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Medical Support

DC Law 17-128, Child Support Compliance Amendment Act of 2007, provides that every child support order must contain a provision for medical support for each child (ren).  This could be a provision for health insurance, cash medical support or both.  In all cases where accessible health insurance coverage is available to either or both the non-custodial parent (“NCP”)  and custodial parent (“CP”)  at reasonable cost, the court shall order either or both parents to provide health insurance coverage.

Under the law, the court shall consider, at a minimum, the cost, comprehensiveness, and accessibility of all health insurance coverage options available to either parent when selecting among health insurance coverage options.  If accessible health insurance coverage is not available to either parent at a reasonable cost, or where the medical expenses of a child are not fully covered by health insurance, the court shall order either or both parents to pay cash medical support.

How will Employers be Notified?

The Child Support Services Division (“CSSD”) shall, when appropriate, submit a National Medical Support Notice (“NMSN”) to an employer when the support order requires either a CP, an NCP, or both parents to provide health insurance coverage for the dependent child (ren), and when the employer is known to CSSD, unless the support order directs enrollment of the child (ren) in alternative coverage. 

When a noncustodial parent is a newly hired employee entered in the D.C. Directory of New Hires (“NDNH”), and the support order requires the NCP to provide health insurance coverage for his/her dependent child (ren), CSSD shall submit the NMSN to the employer within 2 business days after the employee has been entered in the NDNH.

What are the Medical Support Definitions?

Cash Medical Support:   An amount ordered to be paid toward the cost of health insurance provided by a public entity or by another parent, through employment or otherwise, or for extraordinary medical expenses or for other medical costs not covered by insurance.   

Reasonable Health Insurance Coverage:  

Health insurance coverage shall be considered reasonable in cost if the cost to the parent obligated to provide coverage does not exceed 5 percent of the parent’s gross income.

Accessible Health Insurance Coverage:  

Health insurance coverage shall be considered accessible if, based on the work history of the parent providing the coverage:

  • It will be available for at least one year, and
  • If the child lives within the geographical area covered by the plan, or
  • Within 30 minutes or 30 miles of primary care services.

Comprehensive Health Insurance:  

Health insurance coverage shall be considered comprehensive when it offers a broad and inclusive array of health services. 

Extraordinary Medical Expenses:

Extraordinary medical expenses are uninsured or unreimbursed medical expenses in excess of $250 per year per child and include the following:

  • Co-payments
  • Deductibles
  • Contributions associated with public and private health insurance coverage.

What are the Responsibilities of the CP and NCP?

When the Court issues an order for either a CP or NCP or both to obtain or maintain health insurance through an employer, each individual is responsible for ensuring that his or her employer/payroll office processes the NMSN in a timely manner.   If there is more than one health insurance plan available for a CP or NCP to select, each party is required by CSSD to choose the plan preferred within 10 business days or a plan will be selected automatically by CSSD.