Cash medical and Health Insurance   

Cash medical support is an amount ordered to be paid in a child support order toward ordinary medical expenses incurred during the calendar year. Every child support order established or modified on or after March 28, 2019, includes a cash medical order as part of the total order.

Who receives the cash medical support?

The child support obligee will receive the Cash Medical Support unless the child support obligee is receiving Medicaid.  Then, the Cash Medical Support is paid to the State of Ohio to defray the cost of Medicaid expenditures.

What if the ordinary medical expenses of the child(ren) exceed the annual cash medical amount?

Once the annual cash medical amount, currently $388.70 per child, is spent on ordinary medical expenses, the remainder of the child(ren)’s medical expenses will be split by the parties according to a percentage determined by the CSEA or court.

What if the cost of my health insurance has changed and is no longer considered reasonable or my income has been reduced?

When determining the reasonableness of insurance, the CSEA is required to consider the cost of the insurance based on the parent’s gross income.  Once a child support order is set, if the cost of health insurance changes, either party may request a Review & Adjustment of the support order to determine whether the cost is no longer reasonable.  If so, the order will be adjusted accordingly.

Determination of reasonable cost for health insurance coverage

The child support obligee is presumed to be responsible for carrying insurance.  The child support obligor may rebut this presumption if they already have health insurance coverage for the child(ren) that is reasonable in cost, have health insurance coverage in place for the child(ren) that is not reasonable in cost but wish to continue providing coverage, or they have health insurance coverage available at a reasonable cost through an employer or other source.

 Health insurance is considered reasonable in cost if the annual cost does NOT exceed 5% of that parent’s gross income.  Health insurance is accessible if primary care services are available within thirty miles of the child’s home.  Health care coverage includes public health care plans through Ohio Medicaid (including Healthy Start).

My order contains a provision for cash medical support and child support.  I want to waive child support, can I also waive cash medical support?

If the child support order is owed to you, you may be able to waive or deviate the child support order, including cash medical support, through the court. If you receive public assistance and/or Medicaid, all or a portion of your child support may be assigned to the State of Ohio and you may not be able to waive or deviate the child support order, including cash medical support.

Important things to remember

Cash Medical Support is part of the overall child support obligation and remains at the same amount, regardless of insurance being provided. Cash Medical Support covers the out-of-pocket medical expenses.

 When the CSEA becomes aware of changes that affect a parent’s obligation to provide health insurance, the CSEA will notify both parents.

 Cash Medical Support may be assigned (paid) to the State of Ohio when the child is receiving Medicaid benefits.  When the child is NOT receiving Medicaid benefits, the cash medical support is paid to the family.

(Original subject content of this publication is property of the Ohio CSEA Director’s’ Association.  OCDA is not responsible for changes in subject content from the original version.)