Court Ordered Medical Insurance

Health insurance coverage for a dependent child is considered a form of child support. This is why court ordered medical insurance is included in child support orders. 

By WomansDivorce | Answers by Brette Sember, J.D. 

Federal and state laws require parents to provide medical support for their children including health insurance (if available at a reasonable cost), plus pay any uninsured health care costs. Therefore, a child support order may require one or both parents to carry health insurance for their children and to pay their proportionate share of the insurance premiums. 

Who is required to provide health insurance for the children?

It is always preferable for parents to reach a mutual agreement on which one will carry health insurance for their children. If they can’t agree, it will be up to a judge to decide who will be responsible for health coverage. If only one parent has health insurance available through work, the court will generally order that parent to provide health insurance for the children. If both parents have insurance, the parent with the better plan may be required to provide the insurance on their children. 

It’s important to note that the children can be covered on both parents’ insurance plans. In this situation, one plan will be considered the “primary” plan. The “secondary” plan would then cover costs not covered by the primary plan. In deciding which plan should be the primary plan, parents should take into consideration the cost of premiums, deductibles, co-pays, and other unreimbursed medical expenses for both plans.  

Parents generally must maintain health insurance coverage until a child is emancipated or for as long as the court order states. If the obligated parent loses insurance coverage due to a change in employment, notification must be sent to the other parent. To remain in compliance with the child support order, the obligated parent should also seek health insurance coverage either through work or alternate methods. 

If health insurance is not available through a parent’s employer, coverage may be obtained through the health insurance marketplace, Medicaid, or through the state Children’s Health Insurance Program (CHIP). 

Who pays for health insurance for the children?

Some parents are able to mutually agree on who will provide and pay for their children’s health insurance coverage. If a judge decides the matter, these are the possible outcomes:

  • one parent pays for all of the health insurance premiums,  
  • both parents split the cost of insurance equally, or  
  • the cost of insurance is shared in proportion to each parent’s income (for example one parent pays 60% of the premiums while the other parent pays 40%). 

Generally, the parent who is providing health insurance coverage pays the premium and is then reimbursed the designated percentage by the other parent. In some states, the premiums for health insurance may be factored in the child support calculation.  

If the obligated parent fails to reimburse his or her share of the premium to the other parent, the court will not proactively go after them. If you are facing this situation, you’ll need to file a motion with the court to enforce the court ordered medical insurance provision.  

Questions about court ordered medical insurance

Can I make him carry health insurance on our daughter?

Fallon's Question: Can I legally make him put our daughter on his insurance once she is born?

Brette's Answer: Yes, you can request that he carry the insurance, and you can also file for child support as well. Good luck with this.

Can we both carry health insurance on our daughter?

Jean's Question: Can my ex and I both carry health insurance policies on our daughter? In other words can my ex-spouse use his plan like a primary insurance and I use my insurance as a secondary insurance? In the divorce I consented to paying for health insurance for our child. However, we have found she has leukemia and the bills are high.

Brette's Answer: If your daughter is carried on both policies, you should be able to do so. This really has nothing to do with your divorce.

Can I take my kids off his policy and seek Medicaid coverage?

Vicky's Question: My ex was ordered by the court to include the kids on his medical coverage thru his employer. Can I take the kids off his medical coverage to seek Medicaid coverage from the government?

Brette's Answer: You can try, but it's likely that if they have other insurance available to them that they won't qualify. I would suggest you call and ask in advance before doing anything.

How do I switch the health insurance responsibility to my ex?

Vicki's Question: According to our divorce decree, I have a physical custody of our kids and I'm supposed to provide their health insurance. Can I force my ex-husband to assume health insurance responsibilities?

Brette's Answer: You can ask the court to modify the order if you have a reason for the change.

He wants to put the kids on his insurance plan even though mine is better.

Melinda's Question: My ex filed a request for modification to put our kids on his medical insurance instead of mine, even though they have been on mine for over ten years. Mine is a better plan with a lower deductible, and he pays 1/4 of my premiums. One of our children has special needs and a lot of regular medical appointments. Would a judge grant the modification?

Brette's Answer: I think the court is likely to keep the children on the plan that is the better plan with the most coverage, particularly if there are special needs.

Can I switch the health coverage obligation from my ex to my new spouse?

Pamela's Question: I am divorced and we have a daughter together. Our decree states he is to be responsible for medical insurance for her. I am now remarried and we have decided to modify the decree to read that my new husband is able to cover her medical insurance. How should the modification read and what is the legal procedure that the court recognizes?

