When reviewing a Uniform Child Support Order, the total amount is primarily composed of the Base Support, Premium Adjustment, Ordinary medical, and Child care. The most common question the payor has is in regards to the Ordinary medical portion. Attorneys should make it a habit of going over what this means with their Client whether that individual is the payor or the payee.

I have had numerous Clients question why they should pay for “ordinary medical” expenses when they in fact pay for the child(ren)’s health insurance. To better understand this, a Client should be advised that the amount they pay for the child(ren)’s medical, dental, and vision insurance is reflected in the line labeled “Premium adjust.” It is this line that gives the holder of the insurance policy an adjustment for health insurance when determining the monthly child support obligation.

The “Ordinary medical” line does not relate to health insurance, but to the out of pocket medical expenses that a child(ren) incur each year. The State of Michigan has determined, as of the year 2024, that the average out of pocket medical expenses per child is $454. These expenses include routine medical costs like doctor visits, vaccinations, and prescriptions. When the Payor of support sees an amount in the Ordinary medical line, this is their contribution to the out of pocket medical expenses. Think of it as a pre payment for doctor co-pays and other medical needs that the Payee will be paying upfront when the child(ren) go to these appointments. The Payor of child support is pre-paying their share of out of pocket medical expenses while the Payee will pay the cost when they happen.

Only after the Payee pays out of medical expenses greater than $454 per child is the Payor then required to start contributing to these cost. That means, when the Payee calls the Payor and says “I just paid $100 for a doctors visit so you need to give me half,” the Payor should say “please provide verification that you have already paid $454 for this year. And remember, this amount is per child. So if there is only one child, then the Payee has to spend $454. If there are two children, the Payee has to spend $908 before asking the Payor for additional sums. And so on for each child.

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Alexander Phillip Sheldon-Smith is an Attorney specializing in family law and divorce at Alan B. Cooper & Associates PLLC in Farmington Hills, MI.