Can I use my health insurance without my parents knowing?

If you’re here, good work. You’re self-aware enough to know that you might want to seek care, and you’re taking steps toward figuring out how to do so. Using your healthcare in a way that fits your own personal and family situation is important. But it’s not always clear how to do that.

If you’re on your parents’ insurance, but don’t want your appointment to show up on a bill that goes to them, there are a few things you need to do. Even if you’re over 18, you need to call your insurance company and make sure that your explanation of benefits, or EOB, is getting sent to your personal address. This applies to appointment with a therapist, psychiatrist, or health professional. After calling your insurance company, you still need to be careful about what information gets sent home. Insurance companies can also deny your request.

Why don’t I automatically get privacy?

After the passage of the Affordable Care Act (ACA) in 2010, adult children could stay on their parents’ insurance until the age of 26. That means one of your parents is the health insurance policy holder, and you’re what’s called an adult dependent on that policy. The provision helped a lot of people get or stay insured.

Those benefits came with a downside, though. Insurance companies want to send you an EOB so that you can understand what healthcare services are covered by them and what is getting billed to you. When insurance companies keep you in the loop, you can also track how much of your deductible you’ve met. Some also argue that sending an EOB to the policy holder can help prevent fraud.

All of that makes it a little complicated for an adult dependent to access their own health insurance without their parents knowing, because of the EOB that gets sent home. California passed a special Confidential Communication Request law (of course they did, right?), so that anyone on someone else’s health insurance plan can submit a request for information to be sent to them directly. But there are actions that the rest of us who don’t live in California can take, too.

The explanation of benefits

So what’s on an EOB?

• Name of patient
• Type of service (could include provider’s name)
• Total billed
• Amount covered by insurance
• Amount owed by you

Here are two EOBs from Blue Cross Blue Shield and United, two national insurers, that show you exactly what an EOB looks like.

What do I need to do?

If you want to use your health insurance plan to see a therapist or psychiatrist, but want privacy from the policy holder, here’s what you can do:

1. Identify your plan

• What insurance plan are you on? The easiest way to find out is by looking at your insurance card. If you don’t have your insurance card, you can call the policy holder of your plan to find out. If your insurer has a patient portal or online login, that might also include some details about your plan.
• Note: If you have student health insurance or state health insurance, it is still worth calling your insurer to double check where your EOB is sent.

2. Understand your plan

• Check whether your insurer covers care in your area. For example, if you’re from Pennsylvania but live in DC, there might be certain approved providers that your insurance company works with. Otherwise, be aware that your visit will be billed as an “out of network” visit, and might be reimbursed differently or not at all by your insurance company. Again, when in doubt, give your insurer a ring to make sure.

3. Prepare questions

• Prepare the right questions for your insurer. Here are a few potential scripts you can use:
• “Hi, my name is _____ and I’m on your _____ insurance plan. I’d like to have my explanation of benefits sent directly to me, rather than the policy holder.”
• “I’m a dependent on my plan, and I would like privacy for the care I receive. Can you send my explanation of benefits exclusively to me?”
• “Will any other personal information be sent home if I seek care? Will any: prescription information, denied claims, or marketing material still be sent to the policy holder even if my mailing address for EOBs is now my personal address?”

4. Call your insurer

• Give them a call! You can find their customer service number on the back of your insurance card, and they should answer any questions you have. (Again, you’ll need your member ID for this one). Since your experience can depend on what customer service representative you get, don’t be afraid to call back if you don’t get a clear answer the first time around!

That’s how to go about learning if you can keep your care private as an adult dependent on your parent’s plan. It can be tricky, but it is possible! There’s another option that’s worth noting. Talk to your parent or guardian. It’s not an easy conversation to have with anyone, often times most of all our parents. But they might just be more understanding than you think.

Good luck, and kudos again for taking these first steps.

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A few side notes:

• If your insurer covers in-person therapy in DC, they are also legally required to cover teletherapy, or therapy via video chat.
• This article is geared toward mental health services, but it’s the same process for any health services you want to pay for privately — for example, getting on and paying for birth control.
• Be aware of your deductible. Make sure you know how much you’ll be paying out of pocket.
• Here’s a good, quick primer on how health insurance actually works. Here’s a more in depth one.
• Are you a child dependent or don’t have insurance? Explore free or discounted resources, like the campus counseling center. There are also books and other online resources that can introduce important concepts in therapy.
• Group therapy sessions can often be an effective, lower cost option.

If you have any additional questions or want to see a post about something in particular, write us at info@getqoralhealth.com. We’d love to hear from you!