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52nd Judicial Circuit Court-Family Division

Office of the Friend of the Court

Child support orders entered by the Circuit Court also include provisions specific to medical support.  This includes a parent’s duty to provide healthcare coverage to a child as well as reimbursement for uninsured medical expenses not covered by insurance. 



NATIONAL MEDICAL SUPPORT NOTICE:  Michigan law requires each child support order to contain provisions regarding medical insurance.  Parents are required to obtain and/or maintain health care coverage for children when that coverage is available at a reasonable cost as a benefit of employment. 


Parents working together can control health care costs, make health care decisions that are in the best interests of their children including the use of favored doctors and the ability to receive care in the area in which a child lives.  Mutual decisions also reduce disputes over health care related expenses. 


Federal and state law requires that the Friend of the Court notify parents’ employers to enroll dependent children in available health care coverage.  The National Medical Support Notice (NMSN) is the form sent to the employer.  This notice is sent whenever a parent changes employment.  Michigan’s Notice of Order for Dependent Health Care Coverage complies with the standards established by the federal government under 29 USC 1169. 


How to object to the Notice of Order for Dependent Health Care Coverage.


The NMSN is to be sent to the employer within two business days of the Friend of the Court learning of new employment for the parent. Parents will be sent a copy of the notice if the Friend of the Court has current addresses. A parent has fourteen (14) days to file an objection with the Friend of the Court. The objection to the National Medical Support Notice:

  1. Must be in writing

  2. Must clearly be titled as an administrative review request.

  3. Must clearly request a review of the NMSN.

  4. Must be signed and dated by the requesting parent.

  5. Must only object because the cost is unreasonable.

  6. Must include the case number.


How to amend the health care provisions of the court order:


Parents may wish to ask the court to change the requirement that both parents maintain health care coverage through employment. A new spouse could be maintaining coverage or the parents could agree that only one needs to maintain coverage at the present time. If a letter of agreement is signed and submitted by both parents, the Friend of the Court may prepare an order designating the insurance policyholder. You may also ask your attorney to file the motion or petition, or request forms and instructions from the Friend of the Court.


How to supply input to assist the Friend of the Court if it must select from healthcare options available under the employer’s healthcare plan:

Advise the Friend of the Court in writing within fifteen (15) days of your preference if you are the custodial parent. You will have to ask the employer or the other parent what options are available. Indicate your preferences in order. The Friend of the Court may find that an option does not meet the reasonable cost test.

How reasonable cost is determined:

Pursuant to the 2021 Michigan Child Support Formula Manual, the reasonable cost for providing private health care coverage may not exceed six percent (6%) of the gross income of the providing parent.

What if I qualify for public healthcare coverage:


Public healthcare coverage including medical insurance available through the State of Michigan such as Medicaid may meet a parent’s obligation to provide healthcare coverage. 



UNINSURED MEDICAL EXPENSES:  Uninsured medical expenses may be submitted through the Friend of the Court office for assistance in requesting reimbursement from the other parent for expenses not covered by insurance.  The term “medical” includes treatments, services, equipment, medicines, preventative care, similar goods and services associated with oral, visual, psychological, medical, and other related care, provided or prescribed by health care professionals for the children.


            MCL 552.511a


Your support order may contain an annual ordinary medical expense (OME) provision.  If your order does contain this provision, you cannot seek medical/health care expense reimbursement from the other parent until the annual ordinary threshold amount has been spent.  One way of thinking of this is as a deductible – you cannot seek reimbursement from your co-parent until you’ve spent the deductible.  If your order does not have a charge for ordinary medical expenses you do not have to meet the annual threshold.


            Request for Healthcare Expense Payment



A major typically non-emergency expense for children is orthodontic care. If you and your co-parent have joint legal custody, the decision to proceed with treatment and incur this expense must be made together. It is a major financial commitment.  If you proceed with such treatment without first securing the agreement of your co-parent or an order from the court, you will likely be denied reimbursement.  Parents having sole legal custody do not need co-parent consent. 


            Uninsured Medical Expenses Ortho



The annual threshold amounts are:


      Number of Children        Annual Threshold*

                     1                                    $454

                     2                                    $908

                     3                                    $1362

                     4                                    $1816

                     5 or more                     $2269                            

       *2021 Michigan Child Support Formula Guidelines


If you require additional information or assistance regarding medical support including healthcare expenses, please contact the Friend of the Court Accounts Payable Clerk. 

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