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Child Support includes health care

Produced by Massachusetts Law Reform Institute
Last Updated November 2017

A child support order must include health care coverage. Parents can:

  • Provide health care coverage through their employer.
  • Buy health care coverage on their own.
  • Get health care coverage for their children through MassHealth.
  • Give the court a written agreement that says their child will get health care coverage some other way. For example, a grandparent might provide health care coverage.

The judge can only order the parent who pays child support to provide health care coverage.

The judge cannot order the parent who gets child support to provide health care coverage.

But if the parents agree in writing that the parent who gets child support will provide health care coverage, then the judge will not order parent who pays child support to provide the coverage.

The judge can only order a parent to provide health care coverage if:

  1. it is available at a reasonable cost and
  2. it would not cause "undue hardship" to the parent.

The judge decides:

  1. if the coverage is available at a reasonable cost and
  2. if providing it would cause a parent "undue hardship".

The guidelines say if you can get health care coverage from your employer, that means it is available at a "reasonable cost."

If you cannot get health care coverage at the time of hearing, the judge will order you to tell the Department of Revenue Child Support Enforcement or the other parent as soon as you can get it.

What is "undue hardship"?

If health care coverage is available at a reasonable cost, the judge must still decide if the cost creates a serious or unfair hardship.

If the judge decides it does create a serious or unfair hardship, they will not order you to provide health care coverage. When the judge is deciding if the cost would create a serious or unfair hardship, some of the things they look at are if:

  • Paying for health care coverage means you could not pay the child support order.
  • The health care coverage is not enough to meet your child's health care needs - and you would have to pay a lot more for medical expenses that the coverage does not cover.
  • Your gross income is less than 300% of the federal poverty guidelines.

If any of these reasons apply to you, be sure to tell the judge.

If a judge decides that providing health care coverage creates a serious or unfair hardship, you can read the judge's reasons on the Findings and Determinations for Child Support and Post-Secondary Education court form. See the HEALTH CARE COVERAGE section of the form.

Maintaining health care coverage

When the judge orders you to provide health care coverage for your child, the order is not only about getting coverage. You must also keep the coverage.

What if I cannot provide health care coverage?

If the judge decides:

  • Health care coverage is not available at a reasonable cost, or
  • providing coverage creates a serious or unfair hardship for you,

they will not order you to provide health care coverage.

But the judge will order you to tell:

  • the Department of Revenue Child Support Enforcement (DOR/CSE) as soon you can get health care coverage, if they are providing child support collection services, or
  • the other parent as soon as health care coverage becomes available if the DOR/CSE is not providing child support collection services.

    Does the parent who gets child support have to pay for any of our child' s health care?

    Every year, the parent who gets child support must pay the first $250 of routine, uninsured, medical and dental expenses for your children. This $250 is for all the children in the order together, not $250 for each child.

    For amounts over $250, the Court can order the parent who pays child support to pay all or part of routine, uninsured, medical and dental expenses.

    Who pays for extraordinary and uninsured health care expenses?

    "Extraordinary" health care expenses are those that not all children have. They include things like braces and counseling.

    The judge decides case-by-case how parents should pay for extraordinary, uninsured, medical, dental, and vision expenses.

    Sometimes parents have already agreed on how to pay for these expenses. The judge decides if the agreement is fair.

    See

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