Insurance

Medical Insurance & Cash Medical Orders Changing Court Ordered Child Support

The Child Support Enforcement Agency is required, by federal law to ensure that medical insurance coverage is provided for the child(ren) of the support order. The establishment of medical coverage is to be ordered and enforced on the party ordered to provide medical coverage.

The laws was created to ensure that cash is available to assist with the child’s medical needs anytime the child is not covered by private health insurance. Generally speaking, private health insurance is “reasonable” if the annual cost (family coverage minus self-only insurance) does not exceed five percent of the parent’s annual gross income.

Cash medical support is only paid when private health insurance is not provided as ordered. The non-residential parent will be ordered to pay cash medical support. If the non-residential parent’s annual gross income is less than 150% of the federal poverty level, he/she will not be required to pay cash medical support.

Cash medical support may be assigned and paid to the State of Ohio if the child is receiving medical benefits through Medicaid or Healthy Start.

Important Things to Know...

• If private insurance is NOT available to either parent when the support order is established (or modified), both parents will be required to notify the CSEA when private health insurance becomes available.
• If private health insurance stops (unemployed) the non-residential parent must pay cash medical until the private health insurance becomes available again.
• Changes to a cash medical order can only be made through the court or a a request for a modification.

Question: What determines Reasonable Cost?
Both parents can be ordered to provide private health insurance coverage but only if it is reasonable and accessible. Private health insurance is considered reasonable and affordable if the annual cost does not exceed 5% of the parent’s gross income . Primary health care must be available within 30 miles of the child's home.

Publicly funded health care (Medicaid, Healthy Start, etc.,) does not meet the requirements of providing private health insurance.

Question: Can my spouse provide insurance?
You will need to refer to your order (Court or Administrative) and look at the options regarding alternative coverage. A spouse can provide health insurance for the child and it will meet the intent of the order.