How Courts Determine Child Support
First, it’s important to understand that both parents are responsible for child support. Yes, one parent may be paying it, and the other parent receiving it, but both parents’ financial status comes into play when a court is determining the payment amount.
In an effort to provide consistency in child support orders, states have adopted child support guidelines. Basically, these are rules and formulas courts must follow in order to arrive at a final child support amount. Parents will fill out a child support worksheet, which will include their income information. (Here's an example of a child support worksheet.) The income amount plays a significant role in calculating the support payment. But there are other elements involved, including a child’s medical needs.
What Types of Medical Expenses Are Included in Child Support Orders?
Generally speaking, there are two kinds of medical costs that courts seek to address in child support orders. One is health insurance and the other is medical expenses not covered by insurance.
Child Support and Health Insurance
Having health insurance is crucial today, particularly where children are involved. For that reason, courts will order one or both parents parents to provide health insurance coverage for their children. Because providing coverage usually results in an additional expense for parents, they may be able to deduct the cost from their gross income figure on the child support worksheet, which may lower the support obligation. Once again, state law determines whether the deduction is permissible.
There are exceptions to the obligation to provide health coverage. Ordinarily, there are two situations in which a court may decide that a parent doesn’t have to provide coverage: the insurance isn’t available at a reasonable cost; and, providing the insurance imposes an “undue hardship” on the parent.
There are any number of scenarios that might lead to a court determining that the cost of providing coverage is unreasonable. One example would be where the cost exceeds a certain percentage of a parent’s income (typically five to ten percent, depending on the law). If insurance is available through a parent’s employer, state law is likely to consider the cost of coverage reasonable on its face.
Although health insurance might be available at a reasonable cost, in some states it would still be possible for a judge to find that obtaining coverage would pose an undue hardship for a parent. One example might be where paying for health coverage would prevent the parent from being able to make the court-ordered child support payment.
Child Support and Medical Expenses Not Covered by Insurance
As a rule, most state child support guidelines build into their support calculations an annual medical expense figure of $250 per child. In effect, this means that parents paying support are covering that amount each year as part of their payments. In light of this, the parents receiving support are responsible for the child’s medical expenses not covered by insurance, up to the $250 amount. (Medical expenses usually include ordinary dental and eye care costs.)
Some states may limit the total amount the parent receiving support will have to pay toward the $250 per child figure, thus potentially saving that parent some money. For example, if the parents have four children, the spouse receiving child support should be liable for the first $1000 of medical expenses incurred, in total, for those children. But if the state law caps the total liability at $800, that parent is saving $200.
When medical expenses exceed the $250 per child figure, there are primarily two ways states handle those costs. A state may choose to include in the child support payments a fixed amount for predictable and recurring medical expenses. These would be expenses relating to an ongoing medical condition from which a child may suffer. “Predictable and recurring” are the operative words here, because it means the parents and the court have first-hand knowledge of what those expenses are now and are likely to be in the future.
For states that don’t utilize that method, the law will likely state that the parents will share medical expenses over and above the $250 amount, based on a pro rata share of their combined income. Consider this scenario: the parents’ combined income is $100,000. Parent A makes $70,000, and Parent B makes $30,000. Under those circumstances, Parent A would pay 70% of the medical expenses; Parent B would pay 30%.
Note that both the above approaches relate to ordinary or ongoing medical expenses. But there are some medical costs that may not fall into that category, such as orthodontic needs or mental health treatment. Because they’re often unforeseen or one-time expenses, it wouldn’t be practical, or perhaps even possible, to attempt to include them in the regular child support payment. As a result, courts will normally order the parents to pay for these expenses on the pro rata income basis referenced above.
In many respects, child support laws are state-specific. To learn more, consider consulting a knowledgeable local divorce lawyer.