Can Child Support Be Modified for Medical Expenses?

Children get sick, need braces, and outgrow the health coverage arrangement that made sense the year your order was entered. When medical costs change, your child support order can often change with them.

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The Short Answer

Yes. In Washington, the money that covers a child's health care is treated separately from the base amount of child support, and it can be adjusted when circumstances shift. Health care costs are not baked into the standard support figure. Instead, they are shared by the parents in proportion to their incomes, on top of basic support. When those costs rise, when insurance coverage changes, or when a new medical need appears, either parent can ask the court to revisit how the order handles them.

How Washington Treats Medical Costs in a Support Order

To understand why medical expenses can be adjusted, it helps to see how they fit into a Washington child support order in the first place. The base amount of support comes from a statewide economic table. That table does not include health care costs. State law is explicit that monthly health care costs are not part of the economic table and are instead shared by the parents in the same proportion as the basic support obligation. This is set out in RCW 26.19.080.

The same statute describes what counts as a health care cost, and it is broad. It includes medical, dental, orthodontia, vision, chiropractic, mental health treatment, prescription medications, and other similar costs for care and treatment. In plain terms, the premiums a parent pays to insure the child, along with the out-of-pocket costs that insurance does not cover, are generally shared between the parents according to each parent's percentage of the combined income rather than being absorbed by one parent alone.

Because these costs sit outside the base support number and are tied to a proportional share, an order will often say something like each parent is responsible for a set percentage of the child's uninsured medical expenses. That percentage tracks each parent's share of the combined monthly net income, which is the same proportion used for basic support under RCW 26.19.080.

When Can the Order Actually Be Changed

Having a category for medical costs is one thing. Getting the order changed is another, and Washington law sets the standard for that. The general rule for modifying a support order is found in RCW 26.09.170. Most of the time, a parent asking to change the order must show a substantial change of circumstances. A sharp increase in a child's medical needs, the loss of health insurance, a large jump in premium costs, or a new diagnosis that brings ongoing treatment can all fit that description, depending on the facts.

RCW 26.09.170 also provides routes that do not require proving a substantial change. The statute allows an adjustment once a set period has passed since the order was entered or last changed, based on things like changes in the parents' income or changes in the economic table and standards. There are additional paths as well, including situations where the order as written works a severe economic hardship on a party or the child. Which route fits your situation depends on the timing of your current order and what has actually changed.

It is worth knowing that not every shift in medical expenses requires a full-blown modification. Many Washington orders already contain language allocating uninsured medical costs by percentage. When that is the case, the mechanism for sharing a new expense may already exist in your current order, and the real question becomes enforcement and reimbursement rather than modification. Reading your existing order carefully is the first step.

Health Insurance Coverage Is Part of the Picture

Support orders in Washington commonly address which parent will carry health insurance for the child and how the cost of that coverage is split. When the parent providing coverage loses a job, changes employers, or sees premiums climb, that can be exactly the kind of change that justifies revisiting the order. The reverse is also true. If coverage becomes available to a parent at a reasonable cost when it was not before, the order may need to reflect the new arrangement. Because premiums fall within the health care costs that RCW 26.19.080 says are shared proportionally, a meaningful change in what coverage costs can ripple into what each parent owes.

Practical Steps Before You File

Start by gathering documentation. Bills, insurance statements, premium records, and proof of any new diagnosis or treatment plan build the picture a court will want to see. Next, compare that picture to what your current order already says about medical costs, because the answer may be enforcement rather than modification. Finally, look at when your order was entered, since timing affects which modification path under RCW 26.09.170 is available to you.

Rushing to court without this groundwork often leads to delay. A well-documented request that clearly ties the change in medical costs to the standards in the statute stands a far better chance of moving efficiently.

A Local Note for Snohomish County Families

Support cases in Snohomish County are handled in the Superior Court in Everett, and the same statewide rules on medical costs apply here as everywhere in Washington. What differs from family to family is the detail: a child's specific needs, each parent's income, and the exact wording of the existing order. Those details are where a modification is won or lost.

Let Us Help You Sort It Out

If your child's medical costs have changed and you are not sure whether your order already covers it or whether you need to ask the court to modify it, the Law Office of Chad Foster can help you read your current order and weigh your options. We work with parents throughout Snohomish County on child support questions like this one. Reach out to set up a time to talk through where you stand.