Texas courts are required to make sure that children in divorce and child custody cases are covered by health and dental insurance. Usually, the parent who is ordered to pay child support is also required to pay for the cost of health and dental insurance for the child. That parent may provide insurance through work, purchase it through the Affordable Care Act, or ensure the child is covered by Medicaid.
How Insurance Cost Is Calculated
Calculating the cost of health insurance for child support purposes is not always straightforward. Typically, the cost of insurance for the employee only is deducted from the cost of insurance for employee plus children. If the health insurance covers a child in the case and also other people — such as a new spouse and stepchildren — the cost is prorated.
For example: if Dad must provide insurance for two children and has a family plan covering him, his new wife, his two children from a prior marriage, a new child, and a stepchild:
- Monthly cost (Employee + Family): $730
- Monthly cost (Employee only): $230
- Difference: $500
- Total people covered (not including employee): 5
- Cost per person: $100
- Cost for the two children at issue: $200/month
Uninsured Medical Expenses
Uninsured health expenses for the child — co-pays, deductibles, orthodontics, and other costs not covered by insurance — are usually paid 50% by each party unless the court orders otherwise.
Loss of Coverage at Divorce
Many spouses are covered by health insurance through a husband's or wife's employer. After a divorce, the children can still be covered but the ex-spouse is no longer eligible for that coverage. The divorced spouse needs to find independent insurance. Loss of insurance because of divorce is a qualifying event that allows enrollment in ACA marketplace plans or employer plans outside the normal open enrollment period.
Federal COBRA or state continuation coverage is available but is usually very expensive. For many people, coverage through the ACA marketplace is the most affordable option after divorce.
Important: The court order should specify who is responsible for providing insurance, how costs are divided, and how reimbursement for out-of-pocket medical expenses is handled. Having clear language in the order prevents future disputes.