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You may be responsible for uninsured or unreimbursed medical, dental, and vision expenses for your child depending on the provisions in your divorce decree and child support order.
If the divorce decree or court order specifically addresses uninsured or unreimbursed medical, dental, and vision expenses, then the situation is dictated by those provisions. If neither document addresses the subject, then generally speaking you will be responsible for covering your share of the cost of such expenses when they are reasonable and necessary.
Braces usually qualify as reasonable and necessary expenses unless they are for purely cosmetic purposes. While the courts assess these on a case-by-case basis, it’s safe to assume that if the braces are to relive pain or prevent future problems that could cause pain, harm, or injury, then they qualify as reasonable and necessary.
If your child simply wants braces to get straighter teeth or correct an overbite to improve their physical appearance, that may not qualify for child support.
Arizona Child Support Law
According to ARS 25-501, parents in Arizona have a legal responsibility to provide “reasonable support” for their children’s care and wellbeing. In fact, section C of the statute dictates that a biological or adoptive parent’s child support obligation takes priority over any other financial obligations for the parent. Given the gravity of the charge and the court’s mandate to serve the best interests of the child, the court takes child support payments quite seriously.
Child support is typically addressed in the divorce decree, and it’s always backed by a court order. When determining the amount a non-custodial parent should pay in child support, the state follows strict child support guidelines that consider the needs of the child, the custodial parent’s income, and the non-custodial parent’s income. Child support is intended to last until the child turns 18 (or 19 if they’re still in high school) but the child support order can be modified or terminated in certain circumstances.
Arizona law naturally provides for child support payments to be made by income withholding, so most child support orders are accompanied by a withholding order. The non-custodial parent can waive this requirement if both parents voluntarily sign a waiver, but the custodial parent and the state child support collection agency both have the right to reissue a withholding order if necessary (without the approval of the non-custodial parent). If the non-custodial parent’s employer receives a notice of withholding from the state, the employer is required to comply with the order.
Extraordinary Medical Expenses
In addition to paying predetermined child support payments, non-custodial parents are required to pay for uninsured and unreimbursed medical, dental, and vision expenses. Sometimes referred to as “extraordinary medical expenses,” these can include the cost of prescriptions, insurance deductibles, co-pays, and any other medical, dental, or vision costs that are incurred by medically reasonable and necessary treatments or procedures. As the name implies, extraordinary medical expenses are out-of-pocket medical costs that exceed the cost of basic health care under the child’s health insurance policy.
State law dictates how medical expenses should be handled by a non-custodial parent, though it can be confusing as the laws vary from state to state. Some states require parents to share the cost of extraordinary medical expenses based on a proportion of their monthly income (known as the income shares model), while other states only require the noncustodial parent to share the cost of extraordinary medical expenses if the bill is more than a specified percentage of the regular child support payments.
There are a few states that impose a minimum dollar amount (e.g. the non-custodial parent is responsible for extraordinary medical expenses over $500 per child per year), and there are a handful of states that further distinguish between recurring and non-recurring health care costs. It’s critical to understand the child care laws in your state to determine the extent to which you are obligated to pay extraordinary medical expenses.
In Arizona, the courts specify the percentage of extraordinary medical expenses that each parent is liable for in the child support order. When a child incurs necessary medical, dental, or vision expenses that aren’t covered by insurance, the custodial parent must submit a request for payment or reimbursement to the non-custodial parent within 180 days of the service.
The non-custodial parent is responsible for payment or reimbursement of their share (based on the original court order), and he or she has 45 days to pay the provider directly, reimburse the custodial spouse, or set up acceptable payment arrangements with either party.
During this process, both parents have the right to request receipts or proof of payment from the other parent as evidence that the payments were actually made. If either parent fails to fulfill their share of the burden, the court can change the existing child support order through an adjustment or modification to account for the new obligation.
Enforcing Extraordinary Medical Expenses
The courts view a parent’s failure to submit payment or reimbursement for extraordinary medical expenses in the same regard as failure to pay regular child support payments. In either case, unpaid child support (known as arrearages) are subject to a variety of enforcement options.
The state has the ability to collect unpaid child support through wage garnishment and interception of tax refunds. For punitive measures, the state can also revoke your driver’s license and file contempt of court charges. In extreme cases, unpaid child support can result in jailtime.
A parent who is seeking payment or reimbursement for extraordinary medical expenses may initiate child support enforcement actions under the following circumstances (all must apply):
- The custodial parent has submitted a demand for payment or reimbursement within 180 days of the medical, dental, or vision services
- The non-custodial parent has been given a reasonable amount of time to respond (45 days)
- After 45 days, the non-custodial parent has failed to reimburse the custodial spouse, submit payment to the healthcare provider, or establish an acceptable payment arrangement with the custodial parent or healthcare provider
If you are a non-custodial parent and you are facing enforcement problems, you should consult with an attorney as soon as possible. An attorney may be able to help you reach an agreement with the state and/or custodial parent, and you may be able to amend or modify the child support order if you have experienced changed circumstances that are substantial and continuing (ARS 25-503).