Medical and Dental Support

Medical and dental support are additional forms of child support that a parent must pay. They help cover the costs of health insurance and uninsured medical expenses. 

A court can order a parent to pay medical or dental support by: 

• Providing health or dental insurance for the child; 

• Paying the other parent for the cost of insurance coverage (“cash medical support”); or 

• Paying cash medical support if the child receives Medicaid. 

The parent ordered to pay child support (the “obligor”) usually also provides medical and dental support. Each parent usually has to pay 50% of uninsured or out-of-pocket medical expenses. 

The obligor only has to pay for the “reasonable cost” of insurance coverage. Texas law defines this as a percentage of the obligor’s annual “net resources.” The obligor’s net resources consist of most income sources, including income from employment, self-employment, retirement benefits, and disability benefits. The following percentages are “reasonable”: 

• Health insurance: 9% 

• Dental insurance: 1.5% 

If an obligor has net resources of $30,000 per year, their maximum obligation for the child’s insurance would be: 

• Health insurance: $2,700 per year or $225 per month 

• Dental insurance: $450 per year or $37.50 per month 

An obligation to pay cash medical support is in addition to child support. An obligor who must pay $500 per month in child support, $150 in medical support, and $25 per month in dental support has a total monthly obligation of $675.

Starting September 1, 2023, all ordered cash medical and dental support must be paid to the Texas Child Support Disbursement Unit (SDU) so it is recorded before forwarding the payment to the custodial parent. 

Your child may qualify for health insurance through Medicaid or the Children’s Health Insurance Program (CHIP). Get more information here.

Courts typically order medical and dental support when they order child support. They can do this as part of the following legal proceedings: 

• Divorce; 

• Child custody case, also known as a Suit Affecting the Parent-Child Relationship (SAPCR); 

• Paternity case;

• Family violence protective order case; or 

• Modification case, if a court order affecting the child is already in place. 

If you need a family violence protective order, you can call the National Domestic Violence 24-Hour Hotline at (800) 799-SAFE (7233). They can refer you to help in your area. You can also safely get information about getting help from the Office of the Attorney General (OAG) on this website. 

For more information on how you can get medical and dental support, including do-it-yourself options, read the article Child Support. 

Yes. State law requires judges to make sure that a child will receive medical and dental support in all cases. The court’s order must spell out the responsibilities for insurance coverage and uninsured costs. 

Medical and dental support are court-ordered obligations. If you do not follow the court’s order, a judge can do the following: 

• Order you to pay all past-due child support with interest; 

• Fine you or sentence you to jail for contempt of court; 

• Take your federal income tax refund; 

• Take any lottery winnings you might receive; 

• Suspend your driver’s license, hunting license, fishing license, and any professional licenses; and 

• Place a lien on your property. 

The OAG’s Child Support Division can give you information about filing an enforcement action. TexasLawHelp does not offer medical or dental support enforcement forms. 

Caution: You cannot withhold visitation if the other parent is not meeting their support obligations. Visitation is a separate issue that does not depend on medical or dental support. You could find yourself in violation of the court order if you do not let the parent see the child. 

You can ask the court to change medical or dental support in certain circumstances. See our article on Changing a Child Support Order for more information. 

You and the other parent can present an agreement to the court. The judge must find that it will be in the child’s best interests. You cannot change medical or support without getting a new court order. 

Chapter 154 of the Texas Family Code covers medical and dental support.