Posted on November 30, 2021

Children’s Health Insurance In An Illinois Divorce

Children are expensive. You have to feed them, clothe them, give them shelter and keep them healthy. Keeping children healthy means having your children insured both during and after your Illinois divorce.

“The duty to provide health insurance is an integral part of a parent’s current and future support obligations.” In re Marriage of Seitzinger, 775 NE 2d 282 – Ill: Appellate Court, 4th Dist. 2002

“The provision of health insurance is another integral element of the parents’ support obligation.” In re Marriage of Rash, 406 Ill. App. 3d 381, 385 (Ill. App. Ct. 2010)

Health Insurance For Children Is Mandatory During And After An Illinois Divorce

An Illinois divorce court must be sure that the children have some kind of health insurance before finalizing any paperwork regarding child support.

“The court, in its discretion, in addition to the basic child support obligation, shall also provide for the child’s current and future medical needs by ordering either or both parents to initiate health insurance coverage for the child through currently effective health insurance policies held by the parent or parents, purchase one or more or all health, dental, or vision insurance policies for the child, or provide for the child’s current and future medical needs through some other manner.” 750 ILCS 5/505(a)(4)(A) (emphasis mine)

“The trial court has discretion to order payment of a health insurance premium” In re Keon C., 344 Ill. App. 3d 1137, 1146 (2003).

Typically, courts just verify that the children are currently insured under one parent’s plan and will remain insured under that plan.

If neither parent has health insurance for the children, the court may require a parent to purchase private health insurance.

“If neither parent has access to appropriate private health insurance coverage, the court may order:

 (I) one or both parents to provide health insurance coverage at any time it becomes available at a reasonable cost; or

(II) the parent or non-parent custodian with primary physical responsibility for the child to apply for public health insurance coverage for the child and require either or both parents to pay a reasonable amount of the cost of health insurance for the child.” 750 ILCS 5/505(a)(4)(C)

Often if the children aren’t currently insured via private insurance, the children are insured through the state of Illinois’ All Kids program. If the court believes one parent can afford private insurance in lieu of All Kids, the court may order that parent to purchase a private health insurance plan.

“The order may also provide that any time private health insurance coverage is available at a reasonable cost to that party it will be provided instead of cash medical support. As used in this Section, “cash medical support” means an amount ordered to be paid toward the cost of health insurance provided by a public entity or by another person through employment or otherwise or for other medical costs not covered by insurance.” 750 ILCS 5/505(a)(4)(C)

The requirement to purchase private health insurance is rarely invoked because most people who don’t have insurance cannot insure their for less than 5% of their income or they are making less than 133% of the poverty guidelines.

“A reasonable cost for providing health insurance coverage for the child may not exceed 5% of the providing parent’s gross income. Parents with a net income below 133% of the most recent United States Department of Health and Human Services Federal Poverty Guidelines or whose child is covered by Medicaid based on that parent’s income may not be ordered to contribute toward or provide private coverage, unless private coverage is obtainable without any financial contribution by that parent.” 750 ILCS 5/505(a)(4)(G)

Out Of Pocket Expenses For A Child’s Healthcare After An Illinois Divorce

Even if a child is insured, there will always be out-of-pocket expenses that the court may find either or both parents be responsible for.

“The court, in its discretion, may order either or both parents to contribute to the reasonable health care needs of the child not covered by insurance, including, but not limited to, unreimbursed medical, dental, orthodontic, or vision expenses and any prescription medication for the child not covered under the child’s health insurance.” 750 ILCS 5/505(a)(4)(B)

Even if there is an agreement or previous order for out-of-pocket expenses, the court can still order a parent to pay an uncovered expense.

“[D]espite discernable guidelines on contingent medical expenses not covered by insurance, the trial court also has discretion to order the payment of uncovered and extraordinary medical expenses” Hall v. Clark, 344 Ill. App. 3d 1137, 1146 (Ill. App. Ct. 2003)

Typically, uncovered expenses are apportioned to each parent based on their respective incomes. If one parent made $ 100,000 a year and the other parent made $ 50,000 a year, the allocation would be 66%/33%.

Medical expenses of children have to be paid. Parents must pay their children’s medical expenses.

“Parents are…responsible for necessary medical expenses of the minor child.” In re Marriage of Rash, 406 Ill. App. 3d 381, 385 (Ill. App. Ct. 2010)

“The responsibility to pay medical expenses incurred on behalf of a minor child extends to noncustodial parents following a divorce.” Pirrello v. Maryville Acad., Inc., 19 N.E.3d 1261, 1263-64 (Ill. App. Ct. 2014)

Adjusting Child Support Because Of Health Care Premiums For The Child

Most private insurance plans require the payment of a premium by the plan participant. A portion of that premium will be for the children. Whichever parent is paying the premium associated with the child’s premium shall get a credit for that payment which will reduce the child support paid or increase the child support received.

