The health law opened the door for millions of young adults to stay on their parents’ health insurance until they turn 26. But there’s a downside to remaining on the family plan. Chances are that mom or dad, as policyholder, will get a notice from the insurer every time the grown-up kid gets medical care, a breach of privacy that many young people may find unwelcome.
With this in mind, in recent years a handful of states have adopted laws or regulations that make it easier for dependents to keep medical communications confidential.
Federal law does offer some protections, but they are incomplete, privacy advocates say. The Health Insurance Portability and Accountability Act of 1996 is a key federal privacy law that established rules for when insurers, doctors, hospitals and others may disclose individuals’ personal health information.
It contains a privacy rule that allows people to request that their providers or health plan restrict the disclosure of information about their health or treatment. They can ask that their insurer not send the ubiquitous “explanation of benefits” form describing care received or denied to their parents, for example. But an insurer isn’t obligated to honor that request.
In addition, HIPAA’s privacy rule says that people can ask that their health plan communicate with them at an alternate location or using a method other than the one it usually employs. The insurer has to accommodate those requests if the person says that disclosing the information would endanger them.
Concerns by young people that their parents may find out about their medical care leads some to forgo the care altogether, while others go to free or low-cost clinics for reproductive and sexual health services, for example, and skip using their insurance.
Restricting access to EOBs can be challenging to administer, said Clare Krusing, a spokesperson for America’s Health Insurance Plans, a trade group. A health plan may mask or filter out a diagnosis or service code on the EOB, but provider credentials or pharmacy information may still hint at the services provided.
There’s also good reason in many instances for insurers and policyholders to know the details about when a policy is used, experts say. Policyholders also may have difficulty tracking cost-sharing details such as how much remains on the deductible for their plan.
In addition, “if a consumer receives a filtered or masked EOB, he or she has no way of knowing whether their account has been compromised or used as part of fraudulent activity,” Krusing said.
This article originally appeared on Crestview News Bulletin: Privacy protections for young adults' health info