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Medical Support for Children

In most states, child support guidelines require that the cost of health insurance and extraordinary medical expenses of the child be included in establishing each parent’s child support obligation.

Child Support Guidelines

In all states, the court or tribunal may require that one or both parents provide health insurance for the minor child or children of the parties. How the premiums are treated in establishing child support varies from state to state. In some states, health insurance premiums that are deducted from a parent’s paycheck may not be considered part of the parent’s income in calculating child support. In a few of those states, the amount deducted from a parent’s paycheck to cover health insurance may be prorated among all the beneficiaries and only the amount allocated to the child is deducted from the parent’s gross income in calculating child support. In other states, the cost of health insurance may be prorated between the parents, and if one parent pays the full amount, the amount of child support is adjusted to reflect a credit for the pro-rated amount. Where available, insurance for the child must usually include dental and vision coverage, as well as the basic physician and hospitalization insurance.

Extraordinary Medical Expenses

In addition to health insurance expenses, some children have extraordinary medical expenses. All states add a pro-rata share of such expenses, when not paid by insurance, to the basic child support obligation. Each state has adopted its own definition of what constitutes “extraordinary” medical expenses. Maryland defines “extraordinary medical expenses” as any uninsured expenses over $100.00 for a single illness or condition. Missouri considers any out-of-pocket expenses, including deductibles and co-pays, in excess of $250.00 per year, to be extraordinary medical expenses. Some state statutes leave the amount necessary to constitute “extraordinary” to the discretion of the court. It is typical for a court to pro-rate the monthly payments for treatments such as braces for a child’s teeth, where the after insurance cost is $1,000 or more.

Termination of Obligation

Unless there is a written agreement providing for health insurance after a child reaches the age of majority or while the child is still in school, the obligation to pay for health insurance or for extraordinary medical expenses terminates when the obligation to pay child support terminates. The obligation to continue paying on any accrued arrearage does not require the parent to continue to provide health insurance.

Copyright 2012 LexisNexis, a division of Reed Elsevier Inc.