Outstanding Copayments

Created on: 
Feb 03 2016

Table of Contents

Related WACs

Child Care Subsidy

Seasonal Child Care

DEL Clarifying Information (published February 1, 2017)

n/a

Additional Information

What happens if a client doesn’t pay their copayment?

When a provider reports that a client has an outstanding copayment and has not made payment arrangements, the client is no longer eligible for child care benefits. The case and authorization will be terminated with 10-day notice.  The client will remain ineligible until the debt is resolved.

How does a client with an outstanding copayment become eligible for child care?

The client must pay the past due amount in full, or make satisfactory payment arrangements with the provider. If they pay the balance in full, the Department can accept written or verbal verification from the provider. Verbal verification can be obtained by the Department contacting the provider or vice versa. If arrangements are made to pay the outstanding balance over time, the Department must have a written agreement between the provider and consumer. 

If the copayment has been paid or payment arrangements made during the 10-day advance notice period, the case can be reinstated without a break in eligibility if the client is otherwise eligible. If the copayment is paid or payment arrangements made after the 10-day notice period, however, the client must reapply for benefits.

Note: The failure to pay an outstanding co-pay is a dispute between the client and the provider. The provider can forgive the debt, or the client may perform in-kind services in lieu of payment of the past due amount. A third party can pay the debt, or the provider may accept payment arrangements, or require payment in full. However, if the third party is agreed to the responsible for the co-payment by the client and the provider and the third party fails to pay or make arrangements to pay an outstanding co-pay, the client's eligibility is still at risk. Ultimately, the responsibility to see the co-payment paid lies with the client.

What happens when the outstanding copayment has been sent to a collection agency?

When the past due copayment debt is turned over to a collection agency, the client must provide written verification that a payment plan has been established with the collection agency. Once written proof of the payment agreement is received, child care can be approved if the client is otherwise eligible.

A notice of a collection debt from a collection agency is not sufficient verification. The client must have an actual written agreement to repay the copayment amount to the collection agency.

Example: ABC provider calls to report that the client didn’t pay her copayment and owes $65. The Department terminates the benefits with 10 days’ notice. Six months later the client reapplies. The client states that they paid the past due amount. The Department worker calls the provider and confirms that the debt has been paid.  The client is otherwise eligible and her application approved.
Example: ABC provider calls to report that the client didn’t pay their copayment and owes $65. The worker terminates the benefits with 10 days’ advance notice. The client calls before the termination date and states that they paid the past due amount. The worker calls the provider and confirms that the debt has been paid. The client is otherwise eligible and the case is reinstated.
Example: ABC provider calls to report that the client left their center owing $400. The worker terminates the benefits with 10 days’ advance notice. Six months later the client reapplies online. The application will be denied until the Department receives verification that the balance has been paid or that payment arrangements have been made. The client returns a copy of a statement from Get Paid Now Collections showing that they are making monthly payments. The client is otherwise eligible and the application can be approved.