Uninsured Medical Expenses and Child Support

Besides child support obligations parents also have the obligation to bear the uninsured medical expenses of the child. Extraordinary or uninsured medical expenses refer to the out of pocket medical expenses exceeding the amount covered by the insurance plan and include surgery costs, deductibles and co-pays.

They are referred to extraordinary because they exceed the child’s basic health coverage under a parent’s health insurance plan. In many states, the uninsured medical expenses are required to be shared by the parents. In such states the child support order will specify how the expenses are to be shared.

If the child support order is silent about uninsured medical expenses, these expenses can result in a significant change in the circumstances warranting a change in the support order.

State Guidelines

In many states there are specific guidelines on these expenses. The exact guidelines vary from state to state. In some states, the share of the parents is a proportion of their monthly income. This is referred to as the income shares model.

In other states the non-custodial parent must contribute to the uninsured medical expenses if the expenses exceed a certain percentage of the support payment.

In few states, the non-custodial parent must pay these expenses over a certain amount while the custodial parent bears the expenses below that amount. For example, if this amount is fixed at $500 per year, and the custodial parent has already spent $500, then any other such expenses must be borne by the non-custodial parent.

In some stats the law makes a distinction between recurring and non-recurring healthcare costs. The parents are required to share only the cost of unpredictable non-recurring health care cares and their share is determined by their income.

Please check with your state laws and guidelines.


If you are seeking to collect these expenses from the other parent, you will face many issues like notice, timing and reasonableness of the expense.

Notice, Timing and Reasonable

If you are seeking to collect these expenses form the other parent, you must contact the other parent and ask for payment. You must do so within a certain period of time from the time you incurred the expense.

If there is any disagreement between the parents on the use of medical services such as whether the child had to be taken to a specialist clinic because he sneezed, the court will consider reasonableness of the service to determine whether the cost should be split.

Payment Procedure

In some states, the non-custodial parent must pay his or her share directly to the custodial parent. In other states the payment must be made to the parent or the health care provider. In a few states the payment must be made directly to the health care provider or the state child support agency.

Here are some tips to help you:

• Retain all bills and receipts
• Retain copies of all bills and receipts
• Notify the other parent within the required time period
• Try to resolve the issue informally
• Comply with your obligations under the child support order/agreement


Generally the mechanisms for enforcing payment of these expenses are the same as those used for enforcement of child support – property seizure, wage garnishment, tax refund withholding, revocation of license and contempt orders.

You should initiate enforcement actions if you have made the demand for payment as required but the other parent has not paid despite having received the demand for payment the time period for making the payment has passed.

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