8.4 Medical Support


The federal IV-D child support program requires that each state establish and enforce medical support. For years, this task has been exceedingly difficult. In recent years, the federal CSE Office worked closely both within and outside the program to improve the ability to actually provide “meaningful medical support for children.”1 Most recently, the federal CSE Office released sweeping changes to medical support regulations2 and is doing its best to implement many of the recommendations of the Medical Support Working Group.


The District CSE Office will petition the District Court for medical support for each child involved in a child support case. The District Court will determine if health insurance is both reasonable and accessible as defined by Wyoming Statutes before ordering the custodial or non-custodial parent to provide health insurance.

A health insurance premium is considered reasonable if the cost to provide health care coverage or to provide cash medical support for children is no more than 5% of the providing party’s gross income, and it is considered accessible if it is available and provides coverage for the child residing within the geographic area covered by the insurance plan.

Note: Medicaid and Kid Care (Wyoming’s State Children’s Health Insurance Program (SCHIP)) are not substitutes for the parent’s obligation to provide medical support for the child(ren).

The District Court will take into account the circumstances of both parents to determine how best to ensure the child is covered and may order either parent to provide medical support. Appendix 8.F – Medical Support Matrix provides guidelines that the District Court or District CSE Attorney may use to determine if either parent can provide health insurance.

Once the District Court orders health care coverage, the case worker will update POSSE to ensure the District CSE Office begins enforcing the medical support order.

Cross Reference

Appendix 8.F – Medical Support Matrix


1The 2nd strategic initiative for the federal CSE Office as discussed in the National Child Support Enforcement Strategic Plan for FFY 2005 – 2009.

2Final medical support regulations published July 21, 2008.

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