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Medical Insurance as Child Support and Uninsured Medical Expenses
Health Insurance, uninsured medical expenses for children

Index


 

Statutory Authority.

A common question for divorcing parties is "who pays for the medical care of the child?"  Under current Minnesota law, the court must make an order determining which parent shall provide health insurance for minor children as an additional form of child support. The court must also determines each parent's responsibility for medical expenses not covered by insurance.  This is codified in Minnesota Statutes Section 518A.41.

How Does a Court Decide Who Provides Insurance?

In determining whether a parent has appropriate health care coverage for a child, the court must evaluate the health plan using the following factors:

  1. accessible coverage. Dependent health care coverage is accessible if the covered joint child can obtain services from a health plan provider with reasonable effort by the parent with whom the joint child resides. Health care coverage is presumed accessible if:
     
    • primary care coverage is available within 30 minutes or 30 miles of the joint child's residence and specialty care coverage is available within 60 minutes or 60 miles of the joint child's residence;
    • the coverage is available through an employer and the employee can be expected to remain employed for a reasonable amount of time; and
    • no preexisting conditions exist to delay coverage unduly.

  2. comprehensive coverage. Dependent health care coverage is presumed comprehensive if it includes medical and hospital coverage and provides for preventive, emergency, acute, and chronic care. If both parents have health care coverage that meets the minimum requirements, the court must determine which health care coverage is more comprehensive by considering whether the coverage includes:
        (i) basic dental coverage;
        (ii) orthodontia;
        (iii) eyeglasses;
        (iv) contact lenses;
        (v) mental health services; or
        (vi) substance abuse treatment;

     

  3. affordable coverage. Dependent health care coverage is affordable if it is reasonable in cost; and

     

  4. special needs of child. Te court must consider any special needs of a joint child.

If both parents have health care coverage available for a joint child, and the available coverage is comparable based on the factors above, it shall be presumed that the court require the parent with the least costly plan to provide coverage.

If a joint child is presently enrolled in health care coverage, the court must order that the parent who currently has the joint child enrolled to continue that enrollment unless the parents agree otherwise or the court orders a modification based on the request of a party.

What Happens if Neither Parent has Insurance or Medical Assistance is provided?

If neither parent has appropriate health care coverage available through their employment or other means, the court must order
the parents to:
 

  1. contribute toward the actual health care costs of the joint children based on a pro rata share; or
  2. if the joint child is receiving any form of medical assistance under chapter 256B or MinnesotaCare under chapter 256L, the parent with whom the joint child does not reside shall contribute a monthly amount toward the actual cost of medical assistance under chapter 256B or
    MinnesotaCare under chapter 256L. The amount of contribution of the noncustodial parent is the amount the noncustodial parent would pay for the child's premiums if the noncustodial parent's PICS income meets the eligibility requirements for public coverage. The custodial parent's obligation is determined under the requirements for public coverage as set forth in chapter 256B or 256L. The court may order the parent with whom the child resides to apply for public coverage for the child.

How are Expenses Divided if a Parent has Insurance for Other Non-Joint  Children?

  • Existing Insurance for Other Non-Joint Dependants. If the party ordered to carry health care coverage for the joint child already carries dependent health care coverage for other dependents and would incur no additional premium costs to add the joint child to the existing coverage, the court must not order the other party to contribute to the premium costs for coverage of the joint child.
  • No Existing Insurance for Non-Joint Dependents. If a party ordered to carry health care coverage for the joint child does not already carry dependent health care coverage but has other dependents who may be added to the ordered coverage, the full premium costs of the dependent health care coverage must be allocated between the parties in proportion to their income unless the parties agree otherwise.

Only Insurance Costs for the Child's Premium Divided.  If a party ordered to carry health care coverage for the joint child is required to enroll in a health plan so that the joint child can be enrolled  under the plan, only the expenses related to the child's premium are divided. In other words, the parents divide any expense that is greater than the cost of individual coverage.

What if an Employer Ignores a Medical Support Order?

Any employer or union that willfully fails to comply with the order or notice for medical support tat is properly served under Minnesota laws is liable for any uninsured medical expenses incurred by the dependents while the dependents were eligible to be enrolled in the health plan and for any other premium costs incurred because the employer or union willfully failed to comply with the order or notice.  The employer or union may also be subject to a contempt finding, a $250 civil penalty and an additional  civil penalty of $500 to be paid to the party entitled to reimbursement or the public authority.

How Long Must a Parent Provide Insurance?

Unless a court order provides otherwise, a child for whom a party is required to provide health care coverage must be covered as a dependent of the party until the child is emancipated, until further order of the court, or as consistent with the terms of the coverage.

The health carrier, employer, or union may not disenroll or eliminate coverage for the child unless:

  1. the health carrier, employer, or union is provided satisfactory written evidence that the court order is no longer in effect;
  2. the joint child is or will be enrolled in comparable health care coverage through another health plan that will take effect no later than the effective date of the disenrollment;
  3. the employee is no longer eligible for dependent coverage; or
  4. the required premium has not been paid by or on behalf of the joint child.
     

The health plan must provide 30 days' written notice to the joint child's parents, and the public authority if the public authority provides support enforcement services, before the health
plan disenrolls or eliminates the joint child's coverage.

How Are Costs not Covered by Insurance Divided?

It is presumed under Minnesota law  that parents are required to divide costs related to uninsured medial expenses or unreimbursed medical expenses proportionate to their income 

"Uninsured medical expenses" means a joint child's reasonable and necessary health-related expenses if the joint child is not covered by a health plan or public coverage when the expenses are incurred.

Unreimbursed medical expenses" means a joint child's reasonable and necessary health-related expenses if a joint child is covered by a health plan or public coverage and the plan or coverage does not pay for the total cost of the expenses when the expenses are incurred.

The definition of unreimbursed medical expenses is very broad and includes, but is not limited to, deductibles, co-payments, and expenses for orthodontia, and prescription eyeglasses and contact lenses, but not over-the-counter medications if coverage is under a health plan.

Is a Parent's  Contribution to Health Insurance Premiums paid with Child Support?

Offset Against Child Support. If a party owes a child support obligation and is ordered to carry health care coverage, and the other party is ordered to contribute to the carrying party's cost for coverage, the carrying party's child support payment must be reduced by the amount of the contributing party's contribution.

Added to Child Support.  If a party owes a joint child support  and is ordered to contribute to the other party's cost for carrying health care coverage for the joint child, the contributing party's child support payment must be increased by the amount of the contribution.

Unreimbursed or uninsured medical expenses enforced under this subdivision are collected
as arrears.

Call (612) 240-8005 for a consultation.

 

Call (612) 240-8005

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Unreimbursed and/or Uninsured Medical Dental Expenses Packet (DHS-4931-ENG) This packet is for the collection of unreimbused and/or uninsured medical or dental expenses from the requesting party to the non-requesting (liable) party. The packet contains the information, notice, and instructions for the requesting party, and the notice of intent to collect the unreimbursed and/or uninsured medical expenses and the affidavit that will be completed by the requesting party and sent to the non-requesting (liable) party.






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