Uninsured extraordinary medical costs
DIRECTIONS: Enter the monthly amount of any uninsured extraordinary medical costs paid or to be paid
by the parent by agreement or pursuant to court order for the children who are the subject of this
proceeding. If the amount of the actual uninsured extraordinary medical costs for each child is not available
or cannot be verified, the amount of the uninsured extraordinary medical costs attributable to each child
who is the subject of this proceeding shall be calculated by dividing the total monthly uninsured
extraordinary medical costs by the total number of children for whom the uninsured extraordinary medical
costs are paid or to be paid.
"Uninsured medical costs" are reasonable and necessary medical and dental expenses, as defined by
section 213 IRC, incurred for the children who are the subject of this proceeding, to the extent that
the uninsured portion of such expenses, including any deductibles and co-payments, exceeds $100.00
per year per child. "Extraordinary medical costs" are predictable and recurring, such as expenses for
dental treatment, orthodontic treatment, asthma treatment and physical therapy. Medical and dental
expenses incurred for single occurrence illnesses or injuries that are not covered or fully paid under
any health insurance policy should be handled by separate order.
CAVEAT: A finding by the court or administrative agency that the presumed child support amount
is unjust or inappropriate is not necessary where the parent obligated to pay support is also ordered
to pay any percentage of the uninsured extraordinary medical or dental expenses of the children who are
the subject of the proceeding.