Health Insurance Coverage as Form of Child Support

As a form of additional child support, parents are often ordered to continue or begin providing health insurance coverage for their children. Under California Family Code section 4006, the court shall consider the health insurance coverage of the parties during a child support proceeding. Further, Family Code section 3751 states the courts must require this coverage if it is at no cost or reasonable cost to the parent. Note that child support orders will also include several “add-ons.” This includes those expenses that are not covered by insurance, such as co-pays, surgery or procedures not covered by the parent’s plan, prescriptions, etc. Parents will be ordered to split these costs, regardless of which parent actually incurs the cost.

The types of health insurance coverage required include vision and dental, regardless of whether the parent has to seek out and pay for a separate coverage for this, as many parents don’t have this coverage already included in their health insurance policies.

A parent will be excused of having to provide coverage if the coverage cannot be obtained at a reasonable cost. Family Code section 3751 states that health insurance coverage is presumed to be “reasonable in cost” if the difference between individual and family coverage does not exceed 5% of the gross income of the parent responsible for providing medical support. Often family coverage is cheaper than individual coverage because it’s bundled together as a deal. When families separate, obtaining coverage on their own for the spouse and child can is often much more expensive than what the family was paying for as a whole, or receiving under one spouse’s employment. Therefore, if the difference between the two types of coverage exceeds 5% of the parent’s income who was ordered to obtain coverage, then it is presumed by the court as too expensive. In this case, the court is still required to order that should affordable insurance coverage become available, the parent is to purchase it immediately.

A party ordered to obtain health insurance may also utilize public assistance options that may be free to the parent based on their income, the child’s age, or the child’s special needs, etc. For example, a parent may obtain Medi-Cal or California’s First Five program to satisfy their requirement to provide coverage for their child.