The Labrelle family consists of John and Mary, a married couple, and their two children, Brandon and Taylor. Both parents have medical insurance through their respective employers. The children are dependents on both plans. How is the primary insurance determined for the children if one of them receives services? How is the primary insurance determined for the parents if one of them receives services?
What will be an ideal response?
The primary insurance for the children is determined using the birthday rule. The parent whose birthday occurs first in the calendar year is primary; the other parent’s policy is billed as secondary. If one of the parents receives medical services, the plan for which the patient is the policyholder (through his or her own employer) is primary, and the other policy, through the spouse, is billed as secondary.
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