Understanding Maryland’s Updated Law on Extraordinary Medical Expenses

Effective October 1, 2019, Maryland’s law regarding “extraordinary medical expenses” underwent significant changes. These updates, found in Maryland Annotated Code, Family Law Article §§12-201 and 12-204, impact how these expenses are defined and allocated in child support cases.

What Are Extraordinary Medical Expenses?

Under Maryland’s child support laws, extraordinary medical expenses can be included in the child support guidelines, meaning both parents contribute through child support payments. Alternatively, these expenses can be paid outside of child support, with each parent contributing in proportion to their income, either directly to the provider or through reimbursement to the parent covering the cost.

Previously, the law required the child support recipient to pay the first $100 of these expenses, with any amount beyond that shared by both parents.

What Has Changed?

The new law refines the definition of extraordinary medical expenses. Previously, they were defined as “uninsured expenses over $100 for a single illness or condition,” which created ambiguity. Questions arose about what constituted a “single illness or condition” and whether the cost threshold applied to lifetime expenses or annual costs.

Now, extraordinary medical expenses are defined as “uninsured costs for medical treatment in excess of $250 in any calendar year.” Additionally, the law explicitly includes vision care alongside orthodontia, dental treatment, asthma treatment, physical therapy, treatment for chronic health conditions, and professional counseling or psychiatric therapy for diagnosed mental disorders.

Implications of the New Definition

While this change clarifies some uncertainties, it raises new questions. Notably:

• The child support recipient is now responsible for paying the first $250 per year before the other parent is required to contribute.
• The new law aggregates all uninsured expenses rather than calculating costs per condition.
• It may discourage incorporating extraordinary medical expenses into the child support calculation, instead shifting toward a reimbursement model. Courts are less likely to include speculative expenses in child support calculations, potentially placing the burden on the parent advancing the costs to seek reimbursement.

Impact on Existing Agreements

For existing court orders and agreements that reference “extraordinary medical expenses” without a specific definition, the new law likely applies. However, agreements that explicitly define extraordinary medical expenses under the prior law may continue to be governed by their original terms unless a party seeks modification.

A key question remains: Does this statutory change constitute a “material change in circumstances” necessary to modify an existing order? Until Maryland’s appellate courts provide guidance, out-of-state decisions may serve as a reference point.

Looking Ahead

As Maryland courts begin to interpret and apply the revised statute, more clarity will emerge regarding how these changes impact child support calculations and reimbursements. In the meantime, parents navigating these expenses should consult legal professionals to ensure compliance with the updated law.

Stay informed and prepared—changes in family law can have lasting financial and legal implications for both parents and children. If you have questions about how these changes might affect your situation or need guidance navigating Maryland’s child support laws, our experienced family law attorneys are here to help. We can provide the clarity and support you need during this transition.