Health insurance is one of the most important and often notably expensive costs associated with raising a child. This will be especially true in 2026, with health-insurance premiums projected to rise across the board. Rising healthcare costs, inflation, medical-provider labor shortages, and the potential expiration of enhanced federal subsidies are all major contributors to the expected increase. For parents responsible for providing health-insurance coverage for their children in a child support agreement or order, these rising costs often raise an important question: Will an increase in premiums affect child support in my case?
In North Carolina, the cost of providing a child with health insurance coverage is included directly in the child support calculation under the North Carolina Child Support Guidelines. Note:only the portion actually paid by the parent through payroll deductions or direct payment is included. If any portion of the health insurance premium is paid by an employer, that amount is not included in the calculation since a parent is not actually incurring the cost. In addition to health insurance, the agreement or order may also require a parent to maintain dental and/or vision insurance for the child. .
However, the cost of providing insurance for a child must be “reasonable.” Under the Guidelines, “reasonable” means the cost for the child’s portion of the health insurance premium does not exceed 5% of the paying parent’s gross income. If no “reasonable” health insurance is available, then the court may still require the parent to obtain health insurance coverage once it becomes reasonably available.
But what happens when the cost of providing health insurance coverage increases? A parent’s legal options depend largely on the actual impact of the cost increase. If child support is recalculated with the new, increased health insurance coverage, and the new amount reflects a 15% difference with the current agreement or order, then you may have the ability to request a modification based on the health insurance cost increase. Other financial considerations may also impact this ability as well.
Before filing a motion with the Court, many parents may find it beneficial to discuss the change in their financial circumstance directly with the other parent. Sharing documentation and discussing how the increased cost affects each household may promote cooperation and transparency. Parents can also discuss adjusting other child-related costs to offset the increase in health insurance or other healthcare costs. However, it is important to remember that any changes the parents agree upon should be formalized in a new written agreement or court order. Informal agreements are not enforceable by the court, even if both parents follow them for a period of time.
Parents should monitor premium changes carefully and be prepared to act if the cost substantially impacts their financial circumstance. We encourage parents to be proactive: document premium changes, communicate with the other parent, and seek legal guidance from your family law attorney.
If you or somebody you know wants to learn more about child support, our team at Modern Legal is here to help.
Please note: these educational materials are based on North Carolina law where my legal practice is based. While the insights may have wide applicability, readers should consult with an attorney regarding the specific laws in their state or country.
Growing up as a child of divorce, Briana N. Zimmerman developed an early understanding of the complexities families face during difficult transitions. After earning a Bachelor of Science in Biology and Political Science from Northeastern University and working in biotechnology, she felt called to make a more personal impact. This led her to University of Tennessee College of Law, where her work with the Domestic Violence Clinic inspired her to pursue family law. Today, as a Law Clerk at Modern Legal, Briana is dedicated to guiding individuals and families with compassion, clarity, and strong advocacy through life’s most challenging moments.
