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Health Care Coverage Support

Quick Facts

If both parents have comprehensive coverage, then the court will choose the better of the two.
If neither parent carries appropriate coverage, then the court can order the custodial parent to obtain comprehensive coverage.

Determining Appropriate Health Care Coverage

To determine if a parent has appropriate health care coverage for the joint child, the court must consider the following factors:

comprehensiveness of coverage providing medical benefits;
accessibility;
the joint child's special medical needs;
affordability.

Dependent health care coverage providing medical benefits is comprehensive if it includes medical and hospital coverage and provides for preventive, emergency, acute, and chronic care. If both parents have comprehensive health care coverage, then the court must determine which parent's coverage is more comprehensive by considering what other benefits are included in the coverage.

Dependent health care coverage is accessible if the covered joint child can obtain services from a health plan provider with reasonable effort by the custodial parent of the joint child resides. Health care coverage is presumed accessible if the three following conditions are true:

primary care is available within 30 minutes or 30 miles of the joint child's residence and specialty care is available within 60 minutes or 60 miles of the joint child's residence;
the health care coverage is available through an employer and the employee can be expected to remain employed for a reasonable amount of time;
no preexisting conditions exist to unduly delay enrollment in health care coverage;

Dependent health care coverage is affordable if the cost is reasonable. If both parents have similar, comprehensive health care coverage available that meets the joint child's needs, then the least costly health care coverage is presumed to be the most appropriate health care coverage for the joint child.

Ordering Health Care Coverage

If a joint child is has health care coverage, then the parent providing coverage will continue unless the parents agree otherwise or a parent requests a change in coverage and the court determines that other health care coverage is more appropriate.

If a joint child is not covered, on motion of a parent or public authority,then the court will determine if one or both parents have health care coverage that would be appropriate for the joint child.

If only one parent has appropriate health care coverage for the joint child, that parent must cover the joint child under his or her medical benefits.

If both parents have appropriate health care coverage available, then the parent with whom the joint child resides must carry the coverage for the joint child, unless one of the following is true:

a parent expresses a preference for health care coverage available through the parent with whom the joint child does not reside;
the parent with whom the joint child does not reside is already carrying dependent health care coverage for other children and the cost of contributing to the premiums of the other parent's coverage would cause extreme hardship to the parent with whom the joint child does not reside;
the parents agree as to which parent will carry health care coverage providing medical benefits and agree on the allocation of costs.

If the exception applies, then the parent carrying the most appropriate medical benefits coverage is required to continue to carry coverage for the joint child.

If neither parent has appropriate health care coverage available, then the parents must do one of the following:

contribute toward the actual health care costs of the joint children based on a pro rata share; or
if the joint child is receiving any form of public coverage, the parent with whom the joint child does not reside must contribute a monthly amount toward the actual cost of public coverage.

The amount of the noncustodial parent's contribution is determined by applying the noncustodial parent's PICS to the premium schedule for public coverage. If the noncustodial parent's PICS is eligible for public coverage, then the contribution is the amount the noncustodial parent would pay for the child's premium. If the noncustodial parent's PICS goes beyond the limit of eligibility for public coverage, then the contribution is the amount of the premium for the highest eligible income on the appropriate premium schedule for public coverage. To determine the premium, the noncustodial parent's household size is equal to one parent plus the child or children who are covered by the child support order.

If neither parent has appropriate health care coverage available, then the court has the authority to order the parent with whom the child resides to apply for public coverage for the child.

If a joint child does not have health care coverage that provides dental benefits, then the court must determine whether one or both parents have appropriate dental health care coverage for the joint child. The court may order a parent with appropriate dental health care coverage available to carry the coverage for the joint child.

If a joint child is not presently enrolled in available health care coverage providing benefits other than medical benefits or dental benefits, then on the motion of a parent or the public authority, the court can decide that other health care coverage for the joint child is appropriate, and the court may order a parent with that appropriate health care coverage available to carry the coverage for the joint child.

Spousal or Former Spousal Coverage

If the child lives with one parent, and the other parent provides the child's dependent health care coverage, then that parent must provide coverage for the primary custodial parent if doing so does not increase premiums.