Cash medical support: What are your options?

In an Iowa custody proceeding, the court not only has to order child support, but it also has to order the non-custodial parent (NCP) or the custodial parent (CP) to cover the child’s health insurance. Each parent must provide information to the court regarding the health insurance each has available and if it is available at a “reasonable cost” the court will order that parent to carry the health coverage. The Iowa Child Support Guidelines contain a “Medical Support Table,” which determines what is reasonable according to the parent’s income and the number of children requiring coverage. If the actual cost of the coverage exceeds what is deemed reasonable, the court will order the NCP to pay cash medical support toward the CP in lieu of ordering coverage. A cash medical support order also arises in the context of children who are covered by Medicaid or Hawk-I, which are not considered health insurance under the Guidelines.

It is a good idea to consult with an attorney if you are being assessed cash medical support. Not only is the cash medical support an obligation in addition to your monthly child support obligation, but cash medical support is typically paid directly to the CP and he or she may spend it as he or she chooses. If the CP chooses to cover the child through Hawk-I, the actual cost to the CP is typically much lower than the cash medical support order, and it would benefit the NCP to request the court to adjust the cash medical support accordingly. If CP is covering the child under Medicaid, however, because the cash medical would be directed to the State of Iowa, a battle with the State of Iowa would be required to reduce the amount. Before agreeing to any cash medical order, it is advisable to explore each avenue of coverage (i.e. Affordable Care Act) to determine if there is a less expensive alternative to the amount ordered through the cash medical support order.    

The material in this blog is not intended, nor should it be construed or relied upon, as legal advice. Please consult with an attorney if specific legal information is needed.

- Regan Conder