Are Braces Considered a Medical Expense for Child Support? Decoding the Orthodontic Puzzle

The short answer is it depends. Whether braces are considered a medical expense for child support purposes hinges on the specifics of the child support order, state laws, and ultimately, the judge’s interpretation of those factors. Let’s delve into the intricacies to unravel this often-confusing aspect of family law.

Understanding Medical Expenses in Child Support

Child support orders typically address two categories of medical expenses: routine or ordinary medical expenses and extraordinary medical expenses. Routine medical expenses are usually factored into the base child support obligation, covering things like doctor’s visits and basic healthcare needs. It’s the extraordinary medical expenses that often become the subject of debate, and it’s in this arena where the question of braces lies.

What Constitutes an Extraordinary Medical Expense?

Extraordinary medical expenses are generally defined as significant, non-recurring healthcare costs that are not covered by insurance and are deemed medically necessary. The threshold for what qualifies as “significant” varies by state, often determined by a percentage of the parent’s income or a fixed dollar amount. For instance, an expense exceeding 5% of a parent’s annual gross income might be considered extraordinary. “Medically necessary” is also key; cosmetic procedures are typically excluded, while treatments aimed at correcting a functional impairment are more likely to qualify.

The Braces Dilemma: Medically Necessary or Cosmetic?

This is where things get tricky. While perfectly aligned teeth might be aesthetically pleasing, braces are often prescribed to address underlying medical issues. These can include:

• Malocclusion: Misalignment of teeth or jaws, impacting chewing, speech, and overall oral health.
• Overbite or Underbite: Significant protrusion or recession of the jaw, leading to pain and potential jaw joint disorders (TMJ).
• Crowding: Insufficient space for all teeth, leading to impacted teeth, gum disease, and difficulty cleaning.

If a dentist or orthodontist documents these medical justifications for braces, it strengthens the argument that the treatment is medically necessary and, therefore, a legitimate medical expense for child support purposes. However, if the braces are primarily for cosmetic reasons – improving the appearance of already functional teeth – it becomes less clear-cut.

The Role of the Child Support Order

The language in the child support order is paramount. Some orders explicitly address how extraordinary medical expenses are to be handled, including specific mention of orthodontic treatment. Other orders are more general, requiring a percentage split of all medical expenses exceeding a certain amount. If the order is silent on the issue of braces, it may be necessary to seek clarification from the court.

Seeking Pre-Approval

Before incurring significant expenses like braces, it’s often advisable to seek pre-approval from the other parent (and potentially the court). This avoids misunderstandings and potential legal battles down the line. Submitting a treatment plan from the orthodontist, detailing the medical necessity of the braces and the estimated cost, can be a helpful step in gaining that approval.

Frequently Asked Questions (FAQs) about Braces and Child Support

Here are some common questions regarding braces and child support, providing practical insights and guidance:

1. My child support order doesn’t mention medical expenses. What happens with the cost of braces?

If the order is silent, you’ll likely need to file a motion with the court to modify the order or seek clarification on how extraordinary medical expenses are handled. State law will govern whether braces can be included and how the cost will be allocated between the parents.

2. My ex refuses to pay for braces, even though the orthodontist says they are medically necessary. What are my options?

Gather documentation from the orthodontist supporting the medical necessity of the braces. Then, file a motion with the court to compel your ex to contribute to the cost. Be prepared to present evidence and argue your case.

3. Our child support order states we split medical expenses 50/50. Does this automatically include braces?

Not necessarily. While a 50/50 split seems straightforward, the court may still need to determine if the braces are considered medically necessary and therefore covered under the order. Presenting the orthodontist’s assessment is crucial.

4. Can I claim braces as a medical expense on my taxes, even if my ex is paying for part of them through child support?

You can only claim the portion of medical expenses that you actually paid out of pocket and that exceeds a certain percentage of your adjusted gross income (AGI), as determined by IRS guidelines. You cannot claim expenses reimbursed by your ex through child support. Consult a tax professional for specific advice.

5. What if I have dental insurance that covers some of the cost of braces?

The child support obligation typically only applies to out-of-pocket medical expenses. The portion covered by insurance is not usually factored into the calculation of who pays what.

6. My child is already wearing braces. Can I seek retroactive reimbursement from my ex for half the cost?

It depends. If you did not seek pre-approval or obtain a court order before incurring the expense, it may be difficult to obtain retroactive reimbursement. However, some states may allow it if you can demonstrate the braces were undeniably medically necessary and your ex was aware of the situation.

7. How do I prove that braces are medically necessary to the court?

Obtain a detailed treatment plan from the orthodontist, outlining the specific medical conditions being addressed by the braces, the expected outcomes, and the long-term health consequences of not undergoing treatment. Expert testimony from the orthodontist may also be required.

8. What if my ex argues that braces are a luxury and not a necessity?

Focus on the medical justifications for the braces. Emphasize the functional impairments being corrected and the potential health problems that could arise without treatment. Strong documentation from the orthodontist is critical.

9. Can I use mediation to resolve the dispute over braces?

Yes. Mediation can be a valuable tool for resolving disputes amicably and cost-effectively. A neutral mediator can help you and your ex reach a mutually acceptable agreement regarding the cost of braces.

10. Is there a specific age when braces are considered more likely to be medically necessary?

While there isn’t a specific age cutoff, braces are often considered medically necessary during adolescence when significant jaw and teeth development occurs. However, adults can also require braces for medical reasons.

11. If my child support order says “reasonable medical expenses,” does that include braces?

The term “reasonable” is open to interpretation. A judge will likely consider factors such as the cost of the braces in relation to the parents’ incomes, the medical necessity of the treatment, and the prevailing standards in the community. It’s best to seek clarification from the court.

12. What happens if I simply refuse to pay my share of the braces cost as ordered by the court?

Failing to comply with a child support order can have serious consequences, including wage garnishment, contempt of court charges, fines, and even jail time. It’s crucial to follow the court’s orders or seek a modification if you believe the order is unfair or unaffordable.

Conclusion: Navigating the Orthodontic Landscape

Determining whether braces are a covered medical expense within the realm of child support requires careful consideration of state laws, the specific language of the child support order, and the medical necessity of the treatment. Open communication with the other parent, thorough documentation from the orthodontist, and, if necessary, seeking legal guidance are all essential steps in navigating this complex issue and ensuring the best possible outcome for your child’s health and well-being. Remember, proactive communication and a focus on the child’s best interests are always the most constructive approaches.