Uninsured Medical Expenses and Child Support Laws
Medical treatment for a child involves additional costs beyond what is covered by insurance. Examples include co-pays, deductibles, prescription medications, and adaptive devices. Dental and vision appointments are often considered uninsured medical expenses if insurance coverage is insufficient. Addressing these potential costs in a child support order can clarify financial obligations.
Payment Arrangements and Responsibility
Parents may reach their own agreements regarding how to divide uninsured medical expenses. Some choose to share costs in proportion to their incomes, while others decide on an even split. Courts generally uphold such arrangements if they effectively support the child’s interests. If parents cannot agree, a court will apply state guidelines or statutes to resolve the issue.
Many states have guidelines that allocate uninsured medical expenses based on each parent’s income. Others impose formulas or thresholds that rely on the cost of insurance premiums and the total expense. Courts may consider whether a procedure is deemed necessary and whether the cost is reasonable under the circumstances. In states that allow judicial discretion, the judge may examine factors such as the parents’ earning capacities, additional financial obligations, and the child’s specific needs.
Medically Necessary Procedures
Parents sometimes disagree on whether a treatment qualifies as essential. A procedure like orthodontics may be considered medically necessary if it addresses a serious dental issue rather than a purely cosmetic concern. Therapy sessions for a diagnosed condition and durable medical equipment that helps a child function daily are typically counted as medically necessary. In instances of substantial disagreement, courts may require evidence, such as a doctor’s recommendation or expert testimony, to confirm necessity.
Failure to Pay and Enforcement
Courts typically enforce payment obligations for uninsured medical expenses in a manner similar to child support enforcement. The parent who covers the expense may seek reimbursement from the other parent for their portion of the expense if the court order or agreement stipulates shared responsibility. If that parent fails to pay, courts may impose wage garnishment. Depending on the jurisdiction, courts also may place liens on property, intercept tax refunds, suspend driver’s or professional licenses, or report delinquent payments to credit bureaus. In egregious cases, a judge may impose fines or even jail time for contempt of court if a parent willfully fails to pay.
Modifications to Orders
If either parent experiences a significant change in income or obtains a new form of insurance, an existing child support or expense-sharing order might need revision. Courts consider whether the change substantially affects the parties’ ability to pay. Similarly, when a child’s health expenses significantly increase—whether because of a newly diagnosed condition, additional treatments, or revised insurance coverage—parents may need to adjust their existing child support or medical expense-sharing arrangements. Parents can sometimes agree to adjust payments on their own, but formal modifications generally require a review by a judge.
