When the birthday rule is used to determine which policy is primary and which is secondary?
Asked by: Kathryn Ernser V | Last update: December 9, 2025Score: 4.6/5 (2 votes)
When the birthday rule is used to determine which policy is primary and which is secondary, it is the policy of the person who is the oldest that is considered primary.?
The birthday rule applies when a child is covered under both parents' health plans. Primary coverage comes from the plan of the parent whose birthday (month and day only) comes first in the year, with the other parent's health plan providing secondary coverage.
How do you determine which insurance is primary and which is secondary?
The insurance that pays first is called the primary payer. The primary payer pays up to the limits of its coverage. The insurance that pays second is called the secondary payer. The secondary payer only pays if there are costs the primary insurer didn't cover.
What is the birthday rule used to determine?
The birthday rule determines the order that the insurance companies will pay benefits when a dependent child is covered by two health insurance plans. The health insurance plan of the parent whose birthday month and day occurs earlier in the calendar year is primary.
When there is secondary coverage, the birthday rule designates primary coverage to the patient.?
According to the birthday rule, primary coverage is given by the parent's plan whose birthday comes before the other. While birth years are not considered, the day and month of a parent's birthday determine the coverage. The parent whose birthday comes second in the year will provide secondary coverage.
Health Insurance Birthday Rule
What is the birthday rule for primary insurance?
The Birthday Rule states that for a dependent child of parents who are not legally separated or divorced, the insurance of the parents whose birthday falls earlier in the year (not the actual year but the month in which the parent was born) is the primary carrier.
When using the birthday rule, which parent is designated as providing primary coverage in Quizlet?
Under the birthday rule, the health plan of the parent whose birthday comes first in the calendar year is designated as the primary plan. There are some exceptions to the birthday rule. If both parents have the same birthday, the health plan that has covered the parent the longest is considered the primary plan.
Which of the following describes the birthday rule?
The Birthday Rule indicates that the plan of the parent whose date of birth (month and day) falls earlier in the calendar year is the primary plan for dependent children.
How is cob determined?
In most cases, the health plans will perform coordination of benefits using the “birthday rule.” This means if your birthday month occurs earlier in a calendar year than your spouse or partner's, your plan will be primary and the other plan will be the secondary payor.
When applying the birthday rule of policyholders?
The 'birthday rule' is a term used to determine coordination of benefits in health insurance. When a family is covered by more than one health insurance plan, this rule is applied. In the case where policyholders have identical birthdays, the policy in effect the longest is considered as the primary policy.
How is primary and secondary dental insurance determined?
General Coordination of Benefits Rules
Employee/Main Policyholder - When both plans have COB provisions, the plan in which the patient is enrolled as an employee or as the main policyholder is primary. The plan in which the patient is enrolled as a dependent would be secondary.
What is the process of determining which company is primary and which is secondary?
Coordination of benefits is the process insurance companies use to determine how to cover your medical expenses when you're covered by more than one health insurance plan. It clarifies who pays what by determining which plan is the primary payer and which is secondary.
Can I drop my employer health insurance and go on Medicare Part B?
Once you stop working (or lose your health insurance, if that happens first) you have an 8-month Special Enrollment Period (SEP) when you can sign up for Medicare (or add Part B to existing Part A coverage).
How to determine which policy is primary?
The primary insurance policy is the policy that claims will be billed to first. The claim will process according to the patient's insurance plan with the primary insurance and payments will be paid according to their benefits. Then, the claim will be sent on to the secondary insurance company.
What happens if I have a baby while on my parents' insurance?
Will my parent's plan cover my baby after he's born? Your parent's plan, regardless of the source, is generally not required to cover your child as a dependent. Depending on your income, your child may be eligible for coverage under the Medicaid/CHIP program in your state.
How do you determine primary and secondary?
To determine if a source is primary or secondary, ask yourself: Was the source created by someone directly involved in the events you're studying (primary), or by another researcher (secondary)?
What is the birthday rule?
The rule requires that the parent whose birthday comes first in the calendar year would cover the cost of delivering the new baby regardless of whether one parent has better health coverage for a newborn than the other.
What determines primary and secondary insurance?
If you have coverage under a plan from your employer in addition to a spouse's or parent's plan, your own plan will be primary and the other plan will be secondary. This is also true if the additional coverage is with TRICARE or Medicaid, as those plans are always the secondary insurer if you have other coverage.
How do you identify a cob?
Most cobs are larger than ponies but still relatively compact. They have short legs with generous bone and a stocky build that makes them strong for their size. While well-defined withers are desirable, many cobs have very little wither definition.
When the birthday rule is used to determine which policy is primary?
Final answer: The birthday rule determines primary policy based on the parent whose birthday comes first in the calendar year, not by who is the oldest.
What is the birthday rule quizlet?
Birthday rule. The guideline that determines which of two parents with medical coverage has the primary insurance for a child; the parent whose day of birth is earlier in the calendar year is considered primary. Gender rule.
What is the birthday rule for Medicare?
A 'birthday rule' in eight states allows users to switch Medigap plans. Of those 15 states, eight have implemented a “birthday rule” that allows Medigap enrollees to switch Medigap plans without medical underwriting around the time of their birthday.
Which is an interpretation of the birthday rule regarding two group health insurance policies?
Final answer: The birthday rule determines which parent's health insurance is primary when both parents cover the same child. Under this rule, the parent whose birth month and day occurs earlier in the calendar year is designated as the primary policyholder.
Is my parents insurance primary or secondary?
Generally, the plan belonging to the parent whose birthday comes first in a calendar year is designated as the primary insurance plan, and the plan belonging to the parent with a later birthday becomes the secondary insurance plan.
What is the birthday rule quizlet Chapter 17?
the rule stating that the primary insurance plan for all dependents will be that of the policyholder whose birthday comes first in the year.