If the patient’s spouse or parents have an additional insurance plan, there could be multiple insurance plans which could cover the patient. It is very important to correctly determine which is the primary insurance and which is secondary.
The “birthday rule” can be helpful in establishing the proper coverage. Generally, when both spouses have insurance coverage, the husband’s insurance plan is the primary for him, and the wife’s insurance plan is the primary for her. For dependents, the primary insurance company is determined by the insured’s birthdate, which is referred to as the “birthday rule.” The primary insured is the person whose birthdate (month and day) comes earliest in the year.
For example, if the father’s birthday is September 20 and the mother’s birthday is February 5, the mother’s insurance would be the primary plan for their dependents since her birthday is earlier. The year of birth is not applicable.
Chirocode addresses how to handle multiple plans in the 2016 ChiroCode Deskbook and more!