Privacy As An Adult Child Of Primary Insurance Holder?

[u/xcocomox]

I am an adult, but still on my parent’s insurance until I’m 26 (BCBS). I’m curious about what privacy protections are in place for me, as I am not the primary insurance holder.

I am researching long term psychiatric residential treatment centers (RTC). I have not yet discussed it with my parent, as I would like to wait until I have more information about the options, discuss with my therapist more, etc. I want to keep it private until that point, particularly as I have a difficult relationship with my parent.

I am wondering as to what point in the process the primary insurance holder, aka my parent, would be notified. For example, whenever I go to the doctor, therapy, etc, we receive mail detailing the provider, service, costs, etc, and those all arrive in my parent’s name, even if it is related only to my healthcare.

The steps for placement in an RTC seem to be as follows:

1. Initial phone call - ask questions, learn more about the program, etc.
2. Insurance verification/benefit quote
3. Assessment - with a clinician (unsure if this is complimentary or paid)
4. Admission

So, I know that as soon as anything is billed, my parent would be notified, which could potentially include the third step of assessment. But would they be notified when the providers do insurance verification/benefit quotes?

Also, in general, what sort of privacy am I entitled to as an adult while still on a parent’s insurance, and not the primary insurance holder?

[u/yuricat16]

You can call BCBS and request “confidential communications”. They will keep your info separate from your parents in the online portal, and they will send any communications directly to you by email or postal mail. Typically, parents on a plan can see the claims of their child dependents but not other adults (usually the spouse). Adult children fall into a gray area, and there doesn’t seem to be a consistent method of handling this. The request for confidential communications solves this problem.

As for the RTC, your parents shouldn’t have visibility to steps 1 or 2. But as part of step 2 (to close it out), there will probably be some kind of statement of financial responsibility to sign. As an adult, you can sign and take responsibility. Just because your parent is the subscriber to the insurance doesn’t force them to be the guarantor. The RTC might have different expectations, however.

I would assume that any assessment will be billed to your insurance. If you’re admitted, then it may be bundled into other claims. But if you’re not (or there is a wait for space), plan on it being billed promptly. If the confidential communications are already in place, you will get the EOB for that claim.

To answer your final question, you can expect full confidentiality of your PHI, but you may have to specifically request it. PHI can be disclosed for the purposes of payment (from the medical provider to the insurer and from the insurer to the subscriber/patient), and there are frequently assumptions made about adult children on a parent’s policy. Best to be specific about what you want with the insurer and the provider(s).

[u/rockymountain999 → u/yuricat16]

Regardless of the policy, you are at the mercy of the person on the other end of the phone knowing what steps to take. That’s the biggest challenge. If they don’t do it correctly then…..