a maximum oop of $5k per year. It covers prescriptions as well. This plan runs $216 a month. While the total oop costs for one year is way higher than what we like, it's there in case of something catastrophic. We would rather owe and pay off $5k than go bankrupt due to medical expenses.

The plan does fully cover wellness and physical examines. So preventive care is fully covered. In the last two years, my wife has only been to the doctor 3x. But she has a regular perscription that requires 30 day refills. Of course we did have to get her on the generic version, since the name brand would cost far more on this plan.

It really is a better than nothing plan. It's there temporarily, until she gets back to full-time employment and her own coverage. Or I find a job that covers spouses for a reasonable sum. (Yeah right, that will happen!)

Just saying, if your friends spouse is in good health, they could probably save $400 a month by looking into something similar. If course, you pay for this completely oop and can't write it off as a medical expense. So, no pre-tax deduction to pay fortbneatfreak@gmail.com it. I never tried to use our FSA to pay for it, but we only can put $2500 into our FSA and that would only cover the yearly premium and we'd still have to foot another $2-2500k a year in copays, perscriptions, dental visits, glasses, etc.

 

[Halbleib1]

Are you in PA? Because now they require at least one parent to provide health insurance for the child. Common sense would dictate that if only one parent had health insurance he/she would be it. If both parents carry health insurance then who would carry the insurance would either be an agreement between the parents, or a court order, if they couldn't agree, but just like child support, someone is going to be ordered to pay for it. I would think the child would only be eligible for CHiP if neither parent was insured privately.

You are right, though, child support is not considered income, and a non custodial parent can refuse support if they aren't on public assistance.

I don't know the laws regarding health insurance and living with the child's parent, but I do know to receive AFDC you have to disclose everyone who is living within your household. I am not sure how that affects the amount one would receive, though.

In PA CHIP covers all kids the difference is do you get it for free or do you pay a premium. It is based on household income. Those at the highest income level pay the highest amount that the state negotiated with the insurance companies. Those that pay also have a different level of what the insurance will cover along with copays etc. that those who qualify for the free do not have. If parents were to divorce but live together it would count both parents incomes. If the parents would live seperate they would look at the household income where the child resides. There is a line on the medicaid form (not sure about CHIP) asking you to declare any and all assets including child support. So while it may not be considered income it is considered an asset and would need to be declared. It may or may not get counted in the calculations to determine qualifications but you do have to disclose it. I know some assets are not counted for medicaid/CHIP purposes that are for cash and food stamps. They will also ask if you have had insurance in the last so many months and if insurance is available from either parents work.

 

[Victoriasmom98]

I can tell you as a child support agent and a former eligibility specialist in the State of Maine, getting divorced but living in the same household would still not make a person eligible for Medicaid if you have a mutual child. It could work out if there were no mutual children, though. Same goes with Food Stamps and TANF. The mutual child ties the family together whether they are married or not. As for medical support, here in Maine it usually is worded as one parent "is ordered to provide medical insurance if and when available at a reasonable cost"....wow...I've quoted that so much I didn't even have to look it up! And then the medical expenses not covered by medical insurance are usually broken up in percentages after the first $250 is paid.

It's sad that people feel they should commit fraud to get what they need. I know --- I was a single mom for 6 years without receiving any government help as I was over income. And to the person who states "how will the government find out" you just don't realize how many people out there are willing to rat you out. Believe me....it happens!

 

[luvsJack]

Are you in PA? Because now they require at least one parent to provide health insurance for the child. Common sense would dictate that if only one parent had health insurance he/she would be it. If both parents carry health insurance then who would carry the insurance would either be an agreement between the parents, or a court order, if they couldn't agree, but just like child support, someone is going to be ordered to pay for it. I would think the child would only be eligible for CHiP if neither parent was insured privately.

You are right, though, child support is not considered income, and a non custodial parent can refuse support if they aren't on public assistance.

I don't know the laws regarding health insurance and living with the child's parent, but I do know to receive AFDC you have to disclose everyone who is living within your household. I am not sure how that affects the amount one would receive, though.

No, I am down south. They haven't started requiring anyone to carry insurance on the kids yet here but I think they should. If one parent has insurance through their employer, they should have to carry their kids.

 

[drcmk]

I did not get married for the financial benefit and I would not get divorced for financial benefit. My marriage means more to me than that. If it costs me something for the privilege of being married, I gladly pay.

 

[westjones]

I have a question. I hope I NEVER have to actually face this situation...but...

I have two college aged DDs. They are both on our health insurance. What if a baby came along? How is that handled? Would the baby be on 'our' insurance or would it be through the state program (not sure what it is called here, but they have one for children in lower income).

Again, I hope it doesn't happen, but I have seen it happen to a few families and I honestly don't know how the health insurance is handled and don't want to ask them such a personal question. So I will ask you guys

 

[punkin]

I have a question. I hope I NEVER have to actually face this situation...but...

I have two college aged DDs. They are both on our health insurance. What if a baby came along? How is that handled? Would the baby be on 'our' insurance or would it be through the state program (not sure what it is called here, but they have one for children in lower income).

Again, I hope it doesn't happen, but I have seen it happen to a few families and I honestly don't know how the health insurance is handled and don't want to ask them such a personal question. So I will ask you guys

I think you cannot have grandchildren on your insurance unless you have custody of them. Your DD would be covered for the birth but the baby goes on a state program.

 

[scrapquitler]

"is ordered to provide medical insurance if and when available at a reasonable cost"....wow...I've quoted that so much I didn't even have to look it up! And then the medical expenses not covered by medical insurance are usually broken up in percentages after the first $250 is paid.

And what is considered 'at a reasonable cost'?? And what if someone is self employed or doesn't qualify for insurance thru their employer? My husband is self employed and the cost for health insurance is obscene, and my employer doesn't offer it to me because I don't work full time.