Family Law

Effect of Medical Expenses on Child Support

Deciding on the child support parents must pay can be a complex issue. Two main factors are a child's needs and a parent's ability to pay, set in the framework of state child support laws. One major expense in any budget is health care.

Two types of medical expenses that impact child support decisions are health insurance costs and bills not covered by insurance. Learn how the law treats these expenses and how they may factor into your case.

Health Insurance for Your Child

Expect that child support issues will include health insurance coverage for your child. Look to your state's child support laws for the first answer on which parent must insure and pay for health care. For example, state law may require a noncustodial parent paying child support to also provide health insurance. It's up to the court to decide on the specifics, such as ordering a parent to enroll a child in an employer's health plan.

A court can also address health insurance options when a parent can't get coverage through work. An employer may not offer family coverage, or premiums are unreasonable. Courts can order a parent to seek out alternate insurance options. A parent could be required to insure a child once insurance becomes available.

Check with your lawyer on how insurance costs factor into support calculations. For example, state law may allow you to subtract insurance costs from the income upon which child support is based.

Extraordinary Medical Expenses

Children aren't immune from the need for medical treatment, and bills can add up quickly. "Extraordinary" bills can result from the need for a medical procedure, an accident or routine care. Insurance likely won't cover all costs for:

  • Orthodontics
  • Dental treatment
  • Chronic conditions
  • Physical therapy
  • Medication
  • Psychiatric care

There are different ways courts can divide parents' duties to pay out-of-pocket health care costs. One common method is to divide costs based on parents' relative incomes. If one parent earns significantly more than the other parent, he or she can expect to pay a greater share of the bills.

National Medical Support Notice

A court can order a parent to enroll a child in an employer-provided health plan with premiums paid from the parent's paycheck. A federal form, the National Medical Support Notice (NMSN), gives an employer notice of an employee's duty to provide health insurance for his or her children. The NMSN tells an employer to enroll children for specific coverage (health, vision, dental, etc.), lists who is to be covered, and directs premium payment through payroll withholding.

The NMSN also gives instructions if insurance isn't available, premiums are more than allowed withholding limits, or if a parent is no longer employed.

Limits on Pay Withholding

The Consumer Credit Protection Act (CCPA) is a federal law that protects workers by limiting how much can be taken from their pay for reasons such as garnishment. CCPA limits also apply to withholding for child support and health insurance premiums.

Working out child support issues, whether it's during your divorce or making changes to an existing child support order can take more work than you realize. Gather information on your children's medical needs along with your finances. You'll be well-prepared to work with your lawyer and get the child support that meets your child's needs and is fair to both parents.

Questions for Your Attorney

  • Does state law control which parent must obtain and pay for a child's health insurance?
  • Can I be required to pay added child support if my ex-spouse gets health insurance for our kids through her job?
  • How do courts treat health costs that may be optional, such as braces?
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This article was verified by:
Jacqueline Newman | April 02, 2015
521 Fifth Avenue, 31st Floor
New York,NY

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