Court Ordered Health Insurance

Posted on August 6, 2026 by Steve Shorr — No Comments ↓

What if a Court Order Requires Health Insurance for the Child?

A California child-support order may require either or both parents to maintain health insurance for a supported child when coverage is available at no cost or at a reasonable cost.

Health insurance can include medical, dental and vision coverage.
Cost is generally presumed reasonable when the additional cost to the responsible parent does not exceed 5% of that parent’s gross income.
The additional cost generally means the difference between self-only coverage and coverage that includes the child.
An employer may be ordered to enroll the child in an available group health plan.
The wording of the actual court order controls.

Read more on Steve’s separate page about court-ordered health insurance for a child in California.

Steve can help compare employer, Covered California and direct individual health-plan options. Questions about interpreting, enforcing or changing the court order must be handled by the court, a family-law attorney or the local child-support agency.

Court Order fl 470 to provide Health Insurance for #children
Divorce

Parental Medical #Rights?

The court shall require that health insurance coverage for a supported child shall be maintained by either or both parents if that insurance is available at no cost or at a reasonable cost to the parent.
- Here’s an explanation from Attorney Robert Farzad. *
- California Family Law Code §3750 – 3733 Health Coverage for Supported Child, assignment.
- §3750. “Health insurance coverage” as used in this article includes all of the following:
  - (a) Vision care and dental care coverage whether the vision care or dental care coverage is part of existing health insurance coverage or is issued as a separate policy or plan.
  - (2) the court shall require that health insurance coverage for a supported child shall be maintained by either or both parents if that insurance is available at no cost or at a reasonable cost to the parent.
- Qualified Medical Child Support Orders Department of Labor
Court Forms –
- Health Care Orders for Children FL 192
- HEALTH INSURANCE FL 470
- Email us [email protected] if you need any INSURANCE help complying with these orders. – for legal help – contact an attorney
Get a quote for your child(ren) only
Quotes for Yourself & Children, Family or X & Children
Are you losing Medical Coverage?
If I receive CalWORKS or KinGAP (government cash assistance/welfare), does this affect how much child support I can receive?
- Yes. By law, you can EITHER receive the court ordered child support OR the cash assistance, but not both. As long as you are receiving cash assistance, you will receive $50.00 of the ordered child support payment and the remainder will go to the state to repay the cash assistance you were given. ^{Child Support.CA.Gov} *
Question Can Medi Cal get reimbursed for children’s premiums where the parents have a health insurance order or from an estranged father?
- Answer In accordance with the Social Security Act section 1902(a)(25)(E), and 42 CFR 433.152(b), the Department receives data from The Department of Child Support Services on a regular basis to obtain information for those with a medical support order. Currently, medical child support services are paid within 30 days as it has determined it is cost effective and necessary to ensure access to care; however, the service is “chased” after the fact, unless there is good cause.
  
  Including Links to our State Plan for more information.
  
  Attachment 4.22-A (ca.gov) – data processing described on page 2.
  
  Attachment 4.22-B (ca.gov) – claims processing for Medical Child support services
  
  Lindsey Wilson, Chief

Videos on Health Insurance Orders

Court-Ordered Health Insurance for a Child in California

A California child-support order may require one or both parents to maintain health insurance for a supported child when coverage is available at no cost or at a reasonable cost.

The health-insurance requirement is separate from the monthly child-support payment. A parent may therefore be required to:

Pay monthly child support.
Maintain health insurance for the child.
Share deductibles, copayments or other uncovered medical expenses.

The exact responsibilities depend on the wording of the court order. Review the order before enrolling, cancelling or replacing the child’s coverage.

What Does Court-Ordered Health Insurance Include?

California law defines health insurance for a supported child broadly. It may include:

Medical coverage.
Dental coverage.
Vision coverage.
An HMO.
A PPO.
Fee-for-service coverage.
Another health-care delivery system that can provide services to the child.

See the official definition in California Family Code Section 3750.

What Is Considered a Reasonable Cost?

Under California Family Code Section 3751, health coverage is generally presumed to be reasonable in cost when the responsible parent’s additional cost does not exceed 5% of that parent’s gross income.

The cost used for this calculation is generally:

The premium for coverage including the child,
minus the premium for self-only coverage.

For example, if self-only employer coverage costs $200 per month and employee-plus-child coverage costs $350 per month, the additional cost associated with covering the child would generally be $150 per month.

The 5% rule is a presumption and not a guarantee of how a court will rule in every situation. Read the complete official provision in California Family Code Section 3751.

Can an Employer Be Ordered to Enroll the Child?

Yes. When appropriate employer-sponsored coverage is available, a court can direct that the child be enrolled in the parent’s health plan.

California form FL-470, Application and Order for Health Insurance Coverage, is used to ask a judge to require a parent’s employer to include the child in available health coverage.

Before assuming the employer plan is the best option, review:

The additional premium required to add the child.
The doctors and hospitals in the plan’s network.
Prescription-drug coverage.
The deductible and maximum out-of-pocket limit.
Whether the child lives within the plan’s service area.
Whether the employer plan satisfies the wording of the court order.

What if Employer Coverage Is Not Available or Is Too Expensive?

If employer coverage is unavailable or does not appear affordable, other possibilities may include:

A Covered California family plan.
A child-only individual health plan.
Direct individual coverage outside Covered California.
Medi-Cal for the child, depending on household income and eligibility.
Coverage available through the other parent or a stepparent.

A different plan should not automatically be substituted for coverage required by a court order. Review the order and obtain legal guidance when necessary before cancelling or replacing existing coverage.

Employer coverage can also affect eligibility for Covered California subsidies. Read Steve’s explanation of the Family Glitch and employer affordability rules.

How Steve Shorr Insurance Can Help

Steve can help with the health-insurance portion of the situation, including:

Comparing employer coverage with individual plans.
Checking Covered California subsidy eligibility.
Comparing child-only health plans.
Reviewing premiums, deductibles and maximum out-of-pocket limits.
Checking doctors, hospitals and prescription formularies.
Explaining how tax-household information affects a Covered California application.

Steve cannot:

Interpret the legal effect of a court order.
Change a child-support order.
Determine whether a parent is in compliance with an order.
Provide legal advice about custody, visitation or child support.

Legal questions should be directed to the California Courts Child Support Self-Help Center, the local child-support agency or a qualified family-law attorney.