“The amount to be added to the basic child support obligation shall be the actual amount of the total health insurance premium that is attributable to the child who is the subject of the order. If this amount is not available or cannot be verified, the total cost of the health insurance premium shall be divided by the total number of persons covered by the policy. The cost per person derived from this calculation shall be multiplied by the number of children who are the subject of the order and who are covered under the health insurance policy. This amount shall be added to the basic child support obligation and shall be allocated between the parents in proportion to their respective net incomes.” 750 ILCS 5/505(a)(4)(D)

“After the health insurance premium for the child is added to the basic child support obligation and allocated between the parents in proportion to their respective incomes for child support purposes, if the obligor is paying the premium, the amount calculated for the obligee’s share of the health insurance premium for the child shall be deducted from the obligor’s share of the total child support obligation. If the obligee is paying for private health insurance for the child, the child support obligation shall be increased by the obligor’s share of the premium payment. The obligor’s and obligee’s portion of health insurance costs shall appear in the support order.” 750 ILCS 5/505(a)(4)(E)

In lieu of actually crunching all of these numbers, lawyers and pro se litigants alike merely plug in information to Family Law Software or the HFS Child Support Estimator.

In order to have child support adjusted for health insurance premium payment, the parent must prove the health insurance is valid and the cost of the child’s portion of the premium.

“Prior to allowing the health insurance adjustment, the parent requesting the adjustment must submit proof that the child has been enrolled in a health insurance plan and must submit proof of the cost of the premium. The court shall require the parent receiving the adjustment to annually submit proof of continued coverage of the child to the other parent, or as designated by the court.” 750 ILCS 5/505(a)(4)(F)

Dental And Vision Insurance For Children In An Illinois Divorce

While the court must insist that the children have health insurance, the court has the option of ordering a vision or dental plan for the children.

“If dental or vision insurance is included as part of the employer’s medical plan, the coverage shall be maintained for the child. If not included in the employer’s medical plan, adding the dental or vision insurance for the child is at the discretion of the court.” 750 ILCS 5/505(a)(4)(H)

What If A New Spouse Is Insuring The Children?

While new spouses’ incomes are never considered for the purposes of child support, a new spouse that insures children will allow the parent to use that premium payment as a credit against child support.

“If a parent has been directed to provide health insurance pursuant to this paragraph and that parent’s spouse or legally recognized partner provides the insurance for the benefit of the child either directly or through employment, a credit on the child support worksheet shall be given to that parent in the same manner as if the premium were paid by that parent.” 750 ILCS 5/505(a)(4)(H)

Health Insurance For Children In College

Parties to an Illinois divorce can be ordered to contribute to their children’s college expenses. These “[e]ducational expenses may include, but shall not be limited to…the actual costs of the child’s medical expenses, including medical insurance, and dental expenses” 750 ILCS 5/513(d)(3)

The statute doesn’t provide much more direction than that. If you were insuring a child before college, expect to be ordered to insure the child during college.

“[The spouse who was insuring the children will] remain[] solely responsible for obtaining health insurance for the children until their graduation from college.” Evanoff v. Tomasek, No. 1-15-0017, 7 (Ill. App. Ct. 2016)

Failure To Insure A Child After An Illinois Divorce

A court will definitely order one or both parents to insure their children after an Illinois divorce. If a parent fails to pay those insurance premiums, the other parent will be owed those missed premiums.

“[W]hen a parent owing a duty of support fails to provide health insurance pursuant to a court order, that parent is liable to the other party for premiums not paid.” In re Marriage of Takata, 709 NE 2d 715 – Ill: Appellate Court, 2nd Dist. 1999

It does not matter if the other parent covered the children during the period where the parent failed to properly insure the children. The premiums are a duty owed to the children through the parent.

“[T]he dollar amount of court-ordered insurance premiums is considered as child support and that the obligor is liable to the obligee for the unpaid premiums. Significantly, the statute does not require the obligee to cover the cost of insurance in order to recover unpaid premiums from the obligor.” In re Marriage of Takata, 709 NE 2d 715 – Ill: Appellate Court, 2nd Dist. 1999

Furthermore, the parent failing to pay health insurance premiums for their children will be found in contempt of court unless that failure is neither willful nor contumacious.

People love their children and children are relatively cheap to insure. Do not let insuring your children become an issue in an Illinois divorce court. This is a matter both parents should easily come to agreement upon. If you cannot agree or need clarification, contact my Chicago, Illinois family law firm to schedule an appointment with an experienced Chicago divorce lawyer.

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Russell Knight

Russell D. Knight has been practicing family law as a Chicago divorce lawyer since 2006. Russell D. Knight amicably resolves tough cases while remaining a strong advocate for his client’s interests.

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