ACA vs. HIPPA

[GRG a/k/a goldenrulegirl]

ODS is 19.

Without going into the gory details, ODS is still in high school at 19.

So, ODS is still very much my dependent.  I cook for him, I do his laundry, I give him spending money, he drives MY car using MY gas.  

Under the Affordable Care Act, I can carry him on my health insurance until he is 26.

But, HIPPA says he is free to make his own health decisions as of the age of 18.

So, thanks to the usual gubmint stupidity, I can pay for ODS's health care but I have no say and don't even get to know what kind of care he is getting if he doesn't want me to.  

How STUPID is this??!!

He is about to have knee surgery.  The surgery will take approximately an hour.  He will be under general anesthesia.  We have to complete a Health Care Proxy so that if any issues arise during surgery, I, the patient's freaking mother, can make decisions for him.  Stupid.  Just stupid.  He couldn't even fill out the medical history paperwork on his own without my help (and I am going to go out on a limb and say that most kids his age can't).  

Oy.  Why is so difficult to simply align complementary laws??!!

[hoops902]

Holy control freak!  I'm hoping you're saying this just because you're very worried about the surgery, and not because you actually believe the rant you just wrote.

[Deleted]

I guess it's not different than covering an adult spouse on your insurance.  They still get to make all the decisions about their medical care. 

[The Walk of the Penguin Mich]

Feb 11, 2015 10:45:47 GMT -5 minnesotapaintlady said:

I guess it's not different than covering an adult spouse on your insurance.  They still get to make all the decisions about their medical care. 

Exactly.

Most adults have some sort of healthcare proxy, and there is more than one person on this board who would not want their mother involved in their medical care.

It is easier to designate a proxy than assume their mother is the right choice.  By 18, most kids are making their own healthcare decisions (I know I was).  If they are comfortable enough discussing this with their parent, great.  Your son was.  But not everyone is.

[bean29]

I agree with you somewhat. The difficulty comes in when you go to pay the bill and you can't ask questions about what you are paying for without your kid's permission.

My Dd is 17 will be 18 in April. She has been filling out the health information for years. I recently made an apt for her to have an ultrasound b/c Dd had bladder infection issues - it was the practice her GYN is part of but a different location. I asked if I had to be present? They said yes. I left work, ended up meeting her there, she walked in identified herself they took her back, did the test etc, and I never authorized anything either verbally or in writing -WTF why did I have to be there?

But getting her used to completing the medical history and being comfortable handling Medical Appointments etc., I view as part of my responsibility to set her up to be on her own.

Now, my 21 year old Son, he would not know the Medical History as well, but he also would not necessarily expect me to go with.  He did have a root canal and a crown this year and I did have issues dealing with the dental clinic.  I felt they were not charging us right under the insurance.

I did not have my son handle it...on top of the other issues, DH carries the Dental Ins through his employer, so we have one more level of bureaucracy to deal with. But I had to call and get the total and send him with a check for him to get treatment.  I had to prepay like 75 % of our cost of the crown, even though the insurance covered a significant portion of the bill.  The balance had to be paid the day the crown was placed.

But DD had Knee Surgery several years ago and she has to have the other knee done too.  You are doing the right thing getting your paperwork in order. 

When I first started handling my own medical issues, the insurance coverage was not so complicated and they would treat you and then resolve payment.

[Deleted]

It gets better.  When/if he goes to college, you will not only be able to but will be expected to help pay.  However, you do not have the right to see his grades. 

This used to drive parents nuts!

[Deleted]

Feb 11, 2015 11:21:10 GMT -5 @southernsusana said:

It gets better.  When/if he goes to college, you will not only be able to but will be expected to help pay.  However, you do not have the right to see his grades. 

This used to drive parents nuts!

If I can't see their grades, they can't see my check. 

[cronewitch]

Adults deserve some privacy. Many might for example want birth control pills or other birth control but not to tell the parents. If a girl is 18 and thinks she is pregnant she needs to see a doctor even if her parents think she is a virgin who would never have that problem. As a loving parent you would want to know and help your child but not all parents are loving. Imagine a girl having to tell her dad she was pregnant and not married thinking he would kill her or her knowing her parents were anti abortion and she wanted to have one. Birth control and babies aren't the only private medical issues people might not want to tell anyone about.

[bean29]

Crone, agreed. This is why I don't go in the room with DD. She and I discuss whatever she want's to tell me, but I don't want her to feel she doesn't want to tell her Dr. Something b/c I am in the room.

I also made my Son aware when he was about 17 that he could get treatment by presenting the medical insurance card at the Dr. office.  I also told him about HIPPa.

 This could get iffy now that some Dr's may not be in network. 10 years ago my out of network coverage was fairly decent - probably 70-80%. Now my deductible is in-network $2500 + at least another $1,000 for prescriptions then out of network deductible is $5,000 and then it is not 100%. So really I would prefer I know they have an appointment at least!

[quince]

He's an adult. He can pay the part of the bill not paid by insurance, or he can designate you as someone who gets to see his info, same as my husband and I do for each other.

Adults are entitled to privacy.

I could fill out my own medical information when I went to college at 17, which is a good thing, because my parents were in Hawaii and I was in Michigan.

