Medical Support Orders

In addition to child support, court orders must address medical support if a parent's income is more than 150% of the federal poverty level. Medical support may include health insurance and/or payment of medical costs which sometimes includes repaying birth costs. Both parents are responsible to provide medical support for their children.

Health Insurance

Either parent or both parents may be ordered to add the children to the health insurance provided by the parent's employer

• if the parent's cost to add the children to an existing policy or the difference between the self-only and family plan is not more than 5% of the parent's monthly income.
• or another amount set by the court.

Example 1: Adding the child to an existing policy

• A parent's monthly income is $2,500
• 5% of the monthly income is $125
• The parent now pays $900/month for his or her employer's family health insurance (the coverage is for a parent and a new spouse)
• The premium after adding the child is $1,000
• The difference between the current premium and adding the child is $100 and is less than 5% of the parent's income

Example 2: Difference between the self-only and family plan

• A parent's monthly income is $2,500
• 5% of the monthly income is $125
• The parent's employer offers self-only health insurance (single policy) for $600/month
• The health insurance premium for family coverage is $1,000
• The difference between the self-only and family plan is $400 and is more than 5% of the parent's income

If the court order requires a parent to provide health insurance for the child, and the parent is eligible for family coverage, state law requires insurance companies and self-insured employers to insure the child even if:

• The parents were never married.
• The parent applies for the insurance outside of the plan’s open enrollment period.
• The application for insurance is submitted by the other parent or the child support agency.

For questions about insurance regulations, parents should contact the Wisconsin Office of the Commissioner of Insurance at http://oci.wi.gov, or:

Wisconsin Office of the Commissioner
125 South Webster Street
Madison, Wisconsin 53702
(800) 236-8517 711
(TDD) (ask for 608-266-3586)

Medical Costs

Medical costs are uninsured health-related costs including dental and drug costs. The cost of medical support is based on each parent's ability to pay. If a parent's costs are greater than the standard 5%, or if the health care provider is more than 30 miles or 30 minutes away from where the child lives, or if the insurance does not cover some medical costs, the court may order a parent to pay a monthly amount for medical costs not covered by insurance or to pay a part of the insurance or BadgerCare Plus costs that the other parent carries for the children.

To cover these insurance costs, the court may adjust the amount of child support ordered. The support order may be more, or it may be less.

Example 1:

• Under the Percentage Standard, Parent A would pay $500/month in child support
• Parent A is also ordered to pay the children's health insurance
• However, Parent B carries the insurance that costs $100/month
• The court may add the $100 insurance costs to the support paid by Parent A: $500 - $100 = $600

Example 2:

• Under the Percentage Standard, Parent A would pay $500/month in child support
• Parent B is ordered to pay the children's health insurance
• However, Parent A carries the insurance that costs $100/month
• The court may reduce the support amount to cover the $100 insurance costs paid by Parent A: $500 - $100 = $400/month

The court may order a set dollar amount (such as $100/month) or a percent of costs (such as 50% of costs). If the court orders a set dollar amount and the child support is collected through income withholding, the medical support would also be collected through income withholding.

If you receive child support services either through applying for services or being referred to child support through a public assistance program, your child support agency will enforce an order for a specific amount for medical support such as “$100 a month.” Child support agencies are not responsible for enforcing medical orders if they are for unspecified dollar amounts, such as "half" of the medical bills. If the other parent does not pay the medical costs as ordered by the court, you or your attorney may file a motion in Family Court or a claim in Small Claims Court. If the Family then sets a dollar amount owed for unpaid medical costs, your child support agency will help collect the debt.

Birth Costs

If the parents are not married when the mother applies for Medicaid, Healthy Start, or BadgerCare Plus and the mother is referred to child support, the court may order the father to repay birth costs. Birth costs include health care costs related to the pregnancy, as well as the birth of the child. The repayable amount is based on the father's income and his ability to pay.