Family Secrets: Adult Children's Health Insurance Claims Can Be Private
"While mom and dad may be footing the bill, they do not have the right to an explanation about the bill they are paying," says Katherine Woodfield, a health insurance broker in Gladstone, N.J., and author of "Don't Buy That Health Insurance: Become an Educated Health Care Consumer."
Health care providers can only release information they feel is medically relevant and to which the patient would not reasonably object. However, if the adult child does not want any information shared, the provider must honor that request.
Yet the issues aren't always black and white when it comes to health insurance claims for adults who remain on a parent's plan and are worried about privacy. HIPAA's purpose is to ensure the confidentiality of the insured. It is meant to keep information private from associates and third parties that don't need to know -- not necessarily from people within the same policy.
Health insurance companies, while not expressly mentioned in that law, likewise should not disclose any information about the bills they are asking the parents to pay. The insurance company must follow the intent of the law -- which is why an EOB is coded in a way that doesn't explain what the charges are for.Here's more about health information privacy from the Department of Health and Human Services. That said, adults who are on a parent's health policy and are concerned about privacy should go the extra mile. When seeing a provider:
- Make your privacy request to the doctor so it's in your chart.
- Talk to the front desk and request to have the EOB sent directly to you, not the policyholder.
- Call the customer service 800 number of your health plan before you visit the doctor and have them note that EOBs, balance bills or co-pay statements should not go to the policyholder but be sent directly to you.
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