In cases involving minors and young adults who are covered under their parent’s insurance plans, there is something called the birthday rule that determines which plan is primary and which plan is secondary.
The Birthday Rule
When a child is covered under both parents' health plans, the parent whose birthday falls first in the year (month and day only) is the primary insurance. The other parents' insurance provides secondary coverage.
Example: Patient's mother's birthday is October 11, and patient's father's birthday is April 24. In this case, the father's insurance would be the primary insurance and the mother's insurance would be the secondary.
If the parents share a birthday, the primary plan would be the plan which has been effective longer.
Example: Mom and Dad were both born on May 3, however Mom's plan has been active since 2013, and Dad's plan has been effective since 2019. In this case, Mom's plan would be primary and Dad's plan would be secondary.
If parents are divorced, there may be a court order to determine which insurance plan is primary. If there is no court order, the birthday rule would apply as in the first example.
If one parent is covered under COBRA, the other insurance plan will always be primary.
If a young adult (under the age of 26) is married and covered by both a parent and a spouse, the plan that has been effective longer will be primary. If the plans started the same day, the birthday rule will apply. However, if the young adult is covered on their health plan through their employer, that coverage would be primary and their parent/spouses' coverage would be secondary.
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