What rule determines the primary insurance for a dependent child when both parents have coverage?

What rule determines the primary insurance for a dependent child when both parents have coverage?

• A. Age rule
• B. Coverage order rule
• C. Birthday rule
• D. First to file rule

Answer: (C)

The birthday rule is a guideline used to determine which parent's health insurance plan serves as the primary provider for a dependent child when both parents have coverage. According to this rule, the plan of the parent whose birthday falls earlier in the calendar year is designated as the primary insurance for the child. This method is practical because it provides a straightforward way to decide insurance responsibilities without delving into complex factors like the amount of coverage or the type of policy each parent holds. It helps ensure that there’s clarity in coordinating benefits and reduces confusion in claims processing. For instance, if one parent's birthday is in March and the other in December, the coverage associated with the parent with the March birthday would be primary. This method is widely accepted and utilized across many insurance policies, making it an important concept for anyone working in healthcare access or insurance coordination.

The birthday rule is a guideline used to determine which parent's health insurance plan serves as the primary provider for a dependent child when both parents have coverage. According to this rule, the plan of the parent whose birthday falls earlier in the calendar year is designated as the primary insurance for the child.

This method is practical because it provides a straightforward way to decide insurance responsibilities without delving into complex factors like the amount of coverage or the type of policy each parent holds. It helps ensure that there’s clarity in coordinating benefits and reduces confusion in claims processing.

For instance, if one parent's birthday is in March and the other in December, the coverage associated with the parent with the March birthday would be primary. This method is widely accepted and utilized across many insurance policies, making it an important concept for anyone working in healthcare access or insurance coordination.