Wiki need assistance in the birthday rule under health insuranc3e

[cashby@collectivercm.com]

Hello there,

Have a question as to how the insurance companies choose primary and secondary for married couples and/or older children with respect to who's insurance is first for billing purposes.

thank you

cynthia

 

[thomas7331]

What is the question? Different insurance companies may have different guidelines for this and there may be exceptions based on types of policies. But the general rule is that the policyholder's own policy is always primary, and then the policy on which the patient is a dependent will always be secondary. So for married couples, each person will have their own policy as primary, and their spouse's policy as secondary. The birthday rule applies in the case where the patient has two policies and is the dependent on both (e.g. a child covered by both parents' policies). In that case, the primary will be the policy of the parent whose birthday falls earliest in the year (i.e. looking only at the month and day, not at the year, of the parent's birthday).