Wisconsin Department of Children and Families

Protecting Children, Strengthening Families, Building Communities

 

 

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.

Healthcare options in Wisconsin: Families who do not qualify for BadgerCare Plus or who do not currently have health insurance can apply for insurance through the Health Insurance Marketplace.

 

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 single plan and family plan is not more that 5% of the parent's monthly income; or
  • Another amount is set by the court.
  • A parent's monthly income is $2,500
  • 5% of the monthly income is $125
  • The parent currently pays $900/month for the employer's family health insurance plan
  • The premium after adding the child is $1,000/month
  • The difference between the current premium and after adding the child is $100, which is less than 5% of the parent's income
  • A parent's monthly income is $2,500
  • 5% of the monthly income is $125
  • The parent's employer offers single policy health insurance for $600/month
  • The health insurance premium for family coverage is $1,000/month
  • The difference between the single policy and the family policy is $400, which 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 health 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.

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 50% of income; or
  • If the health care provider is more than 30 minutes away from where the child lives; or
  • If the insurance does not cover some medical costs; then
  • The court may order a parent to pay a monthly amount for medical costs not covered by insurance.

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.

  • Under the Percentage Standard, Parent A would pay $500/month in child support
  • Parent A is also ordered to pay children's health insurance
  • Parent B carries the insurance that costs $100/month
  • The court may add $100 insurance costs to the support paid by Parent A, making the monthly child support $600/month
  • Under the Percentage Standard, Parent A would pay $500/month in child support
  • Parent B is ordered to pay the children's health insurance
  • Parent A carries the insurance that costs $100/month
  • The court may reduce the support amount to cover the $100 insurance cost paid by Parent A, making the monthly child support $400/month
 

The court may order a set dollar amount or a percent of costs.

If the court orders a set dollar amount, the child support agency can enforce the order for medical support the same way they enforce child support.

If the court orders a percent of costs, the child support agency is not responsible for enforcing this medical order. In this case, if the other parent does not pay their share of the medical costs, you or your attorney may file a motion in Family Court to enforce the order.