Who Pays for Children’s Health Insurance After the Divorce?

One thing is sure in California: In a divorce where children are involved, one or both parents will be required to pay for the children’s medical and dental care. Often, one or both parents have health insurance through an employer that allows them to keep the children covered through the age of 25, so that route is chosen. The benefit of that approach is that health insurance through an employer is usually subsidized by the employer, so the out-of-pocket responsibility isn’t as high as it would be if the insurance is fully paid out-of-pocket. But there are exceptions to this.

Every case is unique, and consequently, how the court approaches resolving this situation will depend on various factors for both parents.

What Can the Courts Order in Terms of Children’s Health Insurance?

If the divorcing parents can’t agree on how health insurance will be handled, the courts can determine who is responsible. There are several ways this can go, and here are the circumstances the court will consider.

The financial state of each parent.

If one parent is significantly better off financially than the other, the court may order that parent to pay all the child’s healthcare and dental expenses, including insurance costs.

That said, it’s not given that the higher earner will be put in charge of paying all health insurance costs. This is where other factors come into play.

The employment state of each parent.

Which spouse is employed with access to employer-provided health insurance is a significant factor. If only one spouse has health insurance through work, the court will likely order them to cover the child in that policy. This is especially true if the noncustodial parent is the one with the health insurance.

If both parents have employer-paid health insurance, the courts usually designate one policy as the primary policy and the other as the secondary, which could cover costs not paid by the primary policy.

The courts will also look at what type of coverage each parent has. One may have coverage that’s more extensive than the other, has significantly lower deductibles, or includes vision or dental, while the other doesn’t. In cases like that, the higher-earning parent may be the one with the less valuable insurance. The lower-earning parent with better health insurance could end up responsible for covering the child.

Neither parent has employer-provided health insurance.

In this case, the court is going to require someone to purchase private health insurance to cover the child. This may be one or the other of the parents, or the cost may be divided between them depending on the financial state of each spouse.

The amount of health insurance that either or both parents is required to pay relies on a factor known as “reasonable cost.” In California, the reasonable cost of health insurance is defined as not exceeding five percent of the parent’s gross income. Another factor taken into account is the difference of the cost of health insurance for a single person versus family coverage.

Neither parent can afford health insurance.

The child will then be eligible for health insurance through Medicaid.

What if the Parent Responsible for Paying for Health Insurance Stops Paying?

If the court orders one parent to pay for the health insurance of the child, and they stop paying so the coverage lapses, the court will likely require that parent to pay all the medical expenses out-of-pocket that would have been covered by the insurance. If one parent is noncustodial and already paying child support and is assigned health insurance payments too, the amount of support the court ordered them to pay may be adjusted accordingly.

What Other Health Costs Could the Court Order Me to Pay?

Health insurance is a big cost, of course, but it’s considered mandatory by California courts because it’s vital to the well-being of the child and their ability to grow and thrive. But there are other health care expenses that the courts may assign in their order as well. Those expenses include out-of-pocket items such as copays and deductibles or other care costs. For example, a health insurance policy may not include dental or vision care, so the full cost of those would be out-of-pocket.

Big medical expenses are usually unexpected and can become a contentious issue after the divorce is complete. If a child’s illness or injury runs up medical debt prior to the divorce being finalized, that debt would be considered part of the marital property and divided accordingly. The divorce and child custody orders should specify who is responsible for those debts after the divorce, but if they’re extraordinary, it may take some negotiation to reach a settlement acceptable to both. A family law attorney is recommended to sort through this situation.

What Should I Do if My Spouse and I Can’t Agree on Who Pays the Children’s Health Insurance as We Talk About Divorce?

Call us at 951-460-2003 as soon as possible to request an initial consultation. Because health insurance, along with the other types of health care expenses mentioned above, can be a significant cost, it can easily become a contentious issue when going through the divorce process. We’ll provide you with the legal support you need along with the compassion and understanding that comes with years of experience in family law. We know you want your child cared for in the best possible way, but you also want to be treated fairly by the system. We’re here to help you work toward both goals.