Will my employer find out if I use my job-based health insurance?

[Alex_M]

Hello,

I’m 35 years old and have dealt with ED for the longest time. Pills are no longer effective and I do not want to use a needle for the rest of my life. I live in Texas, and my job-based health insurance (Blue Cross Blue Shield) has Dr. Clavell as an in-network provider and covers implants.

Here’s the tricky part. I work for a small business with less than 20 people. The president of the company is responsible for managing the job’s benefits, including health insurance. Because this is a close-knit company, everyone is familiar with each other’s lives.

I understand that due to my age, I will probably have to work with Dr. Clavell on alternatives before the insurance approves surgery for an implant. But if I do get approved, will the president of the company be notified about it? Chances are that if he finds out, pretty much everyone will be made aware at some point. Yes, it’s supposed to be confidential, but people will find out behind my back. And I don’t want that to happen.

Thank you!

[LastHope]

I wouldn't worry about this.

Your health information is considered PHI (Protected Health Information). Sharing it without your written consent constitutes a HIPAA* violation. Businesses and healthcare organizations that violate this can face lawsuits and, if reported to the Department of Health and Human Services (HHS), may be subject to fines!

*HIPPA
Health Insurance Portability and Accountability Act of 1996 (signed into law by President Bill Clinton on August 21, 1996).

[Motorheadrulz]

You paid for the benefit, so why not take advantage? Besides- it was a "hernia repair"...

[tobenormalagain]

An “inguinal hernia” is the cover story I used with my employer and coworkers. That area is fairly close to the genitals and that surgery comes with some post-operative restrictions that are similar for a penile prosthesis! As pointed out, that is HPI (Healthcare Protected information) and disclosure of any aspects of your medical care is a violation of federal law and subject to heavy fines!

[happycamper59]

While no longer working and on Medicare, I did have you to use a cover story for a few friends. Yes, hernia repair (and not IPP) works as the perfect cover!

No one needs to know your personal business. Your employer should not be so damn snoopy.

[Discovernew]

Hello,

I’m 35 years old and have dealt with ED for the longest time. Pills are no longer effective and I do not want to use a needle for the rest of my life. I live in Texas, and my job-based health insurance (Blue Cross Blue Shield) has Dr. Clavell as an in-network provider and covers implants.

Here’s the tricky part. I work for a small business with less than 20 people. The president of the company is responsible for managing the job’s benefits, including health insurance. Because this is a close-knit company, everyone is familiar with each other’s lives.

I understand that due to my age, I will probably have to work with Dr. Clavell on alternatives before the insurance approves surgery for an implant. But if I do get approved, will the president of the company be notified about it? Chances are that if he finds out, pretty much everyone will be made aware at some point. Yes, it’s supposed to be confidential, but people will find out behind my back. And I don’t want that to happen.

Thank you!

It is a valid concern, but it seems to me that it would be illegal for your employer to get such information. Besides, he is not paying for it, the insurance is paying. You can ask Dr Clavell himself also

[MS_Man]

I wouldn't worry about this.

Your health information is considered PHI (Protected Health Information). Sharing it without your written consent constitutes a HIPAA* violation. Businesses and healthcare organizations that violate this can face lawsuits and, if reported to the Department of Health and Human Services (HHS), may be subject to fines!

*HIPPA
Health Insurance Portability and Accountability Act of 1996 (signed into law by President Bill Clinton on August 21, 1996).

I work for an insurance company and this is 100% accurate. You'll be fine. They won't be able to find out unless you tell them or sign something that would allow them to see it.

[Bigdog4all]

I wouldn't worry about a thing. Besides it's none of their damn business. And if it was.....1. What do you do if you are hearing impaired.....Get a Hearing Aid. 2. If you leg doesn't support you.....Get an artificial Leg. 3. If you don't have 20/20 vision.....Get Glasses or Contacts. 4. If you need missing teeth.....Get Dental implants. 5. And God forbid when people need Hair replacements.....So whats the big deal?

[Rider1400]

I wouldn’t be concerned. I had to go thru my HR department about all my off time and used hernia repair with them and all others who questioned my time off. If the Dr or his practice mentioned this to your employer in any way than they would be liable for a large lawsuit. If you told your superior for some unknown reason and they let it out they would be in violation. Not an issue to worry about! I only hope Clavell is covered by my BCBS when I need a revision!

[MuscleDaddyRWC]

Speaking as an employer, I’ve never received any claims information about my employees. I just pay the premiums and the insurer does their magic.

Having said that, my sister in law worked for a company that self insured. When her husband (on her work plan) got ill, the medical costs were about $500k. The boss announced at a staff meeting that there would be no bonuses that year because of high medical claims and my SIL got ostracized by other staff. The company knew claim dollars but not the medical issue.