I heard that if both my wife and I have health insurance that covers our kids, something called "the birthday rule" applies. What does that mean?

The "birthday rule" is widely used among health insurance companies to determine which of two health insurance plans is considered the "primary" policy.

When a family has more than one health insurance policy, one is considered primary while the other is secondary. The primary plan will pay for medical bills first. Then, whatever is not paid for by the primary plan may be covered under the secondary policy. This is what is referred to as coordination of benefits.



The birthday rule usually comes into play when both parents maintain health insurance for their children. Health insurers look at the parents' birth dates (month and day), and the policy from the parent with the earlier date is considered primary.

Again, insurance companies are only looking at the month and day of your birth, not your actual age. In other words, it doesn't matter which parent is older, only which parent celebrates his or her birthday earlier in the year.

For example, let's say you were born on June 1, 1965, and your spouse was born on April 20, 1970. Your spouse's policy would be considered primary.

The birthday rule isn't a law. It is an insurance industry practice, and there are exceptions to the rule. It is best to check with your health insurance company if you have any questions regarding your insurance status or the claims process.