Brette's Answer: If that is what you want to do, you need to file a motion to modify the order and simply ask that the provision about health insurance be removed. I would suggest you not completely remove it though. If your husband should lose his job or no longer have coverage, you want a backup plan, so the best choice might be to say that your ex will not be responsible for health insurance as long as your husband has a free plan through his employer.

Can his new wife be required to put our kids on her health insurance?

Jill's Question: Our divorce currently says that my ex will provide insurance for our daughter though his work. His new wife has insurance through her work, and they are refusing to put our daughter on her policy. How do I modify the divorce to include this?

Brette's Reply: You can ask for a modification to the insurance clause, however you have to understand the court has no jurisdiction over his new wife - she is not a party to your divorce, so the court can't order her to add your child to her insurance.

Is it legal for his new wife to put our kids on her insurance?

Janice's Question: When we negotiated our divorce 3 years ago, he agreed to continue to cover our 2 children under his health insurance plan through work. He remarried 2 years ago and he recently changed his health insurance election so that he and MY 2 children are now covered under HER health insurance. He said that he did this in order to avoid an interruption in health coverage when he leaves his job. How can MY children be listed as HER dependents for health insurance purposes? I am not happy about this for a number of reasons, but the most important reason is that I don't think it is legal.

Brette's Reply: It depends on the policies and rules the employer and insurer have. I would think you would be glad your children have coverage. Good luck.

What if I can’t afford the court ordered medical insurance for our kids?

Nicole's Question: I am divorced and in my decree I am to carry health insurance for my children. I refused cobra because it was too high and I have 3 children. With what I am collecting plus support I am bringing in 810.00 a week. My children's medication without insurance is 600.00 a month. I make too much for assistance and he's telling me he only has to pay for un-reimbursed medical and is saying I am in contempt for not having insurance. Is this true?

Brette's Answer: If you were ordered to provide the insurance and do not, then yes, you are in contempt. Have you checked into a state health insurance for children? Many states offer programs that are billed on a sliding scale. You could also seek to modify your order based on your financial circumstances and the medical costs involved.

Is he required to carry the same medical benefits as when we divorced?

Lisa's Question: My ex recently started a different job than he had at the time of our divorce settlement. In our original decree, he was required to provide the court ordered medical insurance and his policy had a low deductible and prescription drug plan. His new insurance has a very high deductible and no prescription drug plan. Does he have to find insurance that matches what he had at the time of our divorce? If he refuses, can I take him to court?

Brette's Answer: It's unlikely the court would order that since he isn't given much choice about insurance plans through his employer, most likely. You could seek to have child support modified to include the higher medical costs.

How do I find out what type of coverage his health insurance offers?

Lisa Asks: Do I have a right to ask his employer to verify the details of an employer based plan he is alleging he has before I remove the children from their current health insurance? Or must I blindly release the children to his health insurance without the ability to speak with his employer to verify details of the plan?

Brette's Answer: You would want to contact the insurance company, not the employer. And it would not make sense to cancel existing coverage until you have verification of coverage through him. And no, you don't have to move the children to that coverage if you don't want to.

Is a health share co-op considered providing our kids health insurance?

Julie's Questions: My ex-husband agreed to provide health insurance in the divorce degree, but will only offer a health share co-op (Medishare), which is not health insurance. We have five children and our children's doctor told me to get government health insurance since my ex wouldn't provide real health insurance. Is a health share co-cop considered "providing health insurance" since it's not insurance? 

Brette's Answer: You need to talk with your attorney who can analyze the details of the plans and how they are defined in light of your state's laws. It does sound as though what he has provided may not meet the definition of health insurance. 

Do I have to pay half the premiums if I'm the primary parent?

Gail Asks: My soon-to-be ex has our daughter on his health insurance since I have a temp job. He wants me to pay for half of the health insurance for my daughter, which he gets coverage through his work. I have more placement now than he does, so why should I have to pay him half? He's been able to afford it for 4 years; he can surely still afford it now. Is it the law that I have to pay for half of what his work's medical insurance is?

Brette's Answer: No, you would only be required to pay if the court ordered you to as part of the child support arrangement. Since you are the primary parent, it is unlikely you would be required to pay.

Is he responsible for half the total insurance premium or just what I pay?

Patricia's Question: My ex-husband is court ordered to pay half of the insurance premiums.  My work pay $1567.00 a month for my insurance and I pay $115 a pay check.  Should my ex pay half of $115.00 or $1567.00? 

