Texas courts first look to the parent who is paying child support to provide health insurance for the children. If you are currently providing health insurance for your child through an employer-sponsored plan, the court will likely order you to continue doing so, so long as the cost is reasonable, which the statutes set at 9 percent or less of your yearly income. Under Texas law, a parent's contributions to employer-sponsored health plans are made with pre-tax dollars. Child support is then calculated using his net pay after the deduction for health coverage and taxes. If the parent paying child support does not have access to reasonable employer-sponsored health insurance, the court will look to the other parent's employer-sponsored plan. If a reasonable plan is available, the court will order the parents to acquire this coverage and add this expense to the amount of the child support order.
If neither parent has access to employer-sponsored coverage nor can cover the children at reasonable cost, Texas law allows judges to order parents to purchase private coverage. A judge won't do so, however, if the cost is more than reasonable and the parents clearly can't afford it. A judge can also obligate a stepparent to cover the children on an employer's plan if either spouse remarries after the divorce.
CHIP and Medicaid
If affording private health insurance is out of the question, the court can order either you or your spouse to apply for government-sponsored health insurance coverage for your children, such as Medicaid or the Children's Health Insurance Program. This generally only occurs if your incomes are low enough to qualify for these programs. If you're ordered to cover your children on your employer's plan, you can't opt out and cover them on Medicaid or CHIP instead, even if you meet the income requirements for coverage. The costs for these plans will be considered in the child support order.
Cash Medical Support
Even if you have health insurance coverage for your children, co-pays and unreimbursed medical expenses are usually unavoidable. Texas courts include these costs in medical support orders as well. Depending on your respective incomes, you and your spouse may be expected to share these expenses 50-50. If you earn considerably more than your spouse does, however, you might have to pay the bulk of these costs. A medical support order obligates you to pay a set figure toward these expenses in advance so the funds are available if your children need them – it's similar to having a second child support order. The same applies if you simply cannot cover your children with insurance by any means – you don't qualify for government programs, you can't afford private coverage and your employers don't offer plans. In this case, the medical support order covers the cost of all anticipated medical care your children might need, not just co-pays.