Is the Noncustodial Parent Responsible for Health Insurance?

Both parents are responsible for ensuring their child's physical well-being and financial support. This can include arranging for health insurance and covering other medical costs. Which parent pays depends on your abilities to pay and the law in your area. A parenting plan often specifies how parents must split these costs.

Which parent is responsible for health insurance?

When one parent has sole legal custody, they're responsible for major decisions about their child. For example, they can decide alone whether to vaccinate the child. That they're entitled to make the choices doesn't necessarily mean they handle the bill. Often the noncustodial parent pays child support and may also purchase the child's health insurance.

If the child support order or court-ordered parenting plan doesn't say which parent must pay for health insurance, then as a practical matter the custodial parent may have to take care of it on their own. Especially if parents are high-conflict or not in frequent contact, the custodial parent may prefer to choose and pay for the health insurance without asking the other for help.

Joint legal custody and health insurance

When both parents share joint legal custody, they share responsibility for major decisions about their child. This includes medical choices (unless their court order specifies otherwise), so they should routinely consult each other about what the pediatrician recommends. They shouldn't withhold medical information, as they need to make informed medical choices together.

Rather than have a judge tell them exactly who pays for health insurance, they may prefer to decide together which insurance they'll rely on and how they'll afford it.

For joint custody to work out, co-parents need to be able to communicate, compromise and cooperate most of the time. If they have a specific disagreement — for example, about their child's health care — they may want to try mediation to resolve it.

Is the noncustodial parent responsible for medical bills?

Yes. Both parents must care for their child's basic needs, including arranging for them to receive health care and paying for it. Parents should expect to have some out-of-pocket medical expenses for their child, although it's hard to predict when and how much.

Beyond the insurance premium (the recurring charge for maintaining your child's insured status), you'll have additional medical bills if:

• Your plan requires you to pay part of the cost of each doctor visit (a co-pay, like $25)
• Your plan requires you to pay all your medical expenses up to a certain amount before that year's insurance coverage kicks in (a deductible, like $1,000)
• Your child receives care that is uninsured (e.g., specialist or out-of-network)

It's common for parents to split these medical bills 50/50. However, you may find that a different arrangement makes more sense for you. The court may welcome an agreement that you and your co-parent propose together.

In the United States, money that you pay for your child's medical expenses beyond the cost of health insurance is sometimes called cash medical.

Mention to the family judge or child support administrator if your child has extraordinary medical expenses due to a major illness or disability. Your child has to receive proper care, and the court will order a fair way for you and your co-parent to split these costs.

Examples of disagreements about medical bills

Sometimes a parent objects to a specific medical bill. For example, if a child appears to have autism, ADHD or anxiety, parents may find themselves in these sorts of disagreements:

• One believes there's a physical cause, and the other believes it's psychological.
• One believes the issue should be treated by a professional, while the other believes it will resolve on its own.
• One wants the child to see a doctor, while the other believes a behavioral coach or an academic tutor would be more appropriate.
• One wants to pay extra for an out-of-network specialist, while the other wants to save money by seeing an in-network provider.
• One is ready to switch to a different health insurance plan, while the other insists on staying with the one they have.
• One believes the child has a health problem, while the other thinks everything's fine.
• One believes the child should be diagnosed with a disorder, while the other accepts the child's traits as part of their personality.

Inadequate health insurance or no health insurance can also cause disagreements later on. If you were the parent responsible for choosing the insurance and your child now has high medical bills, your co-parent may argue that you should have chosen a better insurance plan. They may try to hold you responsible for those out-of-pocket costs. Prioritizing good health insurance can avoid this kind of argument.

If your ex refuses to pay medical bills

Even if a parent is unable or unwilling to pay or can't be found, they remain responsible (in principle) for financially supporting their child and (enforceably) for any amount a court or child support agency has ordered.

If they really can't afford child support or medical bills, they may qualify to have their obligation lowered. They should proactively review their options. Asking for a modification is better than simply having the noncustodial parent not paying medical bills at all.

If your ex refuses to pay half of the medical bills but is willing to pay at least something, keep track of what you've each paid and share the log with them. You'll each see who's been taking care of the running expenses, and that'll be one fewer thing for you to argue about. An expense tracker will also be helpful in mediated negotiation, as the mediator will better understand the finances you need to rebalance.

A parent who refuses to bring a child to the doctor at all may be committing medical neglect. Neglect is a kind of abuse. It can result in the loss of custody.

Child support orders and health insurance

In a child support order, the basic costs of caring for the child — housing, food and other day-to-day expenses — is split between the parents. To make this fair and affordable for both parents, the court usually considers their incomes and the amount of time their child lives with them. One parent pays the other on a regular basis to even out the cost.

The cost of the child's health insurance, as well as expected out-of-pocket medical expenses, are often considered too.

In the United States (depending on the state), if both parents have the opportunity to purchase health insurance for their child through their employer, a judge or child support administrator may examine their available options and say which parent must purchase the employer-sponsored insurance.

Child support in each location differs. Your local law may:

• Require health care costs to be factored into the overall child support amount
• Specify that parents must pay for health care as another type of child support. Canada refers to these costs as "special or extraordinary expenses," and a judge tells parents how to split them.
• Require parents to have health insurance for their child, but address this entirely apart from child support — e.g., when applying for public assistance or paying taxes. In Australia, health insurance is usually detailed in the parenting plan, so it's part of establishing parenting arrangements (custody).
• Not require parents to have private health insurance for their child — e.g., because the government provides basic health services, as in the UK through the NHS and similarly in Ireland through the HSE

In the United States, child support laws differ by state.

For example:

California factors the cost of health insurance into the child support amount, then tends to split medical bills according to the parents' incomes.

Texas always awards medical and dental support, even when it doesn't order general child support. In a child support calculation, the amount you pay for medical and dental support is subtracted from your income. Parents split any remaining health expenses (exactly how is up to the judge).

New York calculates child support by subtracting the cost of the child's health insurance from the parents' incomes. Any remaining medical bills are typically split between the parents, proportionally to their incomes.

Florida splits the child's medical and dental insurance between the parents proportionally to their incomes.

Illinois parents who owe child support must buy the child's health insurance through their employer or (if their employer doesn't offer it) reimburse the other parent for buying it.

Decide who will pay for health insurance

Is the noncustodial parent responsible for health insurance? Reaching agreement on which parent is responsible for medical bills removes uncertainty.

In the Custody X Change app, click the "parenting plan" tab. More than 25 categories of parenting provisions will appear.

You can customize this to fit your situation with Custody X Change.

Click "expenses and money", then choose an option or write in your own.

You can customize this to fit your situation with Custody X Change.

Including health care provisions in your parenting plan will save you a lot of time and stress.