child receiving dental care

Does Your Child Support Include a Medical Support Provision?

Many parents are under the assumption that if they are paying child support that health insurance for the child is included. The official answer to that is a typical “lawyer” answer, “It depends.” It depends on whether the medical support provision was set in the court-ordered support. The courts can order the noncustodial parent to carry the health insurance if he or she has an employer that provides a group health plan or the court can order the noncustodial parent to pay his or her portion of the health insurance back to the custodial parent. One is to never just assume that child support covers health insurance and medical expenses without it being clearly stated, as the law does not take health care lightly, especially when a minor child is involved. The state’s primary duty is to preserve public health. A broad definition of health law is that it includes the law of public health, health care generally, and medical care specifically. Arkansas is no exception, as all states require divorced parents to provide adequate financial support for their children, including healthcare coverage for their dependent children. A 1993 amendment to the Employee Retirement Income Security Act (ERISA) requires that health care coverage from an employment-based group health plan be extended to the children of a parent-employee who is divorced, separated, or never married when ordered to do so by a state court or agency. This is called a qualified medical child support order (QMSCO).

Family law courts will decide which parent is responsible for providing health insurance for children based on a variety of things. In addition to the health insurance, they will also decide how to divide out-of-pocket medical expenses. These expenses include co-pays, deductibles, and medical expenses not covered by health insurance. Preferably, the court order is based upon an agreement the parents have put together themselves; however, if they cannot reach an agreement together, the court will decide for them after reviewing each parent’s individual financial statements and make a decision accordingly. The most common court orders pertaining to health insurance coverage are:

  • Require the non-custodial parent that is employed to maintain dependent coverage on their employer-provided health insurance plan.
  • If the non-custodial parent does not have an employer-provided health insurance plan, the courts can require the non-custodial parent to purchase an affordable private plan to cover the children.
  • If both parents have health insurance through their employer, one plan will be designated as primary and the other as secondary.
  • In addition to health coverage, other medical expenses such as out-of-pocket expenses, the court may order the expenses to be divided between both parents equally or based on a percentage basis on their individual incomes.

A couple of additional things to note:

  • If a parent has been ordered to provide health insurance and fails to do so, that parent will not only be in contempt of court but will also be responsible for paying all healthcare costs that would have been covered under the insurance plan.
  • If neither parent can afford health insurance, then the child may qualify for healthcare under a state program such as Medicaid. In Arkansas, it is called ARKids 1st.

To avoid any future issues, I typically include a request for the medical support provision to be included in the court orders. Once this is a part of the court order, the Arkansas Office of Child Support Enforcement (OCSE) will enforce the medical support provision ordered by the court along with child support enforcement. If you are having a difficult time getting the noncustodial parent to provide health insurance or pay his or her portion of medical expenses, contact Kevin Hickey Law Partners. We will file the appropriate paperwork to begin getting your case heard before a judge to make the court-ordered medical support provision or a modification to your current support. One thing to note is that OCSE does not enforce uninsured medical expenses unless a court order specifically requires payment. That must be stated specifically within your court orders. To make sure your child has the medical insurance coverage they deserve, give one of our legal professionals a call. Our River Valley office number is 479.434.2414 and our Northwest Arkansas office number is 479.802.6560.