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How to Complete the Medical Section of an Order

The medical portion of an order consists of four sections:

  1. Medical Support Definitions
  2. Medical Support Order
  3. No coverage or coverage lapsed
  4. Additional Medical Support Orders

Section A – Medical Support Definitions spells out what is considered to be reasonable in cost and accessible health care coverage.

Image of the text of the Medical Support definitions part of the order.

Section B – Medical Support Order is the place in the order that we specify who is to carry the health care coverage and the type of coverage.

Employer Sponsored Coverage

The first paragraph of this section of the order deals with employer sponsored health care coverage. If either of the parties currently have insurance or insurance is available through their employer at a reasonable cost and it is accessible this section will be marked. Either one or both parties may be selected.

Image of the text of the order that covers Employer Sponsored Health Coverage.

The next paragraph of this section of the order is when there is employer sponsored health care coverage and the parties agree (or the court orders) to exceed the reasonable cost limits.

Image of the text of the order that covers the Employer Sponsored Health Coverage when the cost of  the insurance exceeds 5% of the reasonable cost of insurance.

Alternative Healthcare Coverage

The third paragraph addresses other health care coverage. This would be for when the child(ren) are covered on a plan that is not an employer sponsored plan. For example, if the party took out a private plan from an insurance company.

Image of the text of the order that covers when there is Other Health Care Coverage

The next section of the order is for when the child(ren) are covered under Indian Health Services (IHS). Check the first box if the child(ren) are covered with IHS. Then check either the mother and/or father box. Write in the name of the tribe that the parties are affiliated with.

Image of the text of the order that covers Indian Health Services where the worker can enter the tribal affiliations of the mother and/or father

If the CP requests that additional health care coverage (or the court orders) then select the next box and select who will be providing the additional coverage.

Image of the text of the order that covers when the children are covered by Indian Health Services but additional coverage is being ordered

The next paragraph of the order is for when the child(ren) are covered under TriCare. They may be covered with either parent or a third party, such as a step-parent. Check the box(es) that apply to the case. Write in the name and relationship of the party that is the military member/sponsor.

Image of the text of the order that covers military health care coverage through the Defense Enrollment Eligibility Reporting System

Third Party Coverage

The next paragraph of the order is for when the child(ren) are covered by a third party and the medical support cannot be enforced through the use of the National Medical Support Notice (MED5). An example of this would be if the NCPs current spouse is covering the child(ren) on their insurance with their employer.

Image of the text of the order that covers when there is Third Party Health Care Coverage that cannot be enforced with the National Medical Support Notice

SoonerCare (Medicaid)

The next paragraph will be completed when the child(ren) are covered under SoonerCare or another state’s Medicaid program. Check the boxes that apply to the case and write in the name of applicant for services. If the only coverage available is SoonerCare cash medical will also need to be ordered.

Image of the text of the order that covers when the children are covered under a Government Medical Assistance Program

Cash Medical

Next is the Cash Medical portion of the order. When cash medical is being ordered check the top box next to cash medical and then check the box for the reason that cash medical is being ordered. If permanent cash medical is being order then the boxes next to the next two paragraphs will be check (in the red box in the image below).

Image of the text of the order that covers when Cash Medical Support is ordered

The next two paragraphs spell out how the cash medical support will be paid and how to terminate the cash medical portion of the order.

Image of the text of the order that covers how the cash medical support is included in the guidelines and how to terminate cash medical support

Section C – No coverage or coverage lapsed. This is the place in the order where we address what is to happen when there is no coverage available or if the current coverage lapses.

In this part of the order indicate what is to happen if/when there is no coverage or lapse in coverage. Either mother, father or both may be selected.

Image of the text of the order that covers when there is no coverage or if there is a lapse in coverage

Section D – Additional Medical Support Orders. This is the section of the order where we indicate the percentage share of non-covered expenses. It also spells out the responsibilities of the parties for uncovered expenses. Fixed medical expenses are addressed in the section of the order. It also includes a space to write in anything additional orders for medical that are not covered elsewhere in the order. 

In paragraph 1 enter the percentage share from the guidelines for both the father and the mother.

Image of the text of the order that covers Additional Medical Support orders paragraph 1 where the percentage share cost is added to the order

In paragraph 2 it explains the exchange of information for uncovered medical expenses.

Image of the text of the order that covers Additional Medical Support Orders paragraph 2 where the order explains how the exchange of information should take place

In paragraph 3 it explains that the parties are to report any changes to health care coverage within 30 days.

Image of the text of the order that covers Additional Medical Support orders paragraph 3 that states that any change in health care coverage must be reported within 30 days

In paragraph 4 fixed medical expenses are addressed. This section is only used when there are fixed medical expenses that need to be addressed. Check the box and fill in the reason for the fixed medical expenses. Add the amount of the fixed medical from the guidelines. If the fixed medical is to be ongoing with no end date leave the rest of this area blank. If this is for something that will end then complete the blank for the date that it will be terminated and the amount that the child support will be after the termination of the fixed medical.

Image of the text of the order that covers Fixed Medical costs

Paragraph 4 is for any other orders for medical that have not been addressed.

Image of the text of the order that covers other orders pertaining to health care coverage that are not addressed elsewhere in the order

Multiple health care coverage may be selected when filling out the order. Complete the order with all that apply to the case. The cheat sheet How to Complete The Medical Portion of a Child Support Order (PDF) may be of help when filling out the order.