The medical portion of an order consists of four sections:
- Medical Support Definitions
- Medical Support Order
- No coverage or coverage lapsed
- Additional Medical Support Orders
Section A – Medical Support Definitions spells out what is considered to be reasonable in cost and accessible health care coverage.
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.
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.
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.
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.
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.
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.
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.
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.
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).
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.
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.
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.
In paragraph 2 it explains the exchange of information for uncovered medical expenses.
In paragraph 3 it explains that the parties are to report any changes to health care coverage 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.
Paragraph 4 is for any other orders for medical that have not been addressed.
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.