What is Fixed Medical Support?
Legal Authorities:
What is a “fixed medical expense” and how does it affect calculation of medical support?
Fixed medical expenses for a child are paid out-of-pocket by a parent or custodian on a regular or recurring basis that are not covered by health care coverage or other health benefits such as SoonerCare, Indian Health Services (IHS), or TRICARE. The most common examples include monthly co-payments for medication for a chronic health condition or payments to an orthodontist. These expenses are entered on Line F16 (Ongoing Medical Costs) of the Child Support Computation worksheet in the column for the parent incurring the expense. In considering these expenses and requiring the other parent to pay his/her proportionate share of the cost, the Court is usually following the guidelines rather than allowing a deviation.
Authority: According to Section 118F of Title 43 of the Oklahoma Statutes, medical support can include health care coverage, cash medical (CM) support, or a combination of both. CM support can include “fixed periodic payments for ongoing medical costs.” Section 118A defines “Other contributions” as “recurring monthly medical expenses and visitation transportation costs that are not included in the current monthly child support obligation.” According to Section 118F(F)(4)(c)(2), the court in setting an amount of CM support, may also consider:
- proof of past medical expenses incurred by either parent for the child,
- the current state of the health of the child, and
- any medical conditions of the child that would result in an increased monthly medical cost.
However, a fixed medical expense could also include extraordinary transportation costs to visit a specialist for a chronic health condition. The Child Support Guidelines do not dictate the method by which the court would calculate the amount of the expenses. Options include an estimate of the gas expenses for a round trip between child’s primary residence and the health care provider or the state mileage rate for the trip.
*Example of transportation as a fixed medical expense:
Mother/custodian receives SSI as her only income. The minor child lives in Cherokee and has a chronic health condition that requires her to travel every three months to her doctor in Oklahoma City for treatment. Due to Mother’s low income, these travel expenses are a hardship for her. Medicaid pays for the doctor visits and medication costs but not the travel expenses. The Court allows a calculation of Mother’s gas expenses for 4 round trips per year between Cherokee and Oklahoma City, averaged to a monthly amount, on Line F16 (Ongoing Medical Costs) of the Child Support Computation as part of the child support obligation to be paid by NCP Father.
When is Fixed Medical Retained?
There are times when fixed medical payments may be retained in the same way that child support payments may be retained.
The case types that are associated with retained fixed medical are:
- C FM (TANF & fixed medical) – whenever C FM is used it means that the state is issuing or has issued TANF benefits for the time period indicated and the CP does not receive the fixed medical payments for that month. Instead, the fixed medical payments are retained by the state.
- F FM (IV-E foster care & fixed medical) – this means that the child is currently in foster care or was in foster care during the month indicated and the fixed medical will be retained.
- E FM (Non IV-E foster care & fixed medical) – The code E FM represents the case of a child who is in-state, and is or has been in Non-IV-E foster care.
- CC FM (TANF fixed medical judgment) – means that a judgment has been taken for a TANF time frame that also included fixed medical. Money paid towards this case type will be retained by the state.
- FC FM (IV-E foster care fixed medical judgment) – Cases marked with FC FM means there is a judgment for repayment of a foster care time frame.
- EC FM (Non IV-E foster care judgment) – Cases marked with EC FM means there is a judgment for repayment of a foster care time frame.
If we would retain the child support portion of the payment, we will also retain the fixed medical portion of the payment.