Medical Support and Health Care Coverage

When 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
• Coverage is available through an employer, and the employee can be expected to remain employed for a reasonable amount of time
• No pre-existing 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:

• Preventive
• Emergency
• Acute
• Chronic.

If both parents have coverage available that covers these types of care, the court considers which coverage is more comprehensive, such as includes coverage of any of the following:

• Basic dental
• Orthodontia
• Glasses and contact lenses
• Mental health services
• Substance abuse treatment

Affordable

The court considers health care coverage affordable if it does not cost more than five percent of a parent's gross income.

Special needs

The court considers any special medical needs of the children.

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 through the parent's employer
• Coverage 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 the change is appropriate.

If Medical Assistance is in place but other appropriate coverage is available through one of the parents, the court may order the parent to cover the child under the other insurance.

When health care coverage is available for children 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 provide the coverage.

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

The court may make a different decision if:

• Either parent prefers the health care coverage available through 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
• Both parents agree the noncustodial parent will provide health care coverage, and the parents agree on how to share the cost.

If the court determines that both parents' health care coverage is similar, the court must order the least costly coverage for the children.

If the parents do not have health care coverage available and the children are not enrolled in Medical Assistance, the court may order both parents to share the actual cost of medical expenses. The portion 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. In this case, the order may have an amount the noncustodial parent must pay toward the cost of the public coverage for any month that public coverage is in place.

State laws can be found on the Minnesota Office of the Revisor website.

• Minnesota Statutes, section 518A.41