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What does “extraordinary medical expenses” in the support orders?

It is common to come across the words “extraordinary medical expenses” in child support orders. Extraordinary medical expenses are some of the fine details in child support orders that parents tend to overlook, only to come out shocked when invoices come knocking. This article will discuss everything you need to know regarding extraordinary medical expenses in detail.

What are extraordinary medical expenses?

The exact definition of extraordinary medical expenses varies from state to state. However, generally, they refer to uninsured medical costs. Uninsured medical expenses are the healthcare costs that the insurance package taken by the parents for the child does not cover. Common extraordinary medical expenses include prescription, asthma treatments, allergy shots, orthodontia, and physical therapy.

Rather than define extraordinary medical expenses as uninsured healthcare costs, some states define them according to the dollar value of the expenses incurred:

Extraordinary medical expenses in terms of dollar value

The child support order specifies the amount beyond which medical costs will be considered extraordinary medical expenses. The phrasing of the orders varies depending on the state in which the child support case was filed, the judge giving the orders, and the unique circumstances surrounding the case. The following are examples of child support orders expressing extraordinary medical expenses in figures.

  • All medical expenses exceeding $200 should be considered extraordinary.
  • All annual medical expenses exceeding $300 should be considered extraordinary.
  • All medical expenses above 10 percent of the monthly child support amount should be considered extraordinary.

When medical costs exceed the specified amount, the parents will share the costs according to the formula specified in the child support orders.

How are extraordinary medical expenses shared?

Again, this varies from state to state. Some states use the income shares model. In this model, the amount that each parent contributes towards the extraordinary medical expenses is directly proportional to their monthly income. It follows, therefore, that the parent who earns more will contribute more.

Other states determine each party’s contribution towards extraordinary medical expenses using the percentage of income model. Here, the non-custodial parent is required to use a certain percentage of their monthly income to cover extraordinary medical costs.

In some states, recurring and non-recurring medical expenses are treated differently. In such states, non-custodial parents may be required to contribute towards non-recurring extraordinary medical expenses only.

How are unreimbursed or unpaid extraordinary medical expenses collected?

In what we have covered so far, we may have made the concept of extraordinary medical expenses sound simple. On paper, it is simple to understand and implement; however, in real life, implementation of the orders poses serious challenges. For example, what will happen if the custodial parent spends money on medical needs that the non-custodial parent deems unreasonable or unnecessary? In such cases, disputes are bound to arise.

Which expense is deemed reasonable and necessary?

Most child support orders describe extraordinary medical expenses as ‘reasonable’ and ‘necessary’ costs. The problem is that no one knows where the boundary between necessary and unnecessary lies. In most cases, deciding what is necessary or unnecessary is a matter of conscience. If there is a serious dispute regarding the reasonableness of certain expenses, the custodial parent can turn to a court of law.

The following section explains how the process of collecting reimbursement should be in order to minimize disputes.

Giving notice to the non-custodial parent

The custodial parent should notify the non-custodial parent of their intent to incur specific medical expenses. If the non-custodial parent has already covered the costs, as in the case of emergencies, the custodial parent should make contact with the other party to request payment.

Making the payment

Like many things we have discussed above, rules regarding payment of extraordinary medical expenses vary from state to state. In some states, the indebted party can pay the money to the party who incurred the costs, who in most cases is the custodial parent. In other states, the parents can only pay healthcare institutions or child support agencies.

As earlier stated, the process of claiming and collecting reimbursements for extraordinary medical expenses can sometimes have numerous obstacles. Nevertheless, below are some of the tips you can use to make the process smooth and to ensure you don’t lose money.

Tips on how to ensure smooth reimbursement of extraordinary medical expenses


  • Follow the procedures outlined in the child support orders the letter.
  • Maintain a proper record of all the medical expenses you have incurred. For example, keep all invoices alongside their receipts.
  • Give timely notices. For example, it is a wise thing to inform the other party before spending money on extraordinary medical needs.
  • Give an informal notice to the other party. You can then use legal procedures if they refuse to pay. The process is likely to be smooth when there is a rapport.

What if the other party refuses to pay extraordinary medical expenses

If the other party fails to pay or reimburse extraordinary medical expenses, you can seek redress in court. The court will enforce the child support orders. The arrearages can be recovered through garnishment of the party’s wages, interception of tax refunds, contempt of court conviction, and other methods.

What if you cant afford extraordinary medical expenses

Child support arrearages are terrible things to add to your record. They carry penalties such as interest and losing your license. You can even be sent to jail for missing the payments. Those penalties are enough to scare the strongest man; so what should you do when you cant afford the payments? Go back to court and explain your situation. We earlier stated that most child support formulas are based on the parents’ income. If the judge agrees that your income cannot comfortably cover the expenses, they can modify the child support orders.

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