PATCH (Protecting Access to Confidential Health Care) is a Massachusetts law providing confidentiality protections for health insurance notices.
Have you been hesitant to use your health insurance because you are covered under another person’s insurance plan, such as a parent or guardian?
Anytime you receive health care services, your health insurance company can send some of your confidential health information including the name of your provider or the date and type of the services you received to the policyholder, through a form called the Explanation of Benefits (EOB).
The EOB may contain information on sensitive health care services, such as care related to domestic violence or sexual assault, mental health or substance use disorders, sexual and reproductive health or HIV/AIDS. Consumer protection law often requires insurance companies to send the person who owns an insurance plan, called the policyholder, information about how and when an insurance plan is being used.
Keeping healthcare information private
A Massachusetts law, called PATCH, now allows individuals age 18 and older and in many cases age 17 and younger, insured under another person’s Massachusetts-based health plan policy to submit a request to their health insurance plan if they need or want to keep information about their health care service while using their insurance confidential.
The law protects patient confidentiality by allowing patients to opt out of receiving an EOB form if no money is due, decide what physical address or email address the form should be sent to, and allow the patient to receive the form rather than the policyholder. Certain sensitive health care services would not be identified on the form.
This law does not apply to all kinds of health insurances.
For example, you might not be covered if the primary policyholder works for a large employer who provides a health plan that is self-insured. A self-insured plan is usually offered in larger companies where the employer itself collects monthly premiums from employees and takes on the responsibility of paying for part of employees’ and dependents’ medical services. The best way to find out if your plan is self-insured is to contact your health insurance plan’s customer service department. Even if self-insured, your health plan still may choose to accept your request for confidentiality.
It is best that you request that an EOB form be sent to a different mailing address before you receive medical service.
To do this, call the customer service phone number found on the back of your health insurance card or on your health plan’s website. You need your insurance plan’s name and ID number in order to do this. Your health plan may then require that you make the request in writing. Once the request is in place, your health plan must continue to follow it until you either write to your health plan to change your preferred address or to stop future forms from being sent to a different address than the policyholder.