Lorain County Job & Family Services

Cash Medical Support

The new federal medical support regulations became effective July 21, 2008 revising federal requirements for establishing and enforcing medical support obligations in child support enforcement program cases receiving services under Title IV-D. The changes require that all support orders in the IV-D program provide some form of medical support for the child, even when health insurance is not available to either parent; redefine reasonable cost health insurance; and require health insurance to be accessible, as defined by the State.

In compliance with the new federal regulations, the Ohio laws regarding medical support have also changed. The Ohio Revised Code continues to require all child support orders to order the obligor and/or obligee to obtain and/or maintain available private health insurance coverage that is reasonable in cost, and adds the requirement in all child support orders for the obligor to pay cash medical support during any period when the child is not covered by private health insurance as ordered in the support order. The order will contain two child support obligation amounts, an amount when health insurance is provided and an amount when health insurance is not provided, and a cash medical support obligation amount. However, if the obligor's annual gross income is below 150% of the federal poverty level for an individual at the time that the child support order is issued or modified, cash medical support will be set at $0.00.

Cash medical support is defined as an amount ordered to be paid in a child support order toward the cost of health insurance provided by a public entity, another parent, or person with whom the child resides, through employment or otherwise, or for other medical costs not covered by insurance. Per federal law (42 USC 1396k & 42 CFR 433.146d), State Title XIX (i.e., Medicaid) agencies shall require Medicaid applicants & recipients to assign rights to medical support to the agency in order to reimburse the agency for medical expenses.

Click here to view the current Cash Medical Support Obligations based on income and number of children.