What does the birthday rule determine?

The birthday rule is a guideline used in the coordination of benefits when a child is covered under two health insurance plans, typically those of both parents. Specifically, it determines which parent's insurance is primary when both have dependent coverage for their child. Under the birthday rule, the plan of the parent whose birthday falls earlier in the calendar year is considered the primary insurance. This rule helps streamline the process for submitting claims and receiving payment, making it easier for families to manage care without confusion over which insurance should be billed first.

The other options do not relate to the birthday rule: eligibility for Medicare is based on age and specific criteria set by the program, the quality of care provided is not determined by this rule but rather encompasses broader healthcare metrics, and annual benefits for healthcare providers pertain to reimbursement structures and contract specifics, which are unrelated to the coordination of benefits for dependents.