Tex. Codes » Family Code · TITLE 5. THE PARENT-CHILD RELATIONSHIP AND THE SUIT AFFECTING THE PARENT-CHILD RELATIONSHIP · SUBTITLE B. SUITS AFFECTING THE PARENT-CHILD RELATIONSHIP · CHAPTER 154. CHILD SUPPORT
Texas Codes

Tex. Fam. Code § 154.181 (2026)

Medical Support Order

✓ current as of May 2026
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Sec. 154.181. MEDICAL SUPPORT ORDER. (a) The court shall render an order for the medical support of the child as provided by this section and Section 154.182 in:

(1) a proceeding in which periodic payments of child support are ordered under this chapter or modified under Chapter 156;

(2) any other suit affecting the parent-child relationship in which the court determines that medical support of the child must be established, modified, or clarified; or

(3) a proceeding under Chapter 159.

(b) Before a hearing on temporary orders or a final order, if no hearing on temporary orders is held, the court shall require the parties to the proceedings to disclose in a pleading or other statement:

(1) if private health insurance is in effect for the child, the identity of the insurance company providing the coverage, the policy number, which parent is responsible for payment of any insurance premium for the coverage, whether the coverage is provided through a parent's employment, and the cost of the premium; or

(2) if private health insurance is not in effect for the child, whether:

(A) the child is receiving medical assistance under Chapter 32, Human Resources Code;

(B) the child is receiving health benefits coverage under the state child health plan under Chapter 62, Health and Safety Code, and the cost of any premium; and

(C) either parent has access to private health insurance at reasonable cost to the obligor.

(c) In rendering temporary orders, the court shall, except for good cause shown, order that any health insurance coverage in effect for the child continue in effect pending the rendition of a final order, except that the court may not require the continuation of any health insurance that is not available to the parent at reasonable cost to the obligor. If there is no health insurance coverage in effect for the child or if the insurance in effect is not available at a reasonable cost to the obligor, the court shall, except for good cause shown, order health care coverage for the child as provided under Section 154.182.

(d) On rendering a final order the court shall:

(1) make specific findings with respect to the manner in which health care coverage is to be provided for the child, in accordance with the priorities identified under Section 154.182; and

(2) except for good cause shown or on agreement of the parties, require the parent ordered to provide health care coverage for the child as provided under Section 154.182 to produce evidence to the court's satisfaction that the parent has applied for or secured health insurance or has otherwise taken necessary action to provide for health care coverage for the child, as ordered by the court.

(e) In this section, "reasonable cost" means the cost of health insurance coverage for a child that does not exceed nine percent of the obligor's annual resources, as described by Section 154.062(b), if the obligor is responsible under a medical support order for the cost of health insurance coverage for only one child. If the obligor is responsible under a medical support order for the cost of health insurance coverage for more than one child, "reasonable cost" means the total cost of health insurance coverage for all children for which the obligor is responsible under a medical support order that does not exceed nine percent of the obligor's annual resources, as described by Section 154.062(b).

Added by Acts 1995, 74th Leg., ch. 20, Sec. 1, eff. April 20, 1995. Amended by Acts 2001, 77th Leg., ch. 449, Sec. 1, eff. June 5, 2001; Acts 2003, 78th Leg., ch. 610, Sec. 1, eff. Sept. 1, 2003.

Amended by:

Acts 2007, 80th Leg., R.S., Ch. 363 (S.B. 303), Sec. 2, eff. September 1, 2007.

Acts 2009, 81st Leg., R.S., Ch. 767 (S.B. 865), Sec. 7, eff. June 19, 2009.

