Uninsured Medical Expenses and Child Support

It's an unavoidable fact that all children will require medical attention. In addition to basic child support obligations, parents are required to pay for uninsured or unreimbursed medical expenses. Uninsured medical expenses are medical expenses not covered by insurance, including co-pays, deductibles, prescriptions, and any other medical, dental, and/or vision costs incurred as a result of medically necessary treatments or procedures.

These out-of-pocket medical costs are considered "extraordinary" medical expenses because they exceed the cost of basic health care included under a parent's health insurance plan. Some child support orders state the percentage of uninsured and unreimbursed medical expenses that each party is responsible for paying.

Absent a specific child support order concerning uninsured medical expenses, additional medical expenses may invoke the need to change an existing child support order, through an adjustment or modification, at the court's discretion.

State Guidelines for Uninsured Medical Expenses

Generally, there are state-specific guidelines detailing how medical expenses should be handled. One option is to require parents to share the cost of any uninsured medical expenses outright based on a proportion of their monthly income. This is referred to as the "income shares model."

An alternative is to require that parents share in the cost of uninsured medical expenses when the amount equals more than a certain percentage of the original child support payment.

Some jurisdictions require payment from the parent lacking custody of uninsured medical expenses after a certain dollar amount has been expended by the parent that has custody.

Additionally, some states distinguish between non-recurring and recurring health care costs, and these states also require parents to share the cost of only unpredictable non-recurring health care costs based on their income percentage level.

It is important to check the child support laws of your particular state to see how uninsured medical expenses may be handled in your specific case.

Collecting Unpaid or Unreimbursed Medical Expenses

A number of issues may arise when attempting to collect unpaid or unreimbursed medical expenses from the other parent, such as timing, notice, and reasonableness of the expense.

Timing, Notice, and Reasonable of the Expense

A parent requesting payment or reimbursement of uninsured medical expenses must initiate contact with the other parent and essentially ask that the other parent pay. They must also usually do so within a certain time period from the date that the expense was incurred.

When parents disagree over whether a medical service is necessary -- such as whether a child needs to see a doctor at the first sign of a cold -- a court may consider the reasonableness of the medical service to determine whether a payment split should occur.

Payment Procedure

Some states require parents lacking custody to pay their share of uninsured medical expenses directly to the parent having custody who will incur the initial cost. Other states allow payments to be made either to a parent or a health care provider. Sometimes, parents are required to pay a health care provider or child support agency directly.

In all cases, parents should use the following tips when attempting to collect unreimbursed or uninsured medical expenses:

• Retain any and all proof of payment, including receipts, checks, bank statements, and any other financial records that are relevant to such medical expenses
• Make several copies of bills and receipts for your records, if necessary
• Provide notice to the other parent in terms of an agreed-upon numbers of days or timeframe
• Try to reach out to the other parent informally
• Follow all child support procedures outlined in the original child support agreement

Enforcing Unpaid or Unreimbursed Medical Expenses

Failing to pay for unpaid or unreimbursed medical expenses may result in the same enforcement options as regular unpaid child support, also known as "arrearages." Unpaid child support, including medical expenses, can be collected through wage garnishment, interception of tax refunds, license revocation, and/or contempt of court charges.

A parent seeking enforcement of child support may initiate enforcement actions after a demand for payment has been made. This may happen only after the parent responsible for payment fails to pay within a timeframe required by the parents' arrangement concerning reimbursement of relevant expenses.

Get Clarity on Uninsured Medical Expenses: Talk to a Lawyer

A child's uninsured (or underinsured) medical expenses can add up quickly, leaving parents scrambling to pay the bills. Even if you already pay monthly child support, you still may be on the hook for these additional expenses, but laws vary by state. Get more insight into your child support obligations by meeting with an experienced family law attorney near you.