Uninsured Health Care Expenses as a Child Support Add-On

California Family Code sections 4061-4063 state the following regarding uninsured health care costs for minor children. This is only a summary; please do not rely on this to represent yourself.

1. Mandatory Additional Support (Section 4062)

The court is required to order "The reasonable uninsured health care costs for the children" as additional child support (Section 4062(a)(2)).

2. Presumption of Reasonableness (Section 4063(d))

There is a rebuttable presumption that the costs paid for the uninsured health care needs of the children are reasonable.

3. Reimbursement Process (Section 4063(b))

• The parent who incurs or pays the uninsured health care costs must provide an itemized statement to the other parent within 90 days.
• If one parent has paid all costs, they must provide proof of payment and request reimbursement from the other parent for their court-ordered share.
• If a parent has only paid their share, they must provide proof of payment and request the other parent to pay the remainder directly to the provider.

4. Payment Timeline (Section 4063(b)(3))

The reimbursing parent must pay within the court-specified time period, or if not specified, within 30 days of notification, unless another payment schedule is agreed upon or set by the court.

5. Dispute Resolution (Section 4063(b)(4))

If a parent disputes a reimbursement request, they must pay the requested amount first and then seek judicial relief.

6. Enforcement (Section 4063(c))

Either parent can file a motion to enforce the uninsured health care costs order. If a party acted without reasonable cause, the court may award filing costs and attorney's fees.

7. Use of Court-Ordered Insurance (Section 4063(e))

The health care insurance coverage ordered by the court should always be used, unless it can be shown to be inadequate for the child's needs.

8. Additional Coverage (Section 4063(e)(2))

If a parent obtains additional health care coverage beyond what's court-ordered, they bear sole financial responsibility for the extra costs.

9. Preferred Providers (Section 4063(f))

If the court-ordered coverage designates a preferred provider, that provider should be used. If a parent uses a different provider, they may be responsible for any excess costs.

10. Factors Considered in Disputes (Section 4063(g))

When ruling on motions related to uninsured health care costs, the court must consider factors such as:

• Geographic access and availability of necessary healthcare
• Necessity of emergency medical treatment
• Special medical needs of the child
• Parents' ability to pay the full reimbursement amount within 30 days

These provisions aim to ensure that children's uninsured healthcare needs are met promptly, costs are shared fairly between parents, and there's a clear process for handling these expenses.

How Does the Court Determine What Percentage of the Cost Each Parent Pays?

The allocation of these costs is primarily addressed in Section 4061. Here's how it's determined:

1. Proportional Division (Section 4061(a))

The expenses are generally divided proportionately to the parents' net incomes, as adjusted according to the guidelines in subdivisions (c) and (d) of Section 4061.

2. Adjustments to Income (Section 4061(c) and (d))

• If there's spousal support, the paying parent's income is decreased by the amount paid, and the receiving parent's income is increased by the amount received.
• The net disposable income of the parent paying child support is reduced by the basic child support ordered under Section 4055.

3. Calculation Process (Section 4061(b))

• First, the basic child support obligation is computed using the formula in Section 4055.
• Then, the parents must pay any additional child support required for expenses (including uninsured health care costs) in proportion to their adjusted net disposable incomes.

4. Court Discretion (Section 4061(a))

The court has the discretion to order a different allocation if a party requests it or if the court finds on its own motion that expenses should be divided differently.

While there isn't a fixed percentage specified in these sections, the proportion each parent pays is typically based on their relative adjusted net incomes after taking some of the factors into and outside of the equation.