Who is a reasonable person? A reasonable person, simply put, can make commonsense decisions just as you or we would. We have handed the American legal system that legacy, in the form of a standard of behavior: what would a “reasonable person” do in this legal dilemma or that situation? What would that same “reasonable person” consider to be a “reasonable and necessary” medical expense? The answer to that matters because it affects child support in Virginia.
Child Support Guidelines in Virginia
Enshrined in Code of Virginia § 20-108.2, the Guideline for Determination of Child Support, is this legally brief passage:
… any child support order shall provide that the parents pay in proportion to their gross incomes, as used for calculating the monthly support obligation, any reasonable and necessary unreimbursed medical or dental expenses …
Hmm. A little help, please? What do Virginia’s [esteemed] legislators consider reasonable? They offer a glimmer of insight, later in the legally brief passage. We are bullet-pointing it for clarity:
For the purposes of this section, medical or dental expenses shall include but not be limited to
- prescription medication
- mental health or developmental disabilities services, including but not limited to services provided by a:
- social worker
The law provides wide latitude for both parties in a child support agreement to choose for themselves what is “reasonable,” but the broad outline is there. You do not see cosmetic surgery on the list. You do not see experimental procedures, acupuncture, or aromatherapy. The “not limited to” phrasing does allow for both sides in a negotiation over child support to press their argument for or against a particular expense.
The Virginia State Bar Association sheds a little more light on what the typical, reasonable person considers a reasonable medical expense:
“… any reasonable and necessary medical or dental expenses of a child that are not covered by insurance are to be shared by each parent in proportion to his or her gross income.”
So at least we now know the general categories of expenses deemed reasonable (braces for Little Linda’s teeth or Baby Bobby’s legs, yes; liposuction, no). We also know the expenses are split between Mom and Dad according to their incomes.
Get Unbiased Estimates for Medical Care
Finding out what is a reasonable medical cost can be tricky, but national organizations exist to help you. You can use the online tool at FAIRHealth Consumer, for example, to research typical costs in and out of healthcare insurance networks for many medical and dental procedures.
It can help you estimate that Little Linda’s blood tests (CBC; CPT Code85025) , for instance, should cost $11 in network, $37 out of network for a procedure in the Virginia Beach area.
Pro tip: If the mother of your child says the bill was $387, then, you could question its “reasonableness.” You could cite such consumer groups as FAIRHealth Consumer as independent, unbiased sources.
Get Legal Clarification on Reasonable Medical Expenses
If you are facing a steady stream of requests by the mother of Baby Bobby and Little Linda for your share of medical expenses, and you suspect the expenses may be unreasonable, you can ask the court for legal clarification of the meaning of “reasonable costs.”
Your attorney can request a hearing on the issue. The custodial parent would have to prove to the judge’s or master’s satisfaction that every medical and dental cost was “reasonable” under § 20-108.2. You would have the opportunity (through your family law attorney) to demonstrate that some or all of the expenses were not reasonable.
Get Technical … Use the Code of Virginia
Ultimately, you and your attorney can direct the opposing party and her counsel to § 63.2-1900 of the Code of Virginia, which provides this lucid and (legally brief) definition of “reasonable cost:”
“Reasonable cost” pertaining to health care coverage for dependent children means available, in an amount not to exceed five percent of the parents’ combined gross income, and accessible through employers, unions or other groups, or Department-sponsored health care coverage, without regard to service delivery mechanism; unless the court deems otherwise in the best interests of the child or by agreement of the parties.
That five percent rule is a clincher. The children’s mother cannot attempt to dun you for medical services for Little Linda or Baby Bobby so that, by year’s end, you are on the hook for more than around five percent of your gross income.
Neither could your kids’ mother claim she needs to take them to exotic locales [read: vacation spots] for medical treatment, as those would most likely be “out of network,” in violation of § 63.2-1900.
No matter the issue, large or small, connected with your child support program, the attorneys of The Firm For Men can help. Contact our offices online, or by telephone at 757-383-9184. We will be happy to sit down with you and examine requests by your children’s mother for your payment of “reasonable” medical costs.