In a case of a 7-year-old child with divorced parents, who has the primary insurance coverage?

In a case of a 7-year-old child with divorced parents, who has the primary insurance coverage?

• A. Aetna
• B. United Health Care
• C. Travelers
• D. Commerce Benefits

Answer: (B)

In situations involving children from divorced parents, the determination of primary insurance coverage typically follows specific guidelines. The most common approach is to establish which parent's insurance plan is considered the primary coverage based on a set of criteria, which often include the birthday rule. This rule designates the parent whose birthday occurs first in the calendar year as the provider of the primary insurance coverage. In this scenario, the fact that United Health Care is chosen as the correct answer suggests that, according to the guidelines provided by the insurance plan or the birthday rule, the child's parent who holds this policy is determined to have the primary coverage. It’s essential to verify the terms of the individual insurance plans and any agreements between the parents regarding who provides insurance for the child to ascertain the most accurate primary insurer. Knowing which insurance plan is primary helps in managing claims and preventing confusion regarding billing and coverage, making it integral for patient service representatives in medical practices to understand these nuances when processing insurance information for minors.

In situations involving children from divorced parents, the determination of primary insurance coverage typically follows specific guidelines. The most common approach is to establish which parent's insurance plan is considered the primary coverage based on a set of criteria, which often include the birthday rule. This rule designates the parent whose birthday occurs first in the calendar year as the provider of the primary insurance coverage.

In this scenario, the fact that United Health Care is chosen as the correct answer suggests that, according to the guidelines provided by the insurance plan or the birthday rule, the child's parent who holds this policy is determined to have the primary coverage. It’s essential to verify the terms of the individual insurance plans and any agreements between the parents regarding who provides insurance for the child to ascertain the most accurate primary insurer.

Knowing which insurance plan is primary helps in managing claims and preventing confusion regarding billing and coverage, making it integral for patient service representatives in medical practices to understand these nuances when processing insurance information for minors.