DC Law 17-128, the Child Support Compliance Amendment Act of 2007, provides that every child support order must contain a provision for medical support for each child.  This could be a provision for health insurance, cash medical support, or both.  In all cases in which health insurance coverage is available at a reasonable cost, the court will order either or both parents to provide health insurance coverage.

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

Frequently Asked Questions -- Medical Support

How is medical support defined?

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, for extraordinary medical expenses or for other medical costs not covered by insurance

Reasonable Health Insurance Coverage

Health insurance coverage costs that do not exceed five percent (5%) of the parent’s gross income

Accessible Health Insurance Coverage

Health insurance coverage that, based on the work history of the parent providing the coverage, meets both of the following criteria:

  • will be available for at least 1 year
  • is available because 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 that offers a broad and inclusive array of health services 

Extraordinary Medical Expenses

Uninsured or unreimbursed medical expenses in excess of $250 per year per child that include the following:

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

How will a parent's employer be notified about medical support?

When the support order requires a parent to provide health insurance coverage for the child(ren) and employer information is known, CSSD will send a National Medical Support Notice (“NMSN”) to the employer.  The employer will receive a NMSN unless the support order directs enrollment of the child(ren) in alternative coverage.

Also, when a parent, who is ordered to provide medical insurance, becomes a newly hired or re-hired employee, CSSD will submit a NMSN to that parent's new employer within 2 business days of the employer updating the DC Directory of New Hires (“NDNH”) with the information about that parent's hiring.

What are a parent's responsibilities?

When the court orders one parent or both parents to obtain or maintain health insurance through an employer, the ordered individual is responsible for ensuring that the employer/payroll office processes the NMSN in a timely manner.  If there is more than one health insurance plan available for a parent to select, the parent must to choose the preferred plan within 10 business days or CSSD will select a plan.