Mo. Rev. Stat. » Chapter 454
Missouri Revised Statutes

Mo. Rev. Stat. § 454.603 (2026)

Health benefit plan may be required

✓ current as of May 2026
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  454.603.  Health benefit plan may be required — terms — order of coverage — liability for expenses not covered — abatement, termination of coverage. — 1.  At any state of a proceeding in which the circuit court or the division has jurisdiction to establish or modify an order for child support, including but not limited to actions brought pursuant to this chapter, chapters 210, 211, and 452, the court or the division shall determine whether to require a parent to provide medical care for the child through a health benefit plan.

  2.  The court or the division may require that a child be covered under a health benefit plan that is accessible to the child.  Such a requirement shall be imposed in any IV-D case.  The court or division shall require that a child be covered under a private health benefit plan whenever such a health benefit plan is available at reasonable cost through a parent's employer or union.  If a private health benefit plan is not available at reasonable cost through an employer or union, the court, in determining whether to require a parent to provide such coverage, shall consider:

  (1)  The best interests of the child;

  (2)  The child's present and anticipated needs for medical care;

  (3)  The financial ability of the parents to afford the cost of a health benefit plan; and

  (4)  The extent to which the cost of the health benefit plan is subsidized or reduced by participation on a group basis or otherwise.

  3.  To the extent that such options are available under the terms of the health benefit plan, an order may specify required terms of the health benefit plan, including:

  (1)  Minimum required policy limits;

  (2)  Minimum required coverage;

  (3)  Maximum terms for deductibles or required co-payments; or

  (4)  Other significant terms, including, but not limited to, any provision required for a health benefit plan under the federal Employee Retirement Income Security Act of 1974, as amended.

  4.  If the child is not covered by a private health benefit plan but such a plan is available to one of the parents at a reasonable cost, the court or the division shall order that coverage under the health benefit plan be provided for the child, unless there is available to the other parent a private health benefit plan with comparable or better benefits at comparable or reduced cost.  If private health benefit plans are available to both parents upon terms which provide comparable benefits and costs, the court or the division shall determine which health benefit plan, if any, shall be required, giving due regard to the possible advantages of each plan.

  5.  The court shall require the obligor to be liable for all or a portion of the medical or dental expenses of the minor child that are not covered by the required health benefit plan coverage if:

  (1)  The court finds that the health benefit plan coverage required to be obtained by the obligor or available to the obligee does not pay all the reasonable and necessary medical or dental expenses of the minor child; and

  (2)  The court finds that the obligor has the financial resources to contribute to the payment of these medical or dental expenses; and

  (3)  The court finds the obligee has substantially complied with the terms of the health benefit coverage.

  6.  The cost of health benefit plan employee contributions or premiums shall not be a direct offset to child support awards established pursuant to this chapter, chapters 210, 211, and 452, but it shall be considered when determining the amount of child support to be paid by the obligor.

  7.  If two or more health benefit plans are available to one or both parents that are complementary to one another or are compatible as primary and secondary coverage for the child, the court or the division may order each parent to maintain one or more health benefit plans for the child.

  8.  Prior to terminating enrollment in a health benefit plan or changing from one health benefit plan to another, consideration by the court or division shall be given to the child's medical condition and best interests and whether there is reason to believe that a new health benefit plan would omit or limit benefits because of a preexisting condition.

  9.  An abatement of a parent's child support obligation shall not automatically abate that parent's duty to provide for the child's health care needs.  Unless an order of the court or the division specifically provides for abatement or termination of health care coverage, an order to maintain health benefits or otherwise provide for a child's health care needs shall continue in force until further order of the court or the division, or until the child's right to parental support terminates.

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(L. 1993 S.B. 253 § 4, A.L. 1997 S.B. 361, A.L. 2019 H.B. 397)

Notes of Decisions
Cited in 18 cases (1 in the last 5 years), 1994–2021 · leading case: Hosack v. Hosack, 973 S.W.2d 863 (Mo. Ct. App. 1998).
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Hosack v. Hosack, 973 S.W.2d 863 (Mo. Ct. App. 1998). · cites it 5× “Section 454.603 states that, when the circuit court has jurisdiction to establish an order for child support in a dissolution proceeding, the court “may require that a child be covered under a health benefit plan.”
Nichols v. Beran, 980 S.W.2d 342 (Mo. Ct. App. 1998). · cites it 6× “603 states that, when the circuit court has jurisdiction to establish an order for child support in a dissolution proceeding, the court “may require that a child be covered under a health benefit plan. Such a requirement shall be imposed whenever a health benefit plan is…”
Marriage of Kirkwood v. Kirkwood, 77 S.W.3d 675 (Mo. Ct. App. 2002). · cites it 2× “Husband asserts in his third point on appeal that the trial court erred in ordering him to pay for all medical, dental, optical, and hospital expenses not covered by his insurance because the evidence did not justify such an order per the statutory factors set out in section…”
Turner v. Turner, 5 S.W.3d 607 (Mo. Ct. App. 1999). · cites it 4× “RSMo 1994; and § 454.603, RSMo Cum. Supp.1997, relative to Quaid’s future medical care.”
In Re Marriage of Cohen, 884 S.W.2d 35 (Mo. Ct. App. 1994). · cites it 2× “Beginning May 26, 1993 § 454.603, RSMo Supp.1993, governs and provides: 6.”
Bold v. Bold, 912 S.W.2d 477 (Mo. 1995). · cites it 3× “Medical expense provisions are governed by section 454.603, RSMo 1994, which states in pertinent part: 2.”
Wilson v. Whitney, 81 S.W.3d 172 (Mo. Ct. App. 2002). · cites it 2× “Section 454.603 provides, as applicable here: 1.”
Smith v. Smith, 94 S.W.3d 394 (Mo. Ct. App. 2003). · cites it 3× “The pertinent portion in § 454.603 provides: 1. At any state of a proceeding in which the circuit court or the division has jurisdiction to establish or modify an order for child support, including but not limited to actions brought pursuant to this chapter, chapters 210, 211,…”
Sanders v. Hatcher, 341 S.W.3d 762 (Mo. Ct. App. 2011). · cites it 2× “In regard to the health insurance, the circuit court’s judgment said: That Missouri Revised Statutes, section 454.603 provides that a court or agency has discretion in determining which parent shall be responsible for providing a health benefit plan on behalf of the minor child…”
Hoskins v. Hoskins, 164 S.W.3d 188 (Mo. Ct. App. 2005). · cites it 2× “Section 454.603 provides, as applicable here: 1.”
In Re Marriage of Braun, 887 S.W.2d 776 (Mo. Ct. App. 1994). · cites it 2× “Beginning May 26, 1993 § 454.603, RSMo Supp.1993, governs and provides: 6.”
Gatton v. Gatton, 35 S.W.3d 930 (Mo. Ct. App. 2001). · cites it 2× “He argues that his plan was “superior” to hers with respect to deductibles and dental coverage, and that § 454.603, RSMo Supp.1999, required the circuit court to choose between the parents’ plans.”
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