Rule 9.12 - Medical Support Order(1) The court shall enter an order for medical support as required by statute. For purposes of Iowa Code section 252E. 1A, the table contained in rule 9.12(4) is established for use by the courts of this state in determining reasonable cost for a health benefit plan and a reasonable amount in lieu of a health benefit plan (cash medical support). The sum certain dollar amount determined shall be stated in the order, as an amount in addition to the child support amount.(2) Refer to the table in rule 9.12(4) to determine if the parent has health insurance available at "reasonable cost." Find the appropriate cell for the parent's net income (as determined by the guidelines) and for the correct number of children. Multiply the parent's gross income by the percentage in that cell. If the amount is equal to or more than the cost of the children)'s portion of the health insurance premium (family cost minus single cost), it is available at "reasonable cost." For minimum orders in low-income Area A (NCPs with net incomes 0 - 1100), cash medical support is not ordered.(3) If neither parent has health insurance available at "reasonable cost," if appropriate according to Iowa Code section 252E. 1A, the court shall order cash medical support. Refer to the table in rule 9.12(4) to determine the amount of cash medical support. Find the appropriate cell for the parent's preliminary net income (gross income minus all appropriate deductions other than cash medical support in the pending matter) and for the correct number of children. Multiply the parent's gross income by the percentage in that cell to get the cash medical support amount. For minimum orders in low-income Area A (NCPs with net incomes 0 - 1100), cash medical support is not ordered. Cash medical support is also not ordered if a parent is ordered to provide health insurance and that parent or stepparent of the child(ren) has obtained insurance coverage for the child(ren). If the child(ren)'s health care coverage is through the Healthy and Well Kids in Iowa program (Hawki) under Iowa Code chapter 5141, the ordered amount of cash medical support is the cost of the Hawki premium or the amount calculated pursuant to the table in rule 9.12(4), whichever is less. Use the adjusted net income (preliminary net income minus the amount of cash medical support in the pending matter) for the correct number of children on the Schedule of Basic Support Obligations to find the appropriate amount of child support. Once the adjusted net income has been determined, do not allow another deduction for cash medical support.
(4) Medical Support Table. Preliminary Net Income | One Child | Two Children | Three Children | Four Children | Five or more Children |
0-1100 | Area A: Minimum Order Noncustodial parent provides health insurance when it becomes available at no cost to add the child(ren). Health insurance is not an add-on cost in this area. Do not order cash medical support. |
1101-1600 1 child 1601-2000 2 children 2001-2350 3 children 2351-2400 4 children 2401-2650 5+ children | Area B: Shaded area of the schedule Provide health insurance if available at reasonable cost. Find the box for the parent's preliminary net income and number of children. Multiply the percentage in the box (1%-5%) by the parent's gross income to find reasonable cost. Health insurance is an add-on cost in this area. If neither parent has health insurance available at a reasonable cost, if appropriate according to Iowa Code section 252E.1A, the court will order cash medical support under Rule 9.12(3). |
1101-1150 | 2% | 2% | 1% | 1% | 1% |
1151-1200 | 2% | 2% | 1% | 1% | 1% |
1201-1250 | 2% | 2% | 2% | 1% | 1% |
1251-1300 | 2% | 2% | 2% | 1% | 1% |
1301-1350 | 3% | 2% | 2% | 2% | 1% |
1351-1400 | 3% | 2% | 2% | 2% | 2% |
1401-1450 | 4% | 2% | 2% | 2% | 2% |
1451-1500 | 4% | 3% | 2% | 2% | 2% |
1501-1550 | 4% | 3% | 2% | 2% | 2% |
1551-1600 | 5% | 3% | 3% | 2% | 2% |
1601-1650 | 5% | 3% | 3% | 2% | 2% |
1651-1700 | 5% | 3% | 3% | 3% | 2% |
1701-1750 | 5% | 3% | 3% | 3% | 2% |
1751-1800 | 5% | 4% | 3% | 3% | 3% |
1801-1850 | 5% | 4% | 3% | 3% | 3% |
1851-1900 | 5% | 4% | 3% | 3% | 3% |
1901-1950 | 5% | 4% | 4% | 3% | 3% |
1951-2000 | 5% | 4% | 4% | 3% | 3% |
2001-2050 | 5% | 5% | 4% | 3% | 3% |
2051-2100 | 5% | 5% | 4% | 4% | 3% |
2101-2150 | 5% | 5% | 4% | 4% | 3% |
2151-2200 | 5% | 5% | 4% | 4% | 4% |
2201-2250 | 5% | 5% | 4% | 4% | 4% |
2251-2300 | 5% | 5% | 5% | 4% | 4% |
2301-2350 | 5% | 5% | 5% | 4% | 4% |
2351-2400 | 5% | 5% | 5% | 4% | 4% |
2401-2450 | 5% | 5% | 5% | 5% | 4% |
2451-2500 | 5% | 5% | 5% | 5% | 4% |
2501-2550 | 5% | 5% | 5% | 5% | 4% |
2551-2600 | 5% | 5% | 5% | 5% | 5% |
2601-2650 | 5% | 5% | 5% | 5% | 5% |
2651-25,000 | 5% | 5% | 5% | 5% | 5% |
Area C: Nonshaded area of the schedule Provide health insurance if available at reasonable cost. Find the box for the parent's preliminary net income and number of children. Multiply the percentage in the box (5%) by the parent's gross income to find reasonable cost. Health insurance is an add-on cost in this area. If neither parent has health insurance available at a reasonable cost, if appropriate according to Iowa Code section 252E.1A, the court will order cash medical support under Rule 9.12(3). |
(5) "Uncovered medical expenses" means all medical expenses for the child(ren) not paid by insurance. In cases of joint physical care, the parents will share all uncovered medical expenses in proportion to the parents' respective net incomes. In all other cases, including split or divided physical care, the custodial parent will pay the first $250 per calendar year per child of uncovered medical expenses up to a maximum of $800 per calendar year for all children. The parents will pay in proportion to their respective net incomes uncovered medical expenses in excess of $250 per child or a maximum of $800 per calendar year for all children. "Medical expenses" shall include, but not be limited to, costs for reasonably necessary medical, orthodontia, dental treatment, physical therapy, eye care (including eye glasses or contact lenses) mental health treatment, substance use disorder treatment, prescription drugs, and any other uncovered medical expense. Uncovered medical expenses are not to be deducted in arriving at net income.Court Order November 9, 2001, effective 2/15/2002; 9/23/2004, effective 11/1/2004; 3/9/2009, effective 7/1/2009; 5/9/2013, effective 7/1/2013;7/20/2017, effective 1/1/2018; court order September 3, 2021, effective 1/1/2022; court order December 29, 2021, effective 1/1/2022; order June 30, 2023, effective 7/1/2023; court order January 26, 2024, effective 1/26/2024.