How to Determine Primary Insurance

Selecting and billing the proper primary insurance company will save you time, money and headaches. When both spouses work and have insurance through their employers, it can become challenging to determine the primary insurance for yourself and possibly your children. This situation becomes even more confusing when the parents are separated or divorced. Thankfully, the Employee Retirement Income Security Act established a specific set of guidelines, including the "birthday rule" for determining primary insurance when children are involved.

Instructions

• 1

  Bill your personal health insurance policy for all of your medical expenses. When the policy is through your employer, it is your primary insurance.

• 2

  Determine whose birthday, you or your spouse's, comes first. The first birthday of the year is also the primary policyholder for your family. If you and your spouse are divorced, then the bill is sent to the custodial parent's insurance first.

• 3

  Send insurance claims to a group plan first. Group plans trump individual and Medicaid coverage.

• 4

  Bill your expenses to the policy with the best plan or lowest co-pay when all other methods do not apply. This practice minimizes your out-of-pocket cost.