Working With You To Build A Better Future

What is the birthday rule, and does it apply in divorce?

On Behalf of | May 11, 2020 | Divorce |

Divorce creates a lot of confusion, especially when children are involved. Just one of many things you and your child’s other parent will have to figure out is whose insurance will cover your child’s medical expenses?

Typically, when two parties to a couple have individual health insurance plans, the birthday rule applies. What is the birthday rule, and will it still apply in divorce?

The birthday rule

According to Insure.com, the birthday rule is a widely adopted rule that insurers use to coordinate the health benefits of dependents who are listed on more than one plan. Though any person, child or adult, can have coverage under more than one plan, insurers see such situations most often with children.

For instance, both you and your spouse may have listed your shared child as a beneficiary on your separate plans. To ensure that neither you nor your child’s doctor receives double the reimbursement, your plans must coordinate benefits. This where the birthday rule comes in.

So, what is the birthday rule? It is simple, really. Per the rule, the insurance plan of the parent whose birthday falls first in the calendar year is the primary health insurance plan. The rule does not take into consideration either parents’ age. For instance, if your birthday is January 1, 1980, and your spouse’s is June 29, 1976, your plan would prevail as your birthday comes first in the year.

The birthday rule and divorce

It would be nice if the birthday rule applied in divorce but, unfortunately, it does not. In divorce, the custodial parent’s plan pays first. If the custodial parent remarries and his or her new spouse has coverage, the new spouse’s plan pays second. The noncustodial parent’s plan pays last.

Archives