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 Shabbat Parashat Miketz| 5764P’ninat MishpatIntra-familial Obligations - Part IX - Medical Expenses
One of a husband’s obligations to his wife is medical support (refuah) (Even Haezer 79). Why is there a separate category of obligation when refuah seems to be within the framework of regular support (mezonot)? There are similarities and differences between mezonot and refuah. One difference is that mezonot entails, primarily, normal expenses, whereas refuah refers to payments for specific, often costly, expenses that arise. In some ways, refuah is more similar to the obligation to redeem a kidnapped wife from her captors (pidyon) (ibid., 78).
The similarity to mezonot (and difference from pidyon) is in the fact that refuah is usually ongoing and not one lump sum. However, some medical conditions lend themselves to a lump sum appraisal of cost. Halachically, the lump sum expense is different from ongoing expenses in the following way. Inheritors are obligated in mezonot but not in pidyon. What about refuah? Inheritors are obligated in ongoing medical expenses, which are similar to mezonot, but are exempt from lump sum payments from chronic diseases (Shulchan Aruch, EH 79:1).
Another application of this distinction is in regard to divorce. A husband suspends mezonot when he divorces his wife. If a woman was kidnapped and then divorced, the husband is still obligated to pay for her pidyon, since he became obligated when they were still married. What about refuah? The husband is exempt from continuing payment even for conditions which arose during their marriage (ibid.:3). (In our times, she can refuse to receive the get if she rejects an unfair monetary arrangement (Chelkat M’chokek, ad loc.)). However, if an expense that stems from the period of marriage is, by nature, lump sum (even if payment is done in installments), the husband continues to pay after divorce (see Beit Shmuel, ad loc.:1).
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