Brette's Answer: Usually it is half of what you pay our of your pocket.

How are premiums to be paid if each parent is responsible for half?

Jenny's Question: My husband is supposed to pay half of the health insurance premiums to his ex. Does he have to pay her (and how is this recorded) or does it go through the court system? Can he pay insurance directly?

Brette's Answer: He should check with his attorney. Sometimes payment is direct. In which case he would just get a receipt. Or he might be reimbursing her. Again, keep a record or get a receipt for the payment (a cancelled check works) 

Can he reduce his portion of the premium payment if I have another child?

Michelle's Question: My ex-husband is ordered to pay half of my son's health insurance premium, which I carry through my employment. Now that I have another child, he wants to pay half of what he was paying. My insurance cost is the same whether I have 1 or 15 children. Can he do this?

Brette's Answer: No. The only way to change a court order is to go back to court and get it modified. 

What if he isn't paying half the medical insurance costs like ordered?

Hannelore's Question: My ex-husband has never abided by all the terms of the divorce decree; he is supposed to have been paying 1/2 of the kid's insurance costs and owes me $3000. This has been going on for over three years now. What can I do to have this changed?

Brette's Answer: Go back to court and file for enforcement/violation. Good luck.

What if the portion allocated to providing health insurance isn't used?

Amy's Question: My husband's ex-wife is not using the specific part of the child support allocated to providing health insurance for their child. We know this because the child is on my employer's health care...what do we do?

Brette's Answer: Is she required to provide health insurance under your order? If so, your husband should seek to have the order modified to reflect the current situation.

What can I do if he dropped our child from his health insurance?

Lisa's Question: My ex-husband recently remarried and he said he can no longer afford all of my daughter's medical insurance since he added his new wife. I read over our divorce papers and it does read that he pays for her health insurance. What can I do if he drops our daughter from the policy?

Brette's Answer: File for enforcement or a violation. If he's responsible for paying it, the court will make him pay for it.

How long is he supposed to carry health insurance on our child?

Bobbi's Question: In our divorce decree it stated my ex was responsible for paying 60% of medical costs as well as carrying both children on his health insurance. The youngest is 23 and in her first year of law school and is still considered a covered dependent. My ex lost his job, as well as the insurance he carried on my daughter. He said per the divorce decree his obligation to his children ended when they turned 18. The decree does not say how long he is to carry the insurance. When does the health coverage obligation end?

Brette's Answer: In most states it continues to age 18 or 21, depending on state law or how the decree is worded.

Does he have to provide health insurance if the baby isn’t his?

Kim's Question: My brother and his soon-to-be ex live in different states and she had a baby from a different man. She wants my brother to cover the baby under his health insurance. Can she do that?

Brette's Answer: If they are still married, he may be considered the legal parent of this child unless the birth certificate says otherwise or there has been a finding or admission of paternity by someone else. A person can include their legal children as dependents on their health insurance. However if he knows this child is not his, this could be fraud. If she went to court to seek to have him cover health insurance, paternity would be discussed and he would be likely proven not to be the father and would not be required to insure the child. ​So it seems she has no way to actually force him to provide coverage.

Would the courts make him continue insurance if my daughter isn't his?

Pamela's Question: My husband walked out of the marriage one month ago with no notice. When we married, my husband put my daughter on his employer's insurance because she has Cystic Fibrosis. He is now threatening that he will take my daughter off his insurance. Would the courts continue to make him cover her? Can I also request that he now cover me under his insurance?

Brette's Answer: I'm assuming your daughter is not your husband's biological child and that he did not adopt her. If that is the case, he has no obligation to support her. You could purchase COBRA insurance based on his policy or you need to find other insurance, either privately or through the health insurance exchange. You can ask that he be required to pay for your health insurance as part of your divorce settlement or judgment - there's no way to predict how a court would rule without knowing all of the circumstances involved.

Is he required to provide health insurance for our grand baby?

Kathy's Question: Is my ex-husband required to provide health insurance for our 16 year old daughter's baby?

Brette's Answer: No

Do I have to keep my step-daughter on my plan until the divorce is final?

Danielle's Question: My husband previous divorce required court ordered medical insurance on his daughter (which is my step-daughter). He was self-employed, so I added her to my plan. We're separated and going to start the divorce process. Am I obligated to keep his daughter on my plan until the divorce is final...or can I remove her from my insurance (or is she also my responsibility?

Brette's Answer: You have no legal obligation to a child that is not your own.

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