If you have a charging support order in PA for either child or spousal support, you likely have to pay the first $ 250 in out of pocket medical expenses each year per person before the remainder are allocated based on a percentage. You need to keep good records in order to receive your remainder share. You should create a list per person of all medical bills per person that are received each month and keep a copy of the bill. You will also need to keep a copy of the check or credit card receipt showing that you paid the copay or bill. Once you have reached $ 250 for the year, you should provide the documentation showing that you reached this limit and then start keeping track of all bills that come in for the rest of the year and request the percentage the other side is responsible to pay. You will likely have to front the money and seek reimbursement. In all cases, if payment is not made by March of the following year, you will need to file contempt with the court in your Domestic Relations office and again provide proof of notice and payment. It pays to be organized and you should make this something you do in January of each year.