Navigating Insurance
as a Teen or Young Adult
Insurance can be so confusing - especially when it comes to figuring out privacy! Here's some information to help.
Insurance Basics
Health Insurance is something designed to protect you from large hospital bills, in case you get unexpectedly sick. You pay a small amount every month (think of it as an investment in case of an unexpected illness). Your insurance company then protects you from large bills by paying the bulk of those unexpected costs.
In the United States, everyone is not automatically given health insurance. Some jobs help you pay for health insurance, but not all. But, below the age of 21, you are guaranteed health insurance coverage from most state governments. Below the age of 26, because of the Affordable Care Act, you might be able to remain on your parent’s insurance (if they have private insurance).
What is Private vs. Public Health Insurance?
In simple terms, the difference is who pays the monthly costs of insurance.
In private insurance, you or your parents are paying the monthly fee, or premium. In many cases, an employer will pay a portion of this monthly cost and provide their employees with health insurance.
In public insurance, the government pays the monthly fee. In many cases, you must meet state-specific criteria to be eligible for this type of insurance. In this type of insurance, you receive more privacy, because no one receives a list of all of the treatments and medications you might have received at the doctor's office.
How do you maintain privacy on Private Insurance?
Privacy in Maryland on Private Insurance
Know your State policies on Obtaining Privacy in Healthcare
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Maryland: The State of Maryland allows insurance companies to give your protected health information to the primary owner of the insurance policies, in the form of an EOB, such that the primary owner knows what and how much they are paying for.
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S.B. 790 Laws: An enrollee (you) who is dependent on a parent’s insurance (the primary owner) are allowed to request confidential communications between you and the insurance company.
TLDR: You can get the EOBs sent directly to you (rather than to a parent)
and the insurance company is required to accept it.
Requesting Private Communication with your Insurance Company
Call your insurance company:
Use the number on the back of the card (see right upper corner) or by googling the insurance customer service line for your state.
To learn how much privacy your current plan gives you, ask the following questions:
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What do they include in their EOBs on a regular basis?
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Do they detail every procedure and questionnaire you receive, or do they keep it private? (for example: will they show that you had a "routine screening" vs. "HIV screening")
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Do they say the full name of the location you received services? (for example: "Planned Parenthood" vs. "Primary Care Checkup")
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Do they write the reason for the visit within the EOB?
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Will my parents see the full name of the medication or prescription I will be taking?
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Even if I get privacy on my communications with the insurance company, can my parents still get access to my health visits if they ask the insurance company for it?
If you want to proceed with making your communications private, ask your insurance company the following:
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Do you need me to fill out an insurance privacy form and send in via email, or can I request privacy over the phone?
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Do you only send EOBs over mail, or do you have an online portal (where parents could see health information) in which I can also request privacy?
If you want MORE privacy than not having an EOB sent to your parents:
Talk to the insurance provider about using private and confidential language within the EOB (for example: not stating the location of the appointment, medication names, what procedures were actually done).
While this might not always be possible, some insurance companies may have systems set in place to give you as much privacy as you need.
If your insurance company needs you to send in an insurance privacy request form:
Confused?
Need help?
Ask Violet.
(443) 267-7765
References:
(Health Insurance Basics (for Teens) - Nemours Kidshealth, n.d.; REQUEST, n.d.; The Girls’ Guide to Getting Some Privacy on Your Parents’ Health Insurance: Bedsider, n.d.; Understanding Your Health Insurance ID Card | The Daily Dose | CDPHP Blog, n.d.)