A lot of couples put their children as dependents in both their group health insurance coverage to get the most out of the benefits.
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Health Insurance Regulations
A lot of couples put their children as dependents in both their group health insurance coverage to get the most out of the benefits. Still, if there is no organized method to assist the health insurance companies manage coverages, it could end up that insured or the doctors will be paid more than what they actually spent and thus profit from the policy.
To avoid this, health insurance companies normally assign each parent's plan either primary or secondary and the doctor's assistant requests for more data regarding the primary and secondary coverage. All covered expenses will be paid to the authorized limits of the policy by the primary coverage. If there are excesses to the limits, then that is where the secondary policy will come in.
The principal's birthday will decide which health insurance will be the primary plan
The parent's birthday will determine which policy will be designated as primary. The older insured parent will be designated as the primary plan and the younger parent will be the secondary plan.
However, there could also be some exceptions to this rule:
- If both parents have exactly the same birthday then parent who has been enrolled in the plan longer will be designated as primary coverage for their children.
- If one of the spouses is covered by a health insurance by his present employer and the other spouse has coverage from a past employer, then the spouse with health insurance from current employer will be designated as the primary coverage.
- If the spouse divorce or separate, the insurance coverage of the parent who wins custody of the children will be the primary coverage. If the parent who has the custody of the children gets married again, the new husband's or wife's plan automatically becomes the secondary coverage. The other parent's health insurance can supply a third layer of health insurance coverage. This payment arrangement can be reversed by a court order on divorce rulings or through the agreement of the parties involved but all the health insurance company should be duly advised.
These are rules promulagated by the health insurance companies but not necessarily the law!
Remember that these are procedures commonly implemented by the insurance companies for purposes of regulation but these are not necessarily an official ordinance. The procedure may differ from one insurance company to the other. Make sure that you study your policy prudently so you will understand their policy on dual coverage. If there is something that is not clear to you, you can ask for the assistance of your benefits in charge or the insurance company's customer service department.
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