In a case where both personal and spouse's health insurance policies are in effect, which policy pays first in the event of a claim?

When both an individual and their spouse have health insurance policies in place, the general rule for determining which policy pays first is known as the "birthday rule." Under this guideline, the individual's own health insurance policy pays first, making this answer correct.

Essentially, the birthday rule states that if a dependent child is covered under both parents' policies, the coverage associated with the parent whose birthday falls earlier in the calendar year is primary. This logic extends to situations involving both spouses, where typically the individual's policy acts as the primary coverage.

Understanding this hierarchy is crucial for individuals managing multiple health insurance policies, as it affects how claims are processed and what out-of-pocket costs a policyholder may encounter.