Family Matters

Understanding Unreimbursed Medical Expenses in PA Support Orders

In each support order issued in Pennsylvania, there is a provision related to unreimbursed medical expenses that allocates the unreimbursed medical expenses between the parties. The typical language included in an order, however, can leave many unanswered questions for litigants. What’s included under the umbrella of unreimbursed medical expenses? How and when do parties reimburse one another for the out-of-pocket costs? Is there a deadline for reimbursements? Below is a guide to approaching unreimbursed medical expenses in the context of a Pennsylvania support action.

What are unreimbursed medical expenses?

Pursuant to Pennsylvania law, medical expenses are defined as “annual unreimbursed medical expenses in excess of $250 per person.” These specifically include out-of-pocket expenses for surgical services, dental services, optical services, and orthodontia.

If something isn’t defined as an unreimbursed medical expense by the support rules, can it be included in a support order?

Yes. While cosmetic, chiropractic, psychological, and psychiatric expenses are not included under the definition of unreimbursed medical expenses a court order may direct that these types of expenses are also allocated between the parties., While the court is not required to apportion costs associated with these types of expenses, they may apportion expenses that they feel are reasonable and appropriate.

It is important for litigants who would like to have the costs of the aforementioned services shared between the obligor and obligee to raise the issue at a support proceeding and to be prepared to argue the reasonableness of the expenses. 

How and when do parties reimburse one another for the out-of-pocket costs?

The Pennsylvania support rules require parties to promptly provide proof of a qualifying medical expense to the other party and include documentation (i.e. a receipt, an invoice) along with their request. The rules are, however, silent on how reimbursement may be provided to the requesting party. The parties can either agree or request that the court include a term in the support order that specifies the method (i.e. check, cash, Venmo, etc) that the parties will use for reimbursements.

Is there a deadline to seek reimbursements?

Yes, parties seeking reimbursement for a medical expense must submit their documentation to the other party no later than March 31^st of the calendar year following the year in which the bill for the expense was received by the party. By way of example, if a party received a bill for surgery on June 1, 2022, the bill would need to be submitted to the other party by March 31, 2023. If the bill is not timely provided to the other party, the trier-of-fact has the discretion to bar the submitting party from receiving any reimbursement for that expense.

If you are involved in a support action or seeking a support order, a conversation with an attorney can be helpful in navigating the process.

The information contained in this publication should not be construed as legal advice, is not a substitute for legal counsel, and should not be relied on as such. For legal advice or answers to specific questions, please contact one of our attorneys.