PrEP and Privacy Pitfalls
Some of the important questions we answer here at PrEP207 are about PrEP and privacy. Will my parents or partner find out that I'm on PrEP? Can my employer find out I'm using PrEP? How can I protect my privacy, but still access PrEP? While there is no magic solution for healthcare privacy there are a few things you can do to protect your healthcare privacy. Below is some information that might help you navigate the complicated world of healthcare privacy.
What Happens At Your Provider's Office Stays There
HIPAA ensures that if you are over 18 then anything you and your provider talk about or do is strictly confidential. Your provider can only communicate health information to people that you give express, written permission to. If you're concerned about privacy that is at least a relief. What you do need to worry about is the insurance billing after the fact. This can include information on your insurance provider's website, but mostly we are going to talk about the EOB.
EOB - The Usual Suspect
EOB stands for explanation of benefits. These are documents sent to you by your insurer that explain the use of your insurance. Think of them as a kind of bank statement for your healthcare. These usually include identifying information such as name, address, policy number etc., and any procedures, lab tests, or any prescriptions you may have received. For folks who have their own insurance, are single, or who don't have privacy concerns they work fine. For folks who want to keep their healthcare decisions to themselves it can be a little more tricky. Most people receive these via mail, but some insurance companies have a paperless option where they email them. If they come via postal mail they are protected under standard postal service privacy laws, but that won't stop anyone in your household from opening them! A good way to keep your healthcare private is to take control of your EOB.
Call Your Insurer - Call the 800 number on the back of your card, and speak to the representative about your concerns. This conversation is confidential so no one can call and ask what you spoke about. Let them know that you want to keep your healthcare private, and ask what you can do to keep your EOB or information on the policy's website private. If you share a policy with your parents or partner then ask if you can separate the two accounts. Each insurance company handles things a little differently so make sure to get their take on what you can do.
Change Where They Are Sent - If you aren't living with the person or people you don't want to share your health information with then have your EOB mailed to you rather than the policy holder. If you are living with them then have your EOB mailed to work, somewhere else that you trust, or consider getting your own post office box and have it mailed there. You might also be able to get your insurer to send your EOB paperlessly via email, but if you do, make sure its an email that only you have access to.
Can My Employer Access My Health Information?
The answer is technically no, but let's talk about this a little bit. Again, HIPAA ensures that you're health information stays private. Health insurance companies can't disclose your private health information to your employer, but there may be indirect ways that they can inadvertently learn about your use of benefits, including PEP, PrEP, or sexual health services. For example, an employer may request aggregated health information from the insurer in order to make decisions about what plans to offer. This information is de-identified, but often includes usage information. This may allow an employer to narrow down who is using the benefits in what way. In Maine, this requires your written permission so be on alert for that. If you have concerns about disclosure of your health information then the easiest thing to do is not give your permission.
Got a healthcare privacy question?
Contact us! 207-553-PrEP! We're happy to help problem solve when it comes to accessing PrEP/PEP, and sexual health services.
Consumers For Affordable Healthcare - Consumer advocacy and policy analysis for healthcare and Maine. They have a consumer help line that might be able to help you protect your privacy.
References & Further Reading
Can I use my health insurance without my parents knowing? (2018, March 28). Medium. https://medium.com/@qoralhealth/can-i-use-my-health-insurance-without-my-parents-knowing-9196e4b2e68d
Covarrubias, L. (2018, November 1). The girls’ guide to getting some privacy on your parents’ health insurance:Bedsider. https://www.bedsider.org/features/275-the-girls-guide-to-getting-some-privacy-on-your-parents-health-insurance
Health Insurance Portability and Accountability Act of 1996 (HIPAA). (n.d.). Centers for Disease Control and Prevention. https://www.cdc.gov/phlp/publications/topic/hipaa.html
Nelson, J. (2012, November 14). Family secrets: Adult children’s health insurance claims can be private. Insure.Com. https://www.insure.com/health-insurance/adult-children-health-insurance-claims.html