The question of whether a non-custodial ex-partner can be compelled to shoulder private medical expenses of a common child over and above the regular monthly child support is one of the most frequently litigated issues in Philippine family courts. The short, unequivocal answer under prevailing law and jurisprudence is: yes, the obligation exists and is enforceable, provided the expenses are necessary, reasonable, and in keeping with the financial capacity of the family.

The obligation is not extinguished by the amount fixed in a prior child support judgment or compromise agreement. It is a continuing, solidary parental duty that survives separation, annulment, declaration of nullity, or mere cessation of cohabitation.

Legal Foundation: The Solidary Nature of Parental Support

The Family Code of the Philippines (Executive Order No. 209, as amended) imposes a solidary obligation on both parents to support their legitimate and illegitimate children.

Article 194 expressly includes “medical attendance” as part of support, together with sustenance, dwelling, clothing, education, and transportation.
Article 195 makes the obligation mutual between parents and children.
Article 201 states that the amount of support shall be in proportion to the resources of the giver and the needs of the recipient, and may be increased or reduced proportionately when circumstances change.
Article 204 allows the obligee (the child, through the custodial parent) to demand fulfillment of the obligation even beyond the previously fixed amount when justified.

The Supreme Court has repeatedly ruled that parental support is a joint and solidary obligation (G.R. No. 170966, Lacson v. Lacson, Jr., 4 July 2008; G.R. No. 191597, Lim-Lua v. Lua, 22 July 2015; G.R. No. 217477, Reyes v. Dela Rosa, 27 January 2021). This means the child (or the parent who advanced the expense) may proceed against either parent for the full amount, without need of prior demand against the other.

Effect of Separation, Annulment, or Declaration of Nullity

Marital dissolution does not terminate parental authority or the duty of support.

Article 213 of the Family Code retains joint parental authority even after decree of separation or nullity, except when the court appoints one parent as sole administrator of the child’s property or person for compelling reasons.
Article 176 (as amended by R.A. 9255) gives illegitimate children the same support rights as legitimate children.
Even in de facto separation (live-in partners who separated), the obligation remains enforceable under Articles 194–203 and the solidary principle recognized in jurisprudence (David v. Court of Appeals, G.R. No. 111180, 16 June 1995; Mangonon v. Court of Appeals, G.R. No. 125041, 30 June 2006).

Ordinary vs. Extraordinary Medical Expenses

Philippine courts distinguish between:

Ordinary medical expenses – routine check-ups, maintenance medicines, vaccines, minor illnesses. These are presumed covered by the regular monthly child support.
Extraordinary medical expenses – hospitalization, surgery, chemotherapy, dialysis, congenital defect correction, expensive diagnostic procedures (MRI, CT scan in private facilities), long-term therapy, imported medicines not covered by PhilHealth, etc.

Extraordinary medical expenses are not deemed included in the regular monthly support unless the compromise agreement or judgment expressly says so. The parent who shoulders them may seek contribution or reimbursement from the other parent (Spouse Rivera v. Rivera, G.R. No. 200016, 4 September 2013; Gotardo v. Buling, G.R. No. 165166, 13 July 2012).

Private Medical Bills: Are They Covered?

Yes, even if incurred in private hospitals or clinics.

The Supreme Court has consistently held that the level of medical care must be in keeping with the financial capacity of the family (Article 194, last paragraph). The social and economic status of the parents before separation is the benchmark.

Relevant rulings:

Lim-Lua v. Lua (G.R. No. 191597, 22 July 2015) – The Court upheld the obligation of the father to pay for the child’s medical expenses in a private hospital because the family belonged to the upper economic bracket and had always availed of private medical care.
Reyes v. Dela Rosa (G.R. No. 217477, 27 January 2021) – The father was ordered to reimburse 50% of the child’s chemotherapy expenses in St. Luke’s Medical Center despite arguing that the treatment was available in PGH at lower cost. The Court ruled that the child’s best interest and the family’s previous standard of living prevail.
De Asis v. Court of Appeals (G.R. No. 127578, 15 February 1999) – The Court declared that choosing a private hospital over a public one is reasonable when the public facility cannot provide the same quality or immediacy of care.

However, the expense must still be reasonable and necessary. A parent who unilaterally chooses the most expensive hospital without medical justification may be denied full reimbursement. Courts often apply a pro-rata sharing (50-50 or according to income ratio) after examining the parents’ current financial capacity.

Procedural Remedies Available to the Custodial Parent

Motion for Increase of Support under Rule on Provisional Orders (A.M. No. 02-11-12-SC) or Rule 61 of the Rules of Court – fastest remedy; can be filed in the same family court that issued the original support order.
Petition for Additional Support based on changed circumstances (serious illness constitutes a change).
Action for Reimbursement/Contribution – if the custodial parent already paid the bills, file a collection case with prayer for writ of preliminary attachment if the other parent is likely to abscond.
Petition for Issuance of Support Pendente Lite in annulment/nullity cases (Rule on Declaration of Absolute Nullity of Void Marriages and Annulment of Voidable Marriages, or Rule on Legal Separation).
Criminal case for Violation of R.A. 9262 (Anti-VAWC Act) – economic abuse includes deliberate deprivation of financial support, including medical support. This is a public crime and carries imprisonment (Section 5(e) and 5(i) in relation to child).
Habeas Corpus with Prayer for Hold-Departure Order – if the non-paying parent attempts to leave the country.

Common Defenses Raised by Non-Custodial Parents (and Why They Usually Fail)

“It’s already included in the monthly support” → Fails when the expense is extraordinary.
“Public hospitals are available for free” → Fails when private care is justified by urgency, quality, or family standard of living.
“I have no money” → Must be proven with clear evidence; voluntary unemployment or underemployment is not a valid excuse (Mangonon v. Court of Appeals).
“The mother chose the expensive hospital without my consent” → Consent is not required in emergencies; in non-emergencies, good faith consultation is preferred but not fatal to the claim.

Practical Reality in Philippine Family Courts (2020–2025 Trend)

From 2020 onward, family courts have become increasingly strict in enforcing medical support obligations, especially post-COVID when many children incurred large hospital bills. Judges now routinely:

Order 50-50 sharing of uncovered hospital balances as a standard provisional order.
Require submission of PhilHealth benefit statements to determine only the actual out-of-pocket amount to be shared.
Issue Hold-Departure Orders against delinquent parents in medical support cases even faster than in ordinary support cases.

Conclusion

Under Philippine law, the obligation to pay for a child’s private medical expenses is not capped by the monthly child support amount. It is a continuing, solidary parental duty rooted in the child’s constitutional right to support and the State’s policy to protect the rights of children (1987 Constitution, Article XV, Section 3(2); Article II, Section 12).

An ex-partner who refuses to contribute to necessary private medical bills of the common child does so at his or her peril — facing not only civil execution and contempt but possible criminal prosecution under R.A. 9262.

The custodial parent’s strongest leverage is the solidary nature of the obligation and the Supreme Court’s consistent pronouncement that the child’s welfare is paramount and is never compromised by the parents’ failed relationship.