Rule 507.Medical support

Insurance. One or both parents are ordered to acquire private health insurance where it is available through employment, reasonable in cost, and accessible to the child. Insurance available other than through employment is judged case by case.

Reasonable in cost means two things together: the premium covering the parent and their dependent children does not exceed 10% of that parent's gross income, and after the premium goes into the Formula the parents' combined net income still covers all primary expenses other than private school tuition. The second condition is the one that matters — insurance is not affordable if buying it means the children's basic needs go unmet.

A continuing duty. Where affordable coverage is unavailable at the time of the order, or coverage lapses, each parent is ordered to obtain coverage that becomes available within the same 10% limit. The obligation waits for the opportunity rather than expiring with the order.

Accessible means the policy covers medical services within a reasonable distance of the child's primary residence. A cheap plan whose doctors are an hour away is not coverage.

Staying put. Once ordered to acquire or maintain a specific policy, a parent continues it despite changes in cost or accessibility until the court orders otherwise, the other party consents in writing, or the State consents where the child is a Medicaid recipient. Dental, vision and other specialised coverage is decided case by case, and a medical support attachment does not include specialised coverage unless expressly ordered.

Cash medical support. Every new or modified current support order entered on or after January 1, 2015 imposes cash medical support on each parent — their share of healthcare expenses that insurance does not reimburse, including medical, dental, orthodontic, vision and psychological counselling costs.

The share. Multiply the unreimbursed expense by the parent's primary share percentage, rounded to a multiple of 10%: above 50% round down to the next interval, below 50% round up. It is never more than 90% nor less than 10% — except where the recipient is a nonparent and the child has only one known living parent, when it is 100%. For obligations imposed on an incarcerated parent it is 50%.

Rounding to tens is a small mercy. Parents split a dentist's bill many times over the years, and a percentage they can do in their heads is a percentage they will not come back to court over.

Claiming it back. An action for contribution or reimbursement may be brought any time after the expense is incurred — but the right is presumed waived unless a petition is filed by December 31 of the second year following the date the expense was incurred, and that presumption may be rebutted for good cause. An expense is incurred on the date the service was provided, except that where a parent contracts to pay for orthodontics or other long-term treatment over time, each periodic payment is incurred when it falls due.