Background
Billing and claims processing procedures widely used in private health insurance routinely, albeit inadvertently, prevent anyone insured as a dependent on someone else’s policy from obtaining sensitive services confidentially. One of the most frequent ways in which disclosure occurs is through explanation of benefits forms (EOBs) sent by insurers to policyholders after anyone covered under their policy obtains care. EOBs—which typically identify the individual who received care, the health care provider and the type of care obtained—essentially make it impossible for dependents, often minors and young adults, to obtain the confidential access to sexual and reproductive health care they need.
Several states have developed creative approaches to address these as well as broader confidentiality concerns—solutions that satisfy the needs of insurers, protect policyholders from unexpected financial exposure and, most importantly, facilitate access to confidential care for all covered individuals.
Highlights
- 13 states have provisions that serve to protect the confidentiality of individuals insured as dependents.
- 5 states allow individuals insured as dependents to request confidential communications from their insurance provider via a written request.
- 3 states have confidentiality protections specific to EOBs. These states allow insurers to mail an EOB directly to the patient instead of the policy holder. Insurance providers in New York and Wisconsin are not required to send an EOB to the policyholder if there is no balance due.
- 6 states explicitly protect the confidentiality of minors insured as dependents.
- 4 states have specific protections for minors seeking STI treatment.
- 3 states have protections for minors seeking any medical service.
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Topic
United States
Geography
- United States: Alabama, Alaska, Arizona, Arkansas, California, Colorado, Connecticut, Delaware, District of Columbia, Florida, Georgia, Hawaii, Idaho, Illinois, Indiana, Iowa, Kansas, Kentucky, Louisiana, Maine, Maryland, Massachusetts, Michigan, Minnesota, Mississippi, Missouri, Montana, Nebraska, Nevada, New Hampshire, New Jersey, New Mexico, New York, North Carolina, North Dakota, Ohio, Oklahoma, Oregon, Pennsylvania, Rhode Island, South Carolina, South Dakota, Tennessee, Texas, Utah, Vermont, Virginia, Washington, West Virginia, Wisconsin, Wyoming
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