In the event of divorce, the state of Texas requires parents to provide medical support for their children. This includes both health insurance and dental insurance. Which parent is responsible for health insurance is generally based on the parents’ income and who serves as the primary conservator of the child but it depends on the circumstances.
Parents frequently ask us questions about child health insurance after divorce and how it pertains to child support, including:
- Who pays for health insurance while a divorce or child custody case is pending?
- Who pays for child health insurance after divorce?
- Is the non custodial parent responsible for health insurance?
- Does child support include health insurance?
- Why do I have to pay health insurance when we have 50/50 custody?
We will answer these questions and provide additional information about child health insurance in Texas below.
FAQs about child health insurance in Texas
Who pays for child health insurance while a custody case is pending?
Whether you’re going through a divorce involving custody issues, seeking modification of an existing child support agreement or have filed a SAPCR (suit affecting the parent child relationship) not related to a divorce, the court will order parents to provide medical support for the child or children in question.
When rendering temporary orders for child custody and child support, the court generally will order that any existing child health insurance remain in place until final orders are established. For example, if your spouse currently insures your child through an employer-sponsored health plan, the court would likely order he or she to continue doing so until final orders are established.
NOTE: If neither parent has access to employer-sponsored or private health insurance, the court will order the obligor (the parent responsible for paying child support) to apply for participation in a government medical assistance program or health plan, like Medicaid or Children’s Health Insurance Program (CHIP). (See Texas Family Code Sec. 154.182)
Who pays for child health insurance after divorce?
In general, when parents are operating under a standard or expanded standard custody agreement in Texas, the parent who is the non-custodial parent (the parent who does not have primary custody), will be ordered to pay child support and medical support for their child. The court can also order a non-custodial parent to reimburse the primary conservator for health insurance expenses if the child is covered by the primary parent’s employer-sponsored or private health plan.
Keep in mind, the court will consider the income of both parents when determining child support and medical support, but in general, the parent who pays child support (referred to as the obligor) will also be required to pay for medical support (health and dental). In most cases, parents will be ordered to split the cost of uninsured or out-of-pocket medical expenses.
Even when one parent covers the insurance or pays cash medical to reimburse, the courts almost always split all unreimbursed expenses 50/50 between the parties. What generally occurs is the party incurring the expense will furnish the receipt, invoice or other payment information, and the other conservator (depending on the specific orders) will reimburse or pay their half directly to the provider. There are also specified time frames established to make the orders enforceable.[1]
How much am I expected to pay for child health insurance?
As explained in Texas Family Code Chapter 154 on child support, the obligor is only expected to pay a “reasonable cost” for child health insurance. The amount is based on the obligor’s net resources, and the state defines “reasonable cost” for health insurance as an amount not exceeding 9% of the obligor’s net resources and not exceeding an additional 1.5% for dental insurance. (Your child support lawyer can help you calculate net resources.)
Does child support include health insurance?
No. The obligor must pay child medical support (health and dental) in addition to child support. However, when determining a parent’s net resources, the amount the parent pays for child support is taken off the top, thereby reducing the net resources available to go toward medical support.
Why do I have to pay health insurance when I have 50/50 custody?
We frequently get questions about 50/50 and joint legal custody and health insurance. When you have a 50/50 custody arrangement, you flesh out most everything by agreement with the other party. How you and the other parent will cover insurance costs is one of those agreements that should be covered in your child custody and child support orders.
The courts normally try to simplify both the coverage of insurance and the payments, which usually means one parent carries the insurance and the other parent reimburses them in one way or another. Your child custody lawyer can explain how this applies in your specific case but it is unlikely the courts would order parents to seek out a “joint custody health insurance policy.” One parent typically pays, while the other parent reimburses them in some fashion.
Other important things to consider regarding child health insurance after divorce
When determining who pays child health insurance after divorce and what that insurance coverage should look like, Texas family courts primarily focus on what is in the best interest of the child. The courts also want to simplify the health insurance process to help ensure the health and dental needs of Texas children are met.
One thing we strongly encourage parents to do during child support and custody negotiations is to take time to research what health insurance options are available. Even if—or especially if—the other parent is responsible for paying insurance, it’s important to be proactive about weighing child health insurance options when co-parenting.
If you leave it up to the other parent to choose insurance, they could pick a health plan with the lowest premiums possible. That means you could end up with sky-high deductibles and get stuck paying higher co-pays and other exorbitant out-of-pocket expenses.
While the other parent should reimburse you for half of those costs, it isn’t unusual for such reimbursement claims to go unpaid, and unfortunately, it isn’t always easy to collect. Even worse, it may cost you more in legal fees to go back to court to get a judgment against the other parent for not paying, and even if you do, they may refuse to pay anyway.
While a parent could face serious penalties (fines, imprisonment, loss of driver’s license, etc.) for not reimbursing the other parent, those threats may not act as a deterrent. The fact that Texas jails are overflowing doesn’t help matters. Courts also hesitate to put parents in jail because it could prevent them from earning an income.
To avoid this nightmare scenario, you may want to arrange for your child’s health insurance yourself and ask that the other party be ordered to reimburse you for premiums. While you could get stuck paying premiums, co-pays and other out-of-pocket costs, that could amount to less than what you might pay if the other parent chooses the health plan.
Contact a Texas child support lawyer to learn more about child health insurance after divorce
If you live in north Texas and have questions about child custody, child support or medical support, contact us. We can also answer questions pertaining to stepchildren, such as, “Can I keep my stepchild on insurance after divorce?” To schedule a confidential case review and speak with a Fort Worth / Dallas family law attorney at our firm, please call our office at (817) 336-4444 or schedule an appointment online.
