HEALTH CARE OBLIGATIONS FOR CHILDREN/MEDICAL SUPPORT

The General Obligation of Both Parents.   Under Texas law, both parents are responsible to medical providers for 100% of the cost to treat the medical needs of their child.  A doctor or hospital can attempt to recover the full costs for the medical assistance provided to your child from either parent who might have the ability to pay.  A bankruptcy court order may relieve you of this debt but a family court cannot relieve you of this debt.  A family court order may shift the debt obligation between parents, but that does not affect the right of the doctor or hospital to pursue payment from you.   If the state of Texas pays for medical services to your child through the Medicaid program, the state may have the right to seek reimbursement from you. 

Family Court Orders.   If both parents do not live in the same home with the children, a Texas court will most likely be asked to enter an order setting out the rights and responsibilities of each parent.  Any time a Texas court enters temporary^[1][1] or final orders between two parents identifying and defining the roles and responsibilities for care of the children, the court is required to enter an order regarding health insurance coverage for the children.  If you are required to pay child support for your child, you will probably also be required to provide health care insurance for the child.  If you are providing health insurance coverage for the children at the time of the court order, then you will probably be required to continue providing that coverage.  If you are entitled to receive child support for the children, the other parent will be expected to pay you for the insurance premium needed to cover the children on your health insurance plan.   The judge will expect the parents to work together to provide the best and least expensive health care insurance available.   If both parents are employed with health insurance benefits provided by the employer, the parent paying child support will generally have the option of providing health care insurance for the children as dependents through his or her employment-sponsored plan. 

The judge will first look for health care insurance through the employer of the parent required to pay child support.   If that parent does not have a health care plan available, the judge will look to the employer of the parent who will be receiving child support for a health care plan.  If neither parent has health care insurance available through their employment, the judge will look for some other available insurance, such as the employer of a stepparent who can list the children as dependents.   If no private health care insurance is available, the judge will order the parents to apply for health care benefits available for children through the State of Texas.  If the children are not eligible for state sponsored health care insurance, the court can order money deducted from your paycheck each month to cover anticipated medical costs. 

Medical Expenses Not Paid by Insurance.

Health insurance does not always pay for 100% of the medical costs.  There are office co-pays and hospital deductibles as well as co-pays for prescription medications.  If both parents have equal income and expenses, the usual practice is to divide these expenses equally with each parent paying 50%.  However, the judge does not have to order an equal division of these expenses.  If one parent has more income than the other, the judge can order splitting those costs in proportion to each parent’s income or some other division the judge thinks is reasonable.  If one parent has a medical savings account, that may be a good reason to have that parent pay 100% of these medical expenses. 

Duty to Disclose Information.  If you are required to provide health care coverage for your child, you will be required to disclose the following information:

1. Your Social Security Number.
2. The name and address of your employer.
3. Whether your employer provides health care benefits to employees.
4. If so, the name of the insurance company, a copy of the policy coverage, membership cards, claim forms, and any other information needed to file a claim.
5. Proof that health care insurance has been provided for your child.

State of Texas Sponsored Health Care.

If neither parent has dependent health care insurance available through their employer, they may want to consider eligibility for one of three plans available through the state.

            Medicaid.  This is a jointly funded state-federal program administered by the Texas Health and Human Services Commission (HHSC) to provide medical coverage for specifically defined individuals.  Children receiving Temporary Assistance to Needy Families (TANF) are eligible for Medicaid coverage.  Children receiving Supplemental Security Income (SSI) from the Social Security Administration are eligible.  Young children from low-income homes may also qualify for this Medicaid coverage.   For more information, call 2-1-1 or visit www.yourtexasbenefits.com. You may also call 2-1-1 for health and human services information for your community.

            Children’s Health Insurance Program. (CHIP)   This is a federally funded program with matching state money to provide health care insurance for children in families who cannot qualify for Medicaid or are not enrolled in private health insurance.  The family income must be under 200% of the federal poverty level.  The child must be:  a Texas resident, U.S. citizen, or a legal, permanent resident.  The parents’ citizenship does not matter and is not reported on the application form.  For more information, call 2-1-1 or visit www.yourtexasbenefits.com. You may also call 2-1-1 for health and human services information for your community.

            State Kids Insurance Program.  This is a health insurance program under the Employees Retirement System (ERS) for eligible state employees.  Families with children 0 to 19 years of age may qualify for health insurance benefits for the children.  There is a sliding fee scale depending on the number of people in the family and the amount of family income.  Your children must be U.S. citizens or permanent legal residents. You can obtain more information about eligibility or the enrollment process at www.ers.state.tx.us/insurance/SKIP.htm or by contacting TexCare at (800) 647-6558.  

To learn more about healthcare options or for updated contact information for any of the state, local, or community information provided on this website, contact 2-1-1 Texas.

2-1-1 Texas is a free, confidential information and referral line answered by
nationally certified specialists 24 hours a day, seven days a week. When callers
dial 2-1-1, they are connected to area information centers in their region. These
trained experts have access to the most comprehensive database of community-
based organizations, government agencies, and nonprofits that exist in Texas.
Information can be provided in almost any language, including Spanish. 

Failure to Provide Court-Ordered Health Care.

A parent who has been ordered to provide health care insurance and fails to do so may be ordered to pay all reasonable medical expenses of the child whether or not they would have been covered by a health care policy.  If you are found in contempt of court for failing or refusing to provide health care coverage, the judge can sentence you to 6 months in jail and/or a $500 fine for each offense.