Will Child Support Cover Your Child’s Medical Costs?

If you have a child who needs braces, has special needs, or faces diagnosis or treatment for a serious health condition, the medical costs can add up very quickly. When families of children with these needs are separated (whether through divorce or when parents were never married), it can make it hard to know who is responsible for the medical bills. Will the primary caregiver have to pay out of pocket, will the parent who provides the child’s insurance be required to pay, or will child support cover your child’s medical costs?

This blog post will provide a basic overview of how Maryland child support laws treat medical costs. It will review who is responsible to cover the child’s health insurance and what you can do if you are facing extraordinary medical expenses.

Everyday Medical Costs are Counted into Child Support

Maryland child support laws are designed to make sure that every child has the financial support of both parents, even though they may live with one parent more. That financial support is calculated in consideration of a child’s basic needs, from housing to healthcare. In general, the Maryland child support formula calculates how much each parent must contribute to the support of his or her children based upon a proportional share of the parents’ combined incomes. That combined income falls into one of several buckets that cover up to $15,000 per month and direct the total amount of support Maryland children are entitled to under the law. In high wage-earning families with a combined gross monthly income above $15,000, the court has discretion to award child support based upon the financial circumstances of both the parents and the financial needs of the children.

Once a basic child support amount is determined, the support is divided between parents based upon his or her share of the combined household income. The child support guidelines then recommend an amount of money (child support) that the higher earner or non-custodial parent (depending upon your custodial arrangement) must pay to the lower earner or custodial parent to meet a child’s needs. If your combined household income is less than $15,000 per month the guidelines recommendation is mandatory. If your household income exceeds $15,000 per month then the court, at its discretion, may deviate from the guidelines recommendation.

A child support calculation isn’t only a matter of income. The basic child support calculation may be also adjusted based on:

• Shared parenting time -- is the access schedule shared or sole custody?
• Child-only health insurance costs or the portion of a family health insurance premium related to the child
• Work-related child care expenses, which may include daycare, before care, after care, or camp, if the care is needed for work-related coverage.
• Extraordinary medical expenses (discussed later)

When it comes to the cost of your child’s health insurance premiums, child support is designed to cover basic medical costs. However, when those medical costs start to mount or there are out-of-pocket expenses, basic child support may not be enough to meet your child’s needs.

New Law Expands Extraordinary Medical Expenses to Protect Children

Up until now, there hasn’t been much parents can do when a child’s various physical and mental health conditions resulted in mounting medical costs that were less than $100 per illness or condition. Under former Maryland law, parents were only entitled to additional child support for uninsured extraordinary medical expenses that exceed “$100 per illness or condition.” These extraordinary medical expenses come up frequently as related to things like:

• Braces or corrective dental work (orthodontia)
• Dental treatment
• Glasses
• Asthma treatment
• Physical therapy
• Treatment for a chronic health problem
• Counseling or psychiatric therapy for diagnosed mental disorders

Often, special needs children or those with chronic health conditions have multiple diagnoses at once. Maryland’s old extraordinary medical expenses law wouldn’t apply if the itemized cost of each condition was less than $100 (say an $80 breath treatment for asthma and a $50 allergy shot), even if the total cost far exceeded the limit ($130 in the above example). As a result, that parent that was responsible for taking a child to the doctor and paying basic co-pays could be responsible for significant out-of-pockets that did not meet the definition of extraordinary medical expenses as defined by the statute.

Now, the Maryland legislature approved a change to child support law that would allow extraordinary medical benefits to work more like a deductible. House Bill 742 changed the definition of extraordinary medical expenses to “uninsured costs for medical treatment in excess of $250 in any calendar year.” The law also officially added “vision care” to the list of covered child-only health insurance expenses.

Who Should Pay for the Child’s Health Insurance

What about health insurance? A family court judge may order either parent to provide health insurance for a child. The Maryland child support formula gives a prorated credit in the calculation of child support to the parent that provides a child’s health insurance. When the child-only portion of a parent’s health insurance premium is included in the calculation of child support, the premium is credited between each parent based upon his or her share of the combined household income. Depending upon custodial arrangements, income, and costs of insurance, this credit can cause parents to want to add their children to their health insurance policies, even when the other parent already has insurance, or when the court hasn’t ordered the coverage.

Double-insurance (when both parents provide health insurance for the same child) may work against the family, increase everyone’s overall insurance costs, and result in reduced coverage for your child. As a general rule, when two (or more) insurance policies cover the same person for the same condition, one policy will be considered “primary” and the other “supplemental”. However, the way insurance companies decide whose policy comes out on top may not have anything to do with premiums, coverage options, or even the child’s health. That means that a parent who decides to cover his or her child to save on child support may end up spending more out-of-pocket and might also leave his or her child with poor primary insurance coverage.

At the Law Office of Shelly M. Ingram, our child support lawyers understand the ins and outs of the Maryland Child Support formula. We can educate you about what your child support order will cover, and how to take advantage of changes to the extraordinary medical expenses law. If you need help with your child support matter, contact us today to schedule a confidential consultation with an attorney.