Cash Medical

Cash Medical Support
Effective July 21, 2008, Federal and State laws require all new or modified child support orders provide some form of medical support at ALL TIMES. The new laws were established to ensure that cash medical support is available to assist with the child's medical needs anytime the child IS NOT covered by private health insurance.
All new child support orders may now include two (2) ordered amounts:
a. An amount when health insurance IS PROVIDED.
b. An amount for child support and cash medical support when health insurance is NOT PROVIDED.


PRIVATE HEALTH INSURANCE
The mother, father or both parents can be ordered to provide medical insurance if available and accessible through employment at a reasonable cost.
Reasonable cost means the annual cost (family coverage minus self only coverage) does not exceed 5% of that parent's gross income annually. Ohio Medicaid and Healthy Start do NOT meet the requirement to provide private health insurance. The requirement to obtain health insurance for the parties' minor children cannot be fulfilled through enrollment in the Medicaid system and such enrollment may require the Hardin County Child Support Enforcement Agency to take action to modify your child support and/or health insurance orders as appropriate.

CASH MEDICAL SUPPORT ORDERS
Pursuant to ORC 3119.30(B) there are now four kinds of medical support orders:

B1 - Both parties have insurance available and accessible at a reasonable cost. Both parties are ordered to carry. The child support amount calculated with insurance is charged. If either the obligee or obligor loses insurance and the other still carries it, there is no change to the case. If both lose their insurance coverage, the cash medical amount as stated in the order is implemented and paid by the child support obligor. The child support amount is changed from the amount with insurance to the amount without insurance.

B2 - Obligee is ordered to carry private health insurance available and reasonable at the time the order is established or modified. The child support amount that was calculated with insurance is charged. If the obligee loses insurance, the cash medical amount as stated in the order is implemented and paid by the obligor. The child support amount is changed from the amount with insurance to the amount without insurance.

B3 - Obligor is ordered to carry private health insurance available and reasonable at the time the order is established or modified. The child support amount that was calculated with insurance is charged. If the obligor loses insurance, the cash medical amount as stated in the order is implemented and paid by the obligor. The child support amount is changed from the amount with insurance to the amount without insurance.

B4 - Private health insurance is not available to either party. Both are required to immediately report to the CSEA when private health insurance becomes available. The amount of the monthly obligation is the amount of child support when health insurance is not provided, plus the amount of the cash medical order. If the obligee reports having insurance available, the CSEA will determine if it is accessible and reasonable, and if so, the order becomes a B2 order, and the child support obligee becomes the health insurance obligor. If the child support obligor reports available insurance, the CSEA will determine if it is reasonable, and if so the order becomes a B3 order, and the child support obligor becomes the health insurance obligor.
  • The non custodial parent may be ordered to pay cash medical support. Cash medical support is only paid when private health insurance IS NOT being provided. If the non custodial parent's gross income is less than 150% of the federal poverty level, ($16,245 in 2009) he/she will have a zero (0) cash medical support order.
  • If the private health insurance stops, (for example, a change in jobs) the non- custodial parent must pay cash medical support (if ordered to do so) until new private medical insurance is in effect.
  • When the CSEA is aware of changes that effect a parent's obligation to either pay cash medical support or provide health insurance, the CSEA will notify both parents.


REPORT ANY CHANGES IN YOUR CHILD'S HEALTH INSURANCE COVERAGE IMMEDIATELY TO ASSURE ACCURATE CASE CHARGES.

The Cash Medical Obligor shall begin payment of any cash medical support on the first day of the month immediately following the month in which private health insurance coverage is unavailable or terminates and shall cease payment on the last day of the month immediately preceding the month in which private health insurance coverage begins or resumes. During the period when cash medical support is required to be paid, the obligor or obligee must immediately inform the child support enforcement agency that health insurance coverage for the children has become available.

If the obligor, obligee or both obligor and obligee, are required under section 3119.30 of the Revised Code to provide private health insurance coverage for the children, the health insurance obligor is required to provide to the other parent, not later than thirty days after the issuance of the order, information regarding the benefits, limitations, and exclusions of the coverage, copies of any insurance forms necessary to receive reimbursement, payment, or other benefits under the coverage, and a copy of any necessary insurance cards.

The person required to provide private health insurance coverage for the children shall designate the children as covered dependents under any private health insurance policy, contract, or plan for which the person contracts no later than thirty days after the issuance of the order.

Written verification of compliance with this order must be provided to the Hardin County CSEA P O Box 428, Kenton, OH, 43326 immediately, but no later than 30 days after complying with this order.

Upon receipt of notice by the child support enforcement agency that private health insurance coverage is not available at a reasonable cost, cash medical support shall be paid in the amount as determined by the child support computation worksheets in section 3119.022 [3119.02.2] or 3119.023 [3119.02.3] of the Revised Code, as applicable. The child support enforcement agency may change the financial obligations of the parties to pay child support in accordance with the terms of the court or administrative order and cash medical support without a hearing or additional notice to the parties.

If health insurance coverage for the parties' minor children is not presently available at a reasonable cost through a group policy, contract, or plan offered by either party's employer or through any other group policy, contract, or plan available to either party, and if health insurance coverage for the parties' minor children becomes available later at a reasonable cost, the person to whom the coverage becomes available shall obtain health insurance and inform the Child Support Enforcement Agency in writing within thirty (30) days.

If the CSEA determines that the private health insurance coverage is accessible and reasonable in cost, the CSEA shall notify both parties that the person to whom the coverage is available is now the Health Insurance Obligor and is ordered to obtain and maintain private health insurance for the child (ren) named above and to meet the requirements identified under "Notice to the Health Insurance Obligor" without an additional order or hearing.