Health insurance does not necessarily pay every expense associated with a child’s medical care.

Children may have deductibles, copayments, prescriptions, dental expenses, or other qualifying health care costs that remain unpaid after insurance coverage is applied. California treats reasonable uninsured health care expenses for children as an additional child support obligation.

Are Uninsured Health Care Costs Part of Basic Child Support?

They are treated separately from the basic guideline support amount.

California requires reasonable uninsured health care costs for supported children to be ordered as additional child support.

There is generally a rebuttable presumption that amounts actually paid for the child’s uninsured health care needs are reasonable, subject to applicable exceptions.

The support order should address how these expenses are allocated between the parents.

The court must also include a period within which one parent must reimburse the other for the reimbursing parent’s share.

How Does a Parent Request Reimbursement?

Documentation is important.

When one parent has paid the uninsured expense, the reimbursement process requires information concerning the amount paid and the health care services involved.

The parent requesting reimbursement should provide the other parent with the information required by the applicable procedure.

The source materials discuss the use of the Notice of Rights and Responsibilities—Health-Care Costs and Reimbursement Procedures and Information Sheet on Changing a Child Support Order, Form FL-192, which explains important requirements concerning these expenses.

Following the reimbursement procedure can help create a clear record if a disagreement later develops.

How Quickly Must Reimbursement Be Made?

The court’s order may establish a specific reimbursement period.

If the order does not specify one, the source materials provide that reimbursement or payment generally must occur within a reasonable time not exceeding 30 days after the required notification, or according to an applicable payment schedule established by the health care provider, subject to a written agreement or different court order.

A parent who disputes the requested payment should not simply ignore it.

The source materials provide procedures for seeking judicial relief when a parent disputes an uninsured health care expense.

The Existing Health Insurance Order Also Matters

When a parent provides health insurance pursuant to a court order, the ordered coverage generally must be used consistently with its requirements unless the applicable exceptions are established.

If the plan designates a preferred provider, use of that provider can also affect responsibility for additional costs.

Parents should therefore review both the insurance provisions and uninsured-expense provisions of their child support order before obtaining nonemergency care or disputing reimbursement.

Keeping bills, insurance statements, receipts, and proof of payment organized can make it much easier to determine each parent’s responsibility when uninsured medical expenses arise.