Uninsured Medical Expenses and Child Support
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 cost 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
Most states have specific guidelines as to how medical expenses should be handled, and the laws vary from state to state. Some states require parents to share the cost of any uninsured medical expenses outright based on a proportion of their monthly income ("income shares model").
Other states require the noncustodial parent to share in the cost of uninsured medical expenses when the amount equals more than a certain percentage of the original child support payment.
Some states require payment for uninsured medical expenses after a certain dollar amount has been expended by the custodial parent, for example, "all non-reimbursed reasonable and necessary children's health care costs in excess of $480 per child per year shall be allocated to the noncustodial parent".
Some states distinguish between non-recurring and recurring health care costs, and require parents to share the cost of only unpredictable non-recurring health care cost 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 to pay, usually within a certain time period of the date that the expense was incurred.
When parents disagree over uses of medical services -- such as whether a child needs braces, or a visit to a doctor at the first sign of a cold -- a court may consider the reasonableness of the additional medical service to determine whether a payment split should occur.
Some states require noncustodial parents to pay their share of uninsured medical expenses directly to the parent who will incur the initial cost. Other states allow payments to be made either to a parent or a health care provider. Some states require parents 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:
- Keep all bills and receipts together;
- Make several copies of bills and receipts for your records, if necessary;
- Provide notice to the other parent (for example, 10 days, 30 days, and 60 days);
- Try to reach out to other parent informally; and
- 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 (within a certain time period), and after the parent responsible to pay did not pay (within a certain time period) of receiving the demand for payment.