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by EBSCO Medical Review Board

HIPAA: Your Right to Health Insurance and Privacy

image The Health Insurance Portability and Accountability Act (HIPAA) of 1996 was created to:
  • Set national standards for electronic health information transactions
  • Secure the privacy of health data
HIPAA protects your privacy and may also:
  • Lower the risk of losing your health insurance
  • Make it easier for you to change insurance if you lose your coverage or do not have any insurance
As a health consumer, you should understand what HIPAA means to your care. This can help you make sure that your information is being handled properly. You can also take action if it is not.

HIPAA’s Privacy Rule

HIPAA is perhaps most well known for its Privacy Rule. The Privacy Act gives people more control over who shares their personal medical information. It also makes it easier for them to access details about their own health and healthcare.

Protecting Your Information From Others

According to the Privacy Rule, healthcare providers can't show your health information to employers or others who are not allowed to view it. For example, they may not pass on information to companies who are thinking about hiring you or who want to add you to their mailing lists. Also, they may not share any information about mental health visits.
The Privacy Rule protects information in your medical record, such as talks with health professionals, electronic data, billing details, and most other health information.
There are times when information can be legally shared by:
  • Doctors, hospitals, and insurance companies for purposes of billing and payment or to coordinate care
  • A person you designate to help you with your healthcare
  • Safety regulators looking into care at nursing homes
  • Public health officials, such as reporting when the flu is in your area
  • Police when a crime is committed

Granting You Greater Access to Your Own Data

The Privacy Act also gives you greater access to your data. It used to be hard to view your medical charts and files. Now you have the right to know anything about your health. Under HIPAA, you are legally entitled to:
  • Receive a copy of your health record if you ask for it
  • Make corrections in your file
  • Be told how your health information is used and who it is shared with
  • Choose whether you want your information to be shared
You also have the right to file a complaint with your healthcare provider or with the federal Office of Civil Rights if you think your information has been misused. Call the regional Civil Rights office nearest you for more information. You will be asked to describe what happened and the reason for your complaint.

Buying or Changing Health Plans

HIPAA offers some protections if you have:
  • Health insurance through your employer
  • Individual (non-employment based) health insurance
  • Coverage through a high-risk pool
Here are some protections that HIPAA provides:
  • Allows you to buy insurance even if you have a pre-existing condition
  • Stops health insurance companies from denying you coverage because of your health or your family member's health
  • Guarantees your right to buy insurance
  • Guarantees your right to renew your insurance

What Organizations Does HIPAA Apply to?

HIPAA applies to anybody who deals with your healthcare, such as:
  • Doctors and dentists
  • Hospitals, clinics, and nursing homes
  • Physical and occupational therapists
  • Drug and medical equipment providers
  • Third-party medical billing companies and clearinghouses
  • Healthcare plans, Medicare, Medicaid, and other government sponsored programs

RESOURCES

US Department of Health & Human Services
http://www.hhs.gov
The US Department of Labor
http://www.dol.gov

CANADIAN RESOURCES

Health Canada
http://www.canada.ca
Healthy Alberta
http://www.healthyalberta.com

References

Health information privacy. US Department of Health and Human Services Department website. Available at: https://www.hhs.gov/hipaa/index.html. Accessed October 18, 2021.
Health insurance portability and accountability act (HIPAA). US Department of Labor website. Available at: https://www.dol.gov/agencies/ebsa/laws-and-regulations/laws/hipaa. Accessed October 18, 2021.
Statement of HIPAA portability rights. Arizona Health Care Cost Containment System website. Available at: https://www.azahcccs.gov/Members/Downloads/privacy/StatementofHIPAAPortabilityRights.pdf. Accessed October 18, 2021.
Understanding HIPAA privacy. US Department of Health & Human Services website. Available at: https://www.hhs.gov/hipaa/for-individuals/guidance-materials-for-consumers/index.html. Accessed October 18, 2021.
Your rights under HIPAA. US Department of Health and Human Services website. Available at: https://www.hhs.gov/hipaa/for-individuals/guidance-materials-for-consumers/index.html. Accessed October 18, 2021.

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