Notes of Decisions
Cited in 23 cases (5 in the last 5 years), 2002–2026 · leading case: In the Interest of Tucker, 96 S.W.3d 662 (Tex. App. 2003).
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In the Interest of Tucker, 96 S.W.3d 662 (Tex. App. 2003). · cites it 2× “Tex. Fam. Code Ann. § 154.181 (Vernon 2002).”
Sink v. Sink, 364 S.W.3d 340 (Tex. App. 2012). “” Tex. Fam.Code Ann. § 154.182(c)(2) (West Supp.”
Miles v. Peacock, 229 S.W.3d 384 (Tex. App. 2007). “” Tex. Fam.Code Ann. § 154.181(a) (Vernon Supp.”
Juan Ayala v. Blanca Edit Ayala, 387 S.W.3d 721 (Tex. App. 2011). “Tex. Fam.Code Ann. §§ 154.181, 154.009 (Vernon 2008).”
Miguel Reyes v. Norma Reyes, 458 S.W.3d 613 (Tex. App. 2014). “In return, Miguel was to pay Norma medical support, as additional child support, of $113 per month pursuant to Tex.Fam.Code Ann. § 154.181 (West 2014). The parties were also directed to each pay one half of *621 the unreimbursed medical expenses.”
in the Interest of J.S.P., a Child, 278 S.W.3d 414 (Tex. App. 2008). “See Tex. Fam.Code Ann. § 154.181(a) (Vernon Supp.”
Anna Montes v. Steven Filley, 359 S.W.3d 260 (Tex. App. 2011). “Tex. Fam.Code Ann. §§ 154.181(d), 154.182.”
in the Interest of J.P.M., V.M. & A.M., Child. (Tex. App. 2019). · cites it 2× “181(d)(1) of the family code requires: (d) On rendering a final order the court shall: (1) make specific findings with respect to the manner in which health care coverage is to be provided for the child, in accordance with the priorities identified under Section 154.”
in the Interest of N.K.C., a Child (Tex. App. 2022). · cites it 2× “See TEX. FAM. CODE ANN. § 154.181(a). To read the agreement to commence the parties’ medical support obligation as of the date of entry of the order would ignore the mandate of Family Code § 154.”
In Re Jsp, 278 S.W.3d 414 (Tex. App. 2008). “See TEX. FAM.CODE ANN. § 154.181(a) (Vernon Supp.”
in the Interest of Jared Wade Tucker, a Minor Child (Tex. App. 2003). · cites it 2× “Tex. Fam. Code Ann. § 154.181 (Vernon 2002).”
Mickey J. Hughes v. Amie Hughes & in the Interest of D. S. H., Minor Child (Tex. App. 2009). · cites it 2× “Tex. Fam. Code Ann. § 154.181 (a)(2) (Vernon 2008).”
Show all 23 citing cases →
— Tex. Fam. Code § 154.181(a) — 6 cases
Miles v. Peacock, 229 S.W.3d 384 (Tex. App. 2007). “” Tex. Fam.Code Ann. § 154.181(a) (Vernon Supp.”
in the Interest of J.S.P., a Child, 278 S.W.3d 414 (Tex. App. 2008). “See Tex. Fam.Code Ann. § 154.181(a) (Vernon Supp.”
In Re Jsp, 278 S.W.3d 414 (Tex. App. 2008). “See TEX. FAM.CODE ANN. § 154.181(a) (Vernon Supp.”
in the Interest of M.A.B., a Child (Tex. App. 2017).
in the Interest of N.K.C., a Child (Tex. App. 2022). “See TEX. FAM. CODE ANN. § 154.181(a). To read the agreement to commence the parties’ medical support obligation as of the date of entry of the order would ignore the mandate of Family Code § 154.”
— Tex. Fam. Code § 154.181(a)(1) — 1 case
in the Interest of N.K.C., a Child (Tex. App. 2022). “See TEX. FAM. CODE ANN. § 154.181(a). To read the agreement to commence the parties’ medical support obligation as of the date of entry of the order would ignore the mandate of Family Code § 154.”
— Tex. Fam. Code § 154.181(a)(2) — 1 case
in the Interest of J. S. H., a Minor Child (Tex. App. 2010).
— Tex. Fam. Code § 154.181(b) — 2 cases
in the Interest of H.E.W.M., a Child (Tex. App. 2020).
Mario Ortega v. Sandra Centeno Blanco (Tex. App. 2021).
— Tex. Fam. Code § 154.181(d) — 2 cases
Anna Montes v. Steven Filley, 359 S.W.3d 260 (Tex. App. 2011). “Tex. Fam.Code Ann. §§ 154.181(d), 154.182.”
in the Interest of J.P.M., V.M. & A.M., Child. (Tex. App. 2019). “181(d)(1) of the family code requires: (d) On rendering a final order the court shall: (1) make specific findings with respect to the manner in which health care coverage is to be provided for the child, in accordance with the priorities identified under Section 154.”
— Tex. Fam. Code § 154.181(e) — 6 cases
Sink v. Sink, 364 S.W.3d 340 (Tex. App. 2012). “” Tex. Fam.Code Ann. § 154.182(c)(2) (West Supp.”
In the Interest of Tucker, 96 S.W.3d 662 (Tex. App. 2003). “Tex. Fam. Code Ann. § 154.181 (Vernon 2002).”
Joseph F. Radler III v. Amy Philavanh (Tex. App. 2021).
In the Interest of J. L., a Child v. the State of Texas (Tex. App. 2025).
Rain Levy Minns Udall v. Michael Minns (2026).
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