The Birthday Rule for Newborn Baby Insurance

The Birthday Rule for Newborn Baby Insurance Coverage
•It is a set of rules that determines which parent’s insurance coverage will act as the primary insurer for a child when both parents have coverage with the insurance. As it can be confusing for the provider to decide which insurance will act as primary. Insurance companies use specific guidelines to determine primary and secondary coverage.

Earlier month birthday

As per the birthday rule, the parent whose birthday comes first in the year his/her health plan considers primary insurance while the other parent’s health plan considers secondary insurance.

Imagine a 8-year-old boy named John has coverage through both of his parent’s Health insurance plans. His mom was born on March 12, 1978, and his dad was born on June. 17, 1980. His Mom’s insurance will pay first for John because his mother was born earlier in the year than his Father.

 If each parent birthday coincides

•If both parents have the same birthday, the parent who has insurance coverage for longer duration will act as primary and other will act as secondary.

Imagine a 8-year-old boy named John has coverage through both of his parent’s Health insurance plans. His mom was born on March 12, 1978, and his dad was born on March. 12, 1980. His Mom’s insurance will pay first for John if his mother has insurance coverage for longer period.

Divorced or Separated Parents

When parents are divorced or legally separated, generally, the parent who has primary physical custody will act as primary otherwise if the Court is involved in the process, then insurers need to follow that directive because the COB (coordination of benefits process) comes into the picture in this scenario.

You may also like:

Medicaid and Spend Down

 

By recei

Leave a Reply

Your email address will not be published. Required fields are marked *