image Visit coronavirus.govVisit disclaimer page for the latest Coronavirus Disease (COVID-19) updates.
View ACF COVID-19 Responses and Resources
« Back to Search

National Medical Support Notice Forms & Instructions

OMB 0970-0222 & 1210-0113

Published: March 5, 2020

These documents serve as legal notice that the employee identified on this National Medical Support Notice is obligated by a court or administrative child support order to provide health care coverage for the child(ren) identified on this Notice. This National Medical Support Notice replaces any Medical Support Notice that the Issuing Agency has previously served with respect to the employee and the children listed on this Notice.

The Notice has two parts:

View the Medical Support – FAQs for answers to employers’ common questions.

Last Reviewed: March 5, 2020

Was this page helpful?

Step One
I found this page helpful because the content on the page: (check all that apply)
I did not find this page helpful because the content on the page: (check all that apply)

Your feedback is important to us and will help improve our website. Thank you!

Step Two
Back to Top