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Confidential test results, will an insurance company see them?
Feb 21, 2013

First and foremost, thank you for your service and information on this forum.

My friend in Louisiana tested positive years ago at a "Confidential" testing clinic. Since then he has taken on an individual plan (he did not disclose his status) and now finds himself in need of treatment. Is the confidential testing information something the private insurance company can find on record and most likely strike him from coverage?

Thank in advance for your time.

Response from Mr. Chambers

The term "confidential test site" is not familiar to me. I assume it wasn't an anonymous test site where there is no record at all of the test by the person's name.

If confidential simply means as confidential as any other medical record (protected under HIPAA), then I know of no way an insurance company would know about it unless the claimant told them there was a medical record at that clinic or mentioned the name of that clinic on any medical records with other doctors that he tells them about.

Finally, if he has had the coverage for over two (sometimes three) years, there will probably be a clause that says anything stated on the application cannot be used to stop coverage after it has been in force for two (maybe three) years.

Have him check his policy. The only problem that might arise is if the clause includes the term "with the exception of fraud" which erases the time limit.

Again, however, I do not know how the carrier would know unless the claimant told them about the confidential clinic.

Jacques



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