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Privacy in Billing

Information for patients who are on someone else’s health insurance policy (like parent or spouse) about the possibility of keeping billing information private when receiving services.
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If I am on someone else’s health insurance, what information do they get about my medical visits?

If you are on someone else’s health insurance, like a parent’s/guardian’s, or partner’s/spouse’s, they might get an insurance form about your medical visits. The form is called an Explanation of Benefits (EOB) or a Summary of Payments (SOP). 

The EOB or SOP lists information such as:

  1. The date of the visit
  2. The cost of the visit
  3. The doctor or healthcare provider’s name or the place of the visit

If any money is owed, they may also get a medical bill from the healthcare provider.

Is the type of service or visit listed on the EOB or SOP?

Insurance plans have similar EOBs/SOPs that may list the type of service or visit.

Some services are considered “sensitive” and won’t include much detail.  They might just say things like:

  1. Office visit or medical care
  2. Laboratory tests
  3. Prescriptions

What are Sensitive Services?

Sensitive services include things like:

  1. Birth Control/pregnancy tests
  2. HIV/STD tests or treatment
  3. HIV PrEP or PEP
  4. Viral hepatitis tests or treatment
  5. Treatment for alcohol, tobacco, and other drug use
  6. Mental health care
  7. Gender affirmation/transition care
  8. Partner or domestic violence support

What if I don’t want my parent or partner to get an EOB or SOP about my visits?

You may be able to have billing information sent directly to you instead of to your parent or partner. To find out if this is possible, you MUST call your insurance company. 

This is NOT automatic and won’t happen unless you call your insurance company and ask for it. 

Are there laws to protect this information?

Some protections may be available through Chapter 63 of the Acts of 2018 An Act to Protect Access to Confidential Healthcare (PATCH Act). The text of this law can be found at:  malegislature.gov/Laws/SessionLaws/Acts/2018/Chapter63

If I want to try to get my EOB or SOP sent only to me, what can I do?

  1. Call the customer service phone number on your insurance card.
  2. Ask if you can receive insurance billing information directly, instead of your parent or partner.
  3. Provide any information you are asked for such as the policy number on your insurance card and the visit dates.
  4. Follow the instructions your insurance company gives you.

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