Guttmacher Institute: State Laws & Policies – Protecting Confidentiality for Individuals Insured as Dependents

NEW YORK, Sept. 1 -- The Guttmacher Institute, a research and policy organization that says it is committed to advancing sexual and reproductive health and rights worldwide, issued the following research associated with state laws and policies on Aug. 31, 2023:

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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.

Visit our state legislation tracker for policy activity on all sexual and reproductive health topics.

Highlights

* 14 states have provisions that serve to protect the confidentiality of individuals insured as dependents.

- 6 states allow individuals insured as dependents to request confidential communications from their insurance provider via a written request.

- 4 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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Original text here: https://www.guttmacher.org/state-policy/explore/protecting-confidentiality-individuals-insured-dependents