6.8.7 Extraordinary Medical Expenses (Line 5c)

Per La. R.S. 9:315.5, by court order or consent of the parties, extraordinary expenses incurred on behalf of the child shall be added to the basic child support obligation. Most courts will impute expenses in proportion to the parties share of gross income.

Extraordinary medical expenses are defined as “unreimbursed medical expenses which exceed two hundred fifty dollars per child per calendar year.”1  These expenses include, but are not limited to, reasonable and necessary costs for dental treatment, orthodontist, asthma treatments, physical therapy, and treatment for chronic health problems or professional counseling or psychiatric therapy for diagnosed mental disorders not covered by medical insurance.2

Some courts may not add these expenses into the obligation, despite the mandatory language. If it is a regularly occurring expense, it may be included; however, because these expenses “reset” each year (and for each child), there is generally not a set cost that is incurred each month. Thus, some courts may exclude the expenses with guidance to keep records of the expenses as they occur. Once the $250 is reached, the parent incurring the cost must notify the other parent that the expenses have been reached. Thereafter, the parties share in proportion to their percentage share of the total obligation.

An example may clarify the application of this provision. By June 1, Mother has expended $1000.00 in medical expenses for child #1. She alerts Father (in writing) that the expenses were incurred and provides documentation of invoices and payments in full. Once this occurs, Father must begin (either by reimbursement to mother or via direct payment to the provider) sending his proportionate share. If Father has 75% of the total support obligation, the calculation looks like this:

$1000.00 less $250 = $750.00.

$750.00 * 75%=$562.50 owed to Mother or to the provider

Also remember that the other parent may have also incurred medical expenses for the child. In that case, the other parent may offset the amount due by their proportionate share of the expenses incurred. To continue the above example, Mother has provided the $1000.00 in expenses above. Father’s share is $562.50. However, Father also has $500.00 in expenses he has paid in the same year. Thus, Father is entitled to an offset of 25% of the expenses he paid ($562.50 less 25% or $140.63). His obligation at that point in time would be $421.88 owed to Mother or the provider.

As these calculations can get complex, a spreadsheet is always helpful. Just make sure your client has explanations of benefits, invoices, and proof of payment in order to litigate this claim.

• 1La. R.S. 9:315.5.
• 2La. R.S. 9:315(C)(8).