Child Support – Medical Support/Health Care Coverage

  • Medical support is providing health care coverage for a joint child by:
  • • carrying or contributing to the cost of health care coverage,
  • • public coverage (Medical Assistance or MinnesotaCare), or
  • • the unreimbursed and uninsured medical expenses.

    • Court-ordered medical support

    In Minnesota, every child support order must include health care coverage requirements for the children on a child support case. The order will include the following:

  • • which parent is ordered to provide or maintain the health care coverage for the children
  • • the cost of premiums and how the cost is divided between the parents
  • • how unreimbursed and uninsured medical expenses will be divided and collected by the parents (this would be costs not paid by the insurance company)
  • • reasons, if any, that the obligation to provide health care coverage will shift from one parent to the other.

    • If appropriate health care coverage is not available, the order must say whether either parent is required to pay for medical support.

    Health care coverage

    Health care coverage means health care benefits that are provided by a health plan.

    Health plans include:

  • • plans provided on an individual and group basis, provided by an employer or union and purchased in the private market.
  • • a plan providing for dependent-only dental or vision coverage and a plan provided through a party's spouse or parent.

    • Health care coverage does not include any form of Medical Assistance or MinnesotaCare.

    Private coverage is included in the meaning of a health plan. The court may decide this as an option and order private coverage for the children. Private coverage must still meet the court standard. If private coverage is currently in place for the joint children, the court must order coverage to continue.

    Establishing or modifying medical support

    The court considers the following four factors to determine if health care coverage is appropriate:

  • • Accessible
  • Health care coverage is accessible if it meets one or more of the following:
  • • Primary care is available within 30 minutes or 30 miles from the child’s home.
  • • Specialty care is available within 60 minutes or 60 miles from the child’s home.
  • • 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 that would delay coverage.
  • • Comprehensive
  • Health care coverage is comprehensive if it includes medical and hospital coverage and provides for these kinds of care:
  • • preventative
  • • emergency
  • • acute
  • • chronic
  • If both parents have health care coverage that meets these requirements, the court considers which parent has coverage that is more comprehensive by considering whether the coverage includes any of the following:
  • • basic dental
  • • orthodontia
  • • glasses and contact lenses
  • • mental health services
  • • substance abuse treatment
  • • Affordable
  • The court considers that health care coverage is affordable if does not cost more than five percent (5%) of a parent’s gross income.
  • • Special needs

    • The court considers any special medical needs of the children.

    When health care coverage is in place

    If either parent currently provides health care coverage, the court must order that health care coverage to continue.

    Current health care coverage may include:

  • • private coverage
  • • coverage offered through the parent’s employer
  • • coverage offered through the spouse’s employer.

    • The court may order other coverage if one of the following is true:

  • • the parents agree
  • • one of the parents requests a change, and the court agrees that the change to the health care coverage is appropriate.

    • When health care coverage is not currently in place

    If the children are not currently enrolled, the court must determine if either parent has appropriate health care coverage. If either parent has health care coverage in place, no determination is needed unless either parent requests a change in the health care coverage.

    When health care coverage is available but not in place

    When health care coverage is available but not in place, the court may determine if coverage is appropriate.

    If only one parent has appropriate health care coverage, the court must order that parent to carry the health care coverage.

    If both parents have appropriate health care coverage available, the court must order the custodial parent to carry the health care coverage for the children.

    The court may make a different decision if:

  • • either parent has a preference for the health care coverage of the noncustodial parent
  • • the noncustodial parent is already carrying health care coverage for other dependents, and contributing to the custodial parent’s health care coverage would cause extreme financial difficulty
  • • the parents agree that the noncustodial parent will provide health care coverage, and the parents agree on the how to share the cost.

    • If the court determines that the custodial and noncustodial parent's health care coverage is similar, the court must believe that the least costly health care coverage is most appropriate and order that health care coverage for the children.

    When health care coverage is not available

    If the parents do not have health care coverage available and the children do not receive Medical Assistance or MinnesotaCare, then the court may order both parents to share the actual cost of medical expenses. The proportion each parent pays is based on the Parental Income for Determining Child Support (PICS). These costs can be collected as uninsured medical expenses.

    The order may specify that the custodial parent apply for public coverage for the children.

    If the custodial parent is ordered to apply for public coverage, medical support should be ordered as follows:

  • • The parents should be ordered to divide the actual health care costs based on each parent's percentage share of PICS if the children do not receive public coverage.
  • • The order should also have an amount the noncustodial parent must pay toward the cost of the public coverage for any month that public coverage is in place.

    • Authority

    Minnesota Statutes can be found on the Minnesota Office of the Revisor Web site.

  • • Minnesota Statutes, section 518A.41

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