ESTABLISH ORDER

CS 356P-4 Specified Relative Cases, Medical Support

11/94 Revised 09/03/24 Training Completed 09/17/24 Last Reviewed 05/05/25

If the specified relative is receiving Medicaid-only for the child and there is an existing support order for that child, the Office of Recovery Services/Child Support Services (ORS/CSS) intake worker will open a case to enforce the medical support obligation and the child support obligation.

Utah Code 81-6-208 states:

“(3) A child support order shall:

(a) require the parents provide health care coverage for the medical expenses of a child;

(b) require the parents provide health insurance for the medical expenses of a child if health insurance is available to the parents at a reasonable cost;

(c) designate which health insurance plan is primary and which health insurance plan is secondary if, at any time, a child is covered by both parents' health insurance plans as described in Subsection (7);

(d) require each parent to share equally the out-of-pocket costs of the premium actually paid by a parent for the child's portion of health insurance; and

(e) include a provision that requires each parent to equally share all reasonable and necessary uninsured and unreimbursed medical and dental expenses incurred for a child, including co-payments, co-insurance, and deductibles.

(4) The court may deviate from the requirements described in Subsection (3) if:

(a) the court makes specific findings establishing good cause for the deviation; or

(b) subject to the court's approval, the parents agree which parent shall provide health insurance for the child.”

Medical support does not change in specified relative support-follows-the child situations. Utah Code 81-6-205 provides:

“(8)(a) When physical custody of a child changes after the original child support order, the parent without physical custody of the child is required to pay the amount of child support calculated under this section, without the need to modify the order, to:

(i) the parent who has physical custody of the child;

(ii) a relative to whom physical custody of the child has been voluntarily given; or

(iii) the state when the child is residing outside of the home in the protective custody, temporary custody, or care of the state or a state-licensed facility for at least 30 days.

(b) When physical custody of a child changes from the physical custody that is assumed in the original child support order calculated under this section, the modification of the child support order is not necessary even if only one parent is specifically ordered to pay in the child support order.”

If there is an existing medical support provision in a support order, enforce the medical insurance obligation according to the Medical Support policies found in sections CS 480P through CS 495P. If there is no medical support provision in an order entered on or after May 3, 2023, medical support is deemed ordered by operation of law, per Utah Code 81-6-208:

“(6) Subject to Subsection (4), if a child support order does not contain the requirements described in Subsection (3):

(a) the parents are nonetheless subject to the requirements described in Subsection (3), as applicable; and

(b) for purposes of Subsection (3)(c), the health insurance plan of the parent whose birthday falls first in the calendar year is primary, and the health insurance plan of the parent whose birthday falls second in the calendar year is secondary.”

If there is no medical support provision in a support order and the order was entered prior to May 3, 2023, obtain an order that includes a medical support provision against the parent(s) if the case meets the criteria found in CS 451P Review and Adjustment of a Support Order to Include MEDICAL Support Only. If the parent(s) will not stipulate to a judicial order that includes the medical support provision, refer the case to the Attorney General's office for further action.