Medical Support in California: What You’re Owed Beyond the Monthly Payment

California Child Support Recovery System | Justice Foundation

Child support in California includes more than the monthly guideline payment. California law requires that child support orders address medical support — health insurance coverage and cost-sharing for uninsured medical expenses — and these provisions create independent obligations that are enforceable separately from the basic support amount.

Health Insurance Requirements

California child support orders must include a provision addressing health insurance for the children. When health insurance is available to either parent at reasonable cost through their employer or other group plan, the court can order that parent to maintain the children on that coverage. “Reasonable cost” is generally defined as coverage that does not exceed 5% of the obligor’s gross income. If health insurance is not currently available at reasonable cost, the court may order the paying parent to obtain it when it becomes available.

Enforcement of health insurance obligations follows the same mechanisms as basic support. Income withholding orders can require employers to deduct insurance premiums from the obligor’s wages and maintain the children’s coverage. If an employer is ordered to maintain a child on the paying parent’s plan and fails to do so, the employer can be held liable for resulting medical costs.

Uninsured Medical Expenses

In addition to health insurance, California child support orders typically include provisions for sharing uninsured medical expenses — costs not covered by insurance, including deductibles, co-payments, orthodontia, vision, dental, and mental health care. These expenses are typically shared in proportion to the parents’ relative incomes and are collectible as additional support when the other parent fails to pay their share.

Enforcing Medical Support

Unpaid medical support obligations — health insurance premiums and uninsured expense shares — accrue as additional arrears collectible through the same enforcement mechanisms as regular support arrears. Document all uninsured medical expenses with receipts and explanation of benefits statements, calculate the other parent’s proportional share, and include unpaid medical support in any arrears enforcement action. The Justice Foundation kit includes medical support tracking worksheets and demand letter templates for recovering unpaid medical costs.