When I think health insurance, what comes to mind is…paperwork. Piles on piles of papers and forms– from my doctor, from my insurance, for me to review, “understand the updated terms,” sign here and here – and, truth be told, I barely made it through writing this sentence before hitting SKIP TRACK ⏭️.
Pointless as the paperwork seems, they can contain some powerful need-to-knows for navigating healthcare and accessing care with confidence. Let’s look into one of those docs, an Explanation of Benefits, to understand what it is and how it relates to your privacy.
An Explanation of Benefits (EOB) is a statement from your health insurance plan that describes what costs it will cover for your medical care + products you received. An EOB is generated when your provider submits a claim for the services you received during your visit. An EOB typically identifies: An EOB typically identifies:
• The healthcare provider
• Who received care (that’s you!)
• And the type of care provided
Any care service – treatments, testing, etc. – is jotted down using a 5-digit code. Think of this number like the SKU on a receipt for your latest clothing purchase.
@bettys_co INSURANCE 101: explanation of benefits understanding this insurance document can equip you access to the care and confidentiality you want + need, betties.💛 #gyn #insurance #healthinsurance #gynecology #healthinsurancebasics #medicalbillstiktok #insurancetips #medicalbills #explanationofbenefits #healthcare #insurancetiktok #medicalprivacy #medicalinformation ♬ Countless – Official Sound Studio
EOBS + PRIVACY
What does this have to do with privacy?
Once your insurance processes the claim, this lil’ visit rundown is sent to the insurance policyholder. For Betties under 26, there’s a good chance the insurance policyholder is a parent. Or if you’re a married Betty on your partner’s insurance, a spouse. (See where I’m going with this?)
So, let’s say, as a dependent, you pay your provider a visit for something you’d, er, rather keep on the down-low — like an STI test or a birth control prescription. Though not made explicitly clear, many of the EOB service codes are a Google search away.
Betties, getting an STI test or a birth control prescription is healthcare; equal to getting a COVID test or cough medicine. We believe these topics deserve normalizing because your health is nothing to be ashamed about. We also understand Betties’ relationships are personal, can be complicated, and might not make space for you to openly seek certain types of care.
But just because you are a dependent doesn’t mean you forfeit privacy rights at the exam room door.
Here’s what you can do: At the start of your appointment talk with your provider if you have privacy concerns so you can make arrangements that will allow you to get the care you need with the confidence you want.
The privacy solutions available will depend on your state’s protective measures. For example, some states allow insurers to mail an EOB directly to the patient instead of the policyholder. Guttmacher Institute has a rundown: HERE.
Betties, your provider is an advocate for your health, and that includes your confidentiality concerns, especially if it is preventing you from accessing the care you need.
So while health insurance does involve a lot of paperwork (bleh), knowing your privacy options can be the difference between you living with harmful symptoms and getting back to a healthier you.