[Sam_2.0]

This has been an issue for my brother that is 22. He's still covered under dad's insurance since he doesn't have a job where he can get his own. He's had some sensitive medical issues and he didn't want my parents to know about it, but they still got the bills since it's their insurance. And then DB had a hard time paying the bills but dad wouldn't help him out, but didn't want it to go to collections since dad's name was on there too. Those bills also contributed to the family deductible (HDHP plan - so it all pools together) so mom & dad were getting the "benefit" of DB basically paying their OOP max at the beginning of the year. Lovely hot mess there.

[tskeeter]

It's just as complicated trying to manage the care of a sick spouse.

Mom was having problems and Dad took her to the emergency room.  Since Mom didn't appear to be lucid, Dad was able to provide information, learn about and direct her medical care.  As soon as Mom appeared to be lucid, none of the medical staff would talk with Dad.

Now, think about a situation like I described when you are dealing with an aging spouse who may suffer from periods of dementia.  The spouse suffering from demetia may appear to be lucid, but may not provide the appropriate answers to medical inquiries (Mom did this even though she did not suffer from dementia).  The spouse may be given care instructions that they do not remember or do not comprehend (hey, that's a problem for those of us who are not suffering from dementia, already).

All-in-all, HIPPA may protect people's privacy.  But it may also put their lives and health at risk.

[Cookies Galore]

I was on my dad's insurance until I finished college at 23; my last semester was Fall 2003, so before Obama was even a glimmer in the DNC's eye. I used my coverage for things like birth control, annual exams, dermatology appointments, illnesses, etc. Was I supposed to ask permission every time I needed to go to the doctor?

[giramomma]

Feb 11, 2015 12:39:59 GMT -5 Sam_2.0 said:

This has been an issue for my brother that is 22. He's still covered under dad's insurance since he doesn't have a job where he can get his own. He's had some sensitive medical issues and he didn't want my parents to know about it.

I was covered on my parents insurance until 25 way in the dark ages.

I either went to student health services or paid for things out of pocket, just because I didn't want my parents in my medical life.



Most people left college with student loans. I left college owning my therapist money. Thankfully they had a payment plan.

[CarolinaKat]

Feb 11, 2015 12:44:02 GMT -5 tskeeter said:

It's just as complicated trying to manage the care of a sick spouse.

Mom was having problems and Dad took her to the emergency room.  Since Mom didn't appear to be lucid, Dad was able to provide information, learn about and direct her medical care.  As soon as Mom appeared to be lucid, none of the medical staff would talk with Dad.

Now, think about a situation like I described when you are dealing with an aging spouse who may suffer from periods of dementia.  The spouse suffering from demetia may appear to be lucid, but may not provide the appropriate answers to medical inquiries (Mom did this even though she did not suffer from dementia).  The spouse may be given care instructions that they do not remember or do not comprehend (hey, that's a problem for those of us who are not suffering from dementia, already).

All-in-all, HIPPA may protect people's privacy.  But it may also put their lives and health at risk.

This is scary. It also happened with my Mom. Not dementia situation, but she had Lyme Disease. She wasn't feeling well so Dad took her to the local Dr. Dad has MCS so to avoid exposure, he sent her in alone. Once she was in there, she didn't remember she was sick, what symptoms she was having or what she needed treatment for. They gave her a couple of scripts, which she didn't remember getting and didn't tell my Dad about. Anyway, I talked to my Mom about the appointment on the phone that evening and realized that something went very very wrong. 

I basically had to call the Dr. and deal with the red tape. They didn't want to talk to me because the 'patient was competent.' I called that bullshit and basically went full bitch. Ends up they think they're treating Mom for bronchitis. Mom thought they told her she had a clean bill of health. Once I explained that to them, they were much easier to work with. 

[Tennesseer]

HIPAA, people.  HIPAA.

[bean29]

My son is a full time student. I do consider their Medical Bills part of the support I am willing and able to provide.  We have a $2500 in network deductible then the insurance pays 100%. So, I just try to stay in network. I also like to pay the medical bills leading up to that $2500 from my HSA account.

[The Walk of the Penguin Mich]

Feb 11, 2015 12:44:02 GMT -5 tskeeter said:

It's just as complicated trying to manage the care of a sick spouse.

Mom was having problems and Dad took her to the emergency room.  Since Mom didn't appear to be lucid, Dad was able to provide information, learn about and direct her medical care.  As soon as Mom appeared to be lucid, none of the medical staff would talk with Dad.

Now, think about a situation like I described when you are dealing with an aging spouse who may suffer from periods of dementia.  The spouse suffering from demetia may appear to be lucid, but may not provide the appropriate answers to medical inquiries (Mom did this even though she did not suffer from dementia).  The spouse may be given care instructions that they do not remember or do not comprehend (hey, that's a problem for those of us who are not suffering from dementia, already).

All-in-all, HIPPA may protect people's privacy.  But it may also put their lives and health at risk.

There are ways around this.  All your mom had to do was have a simple form on file giving the doctor's permission to speak to your dad.  It really isn't a big deal.

Once I filled it out for letting them talk to TD while I went through my medical nightmare, then I never had to do it again as it was always on file.  If you are having health issues, this is something you really do need to establish before it becomes pressing.  In fact, I believe this information is on any intake form I've filled out at just about every doctor I've seen.  

Even if you do not have health issues, this is something that needs to be on file with your regular doctor.  Normally, they will let you designate more than one person.  For me, it's now TD and my sister.  That means that when I was having all my surgeries, she was able to call the hospital and get an update on my status and inform the rest of the family.  It's really not a big deal and something you DO have control over.

[NomoreDramaQ1015]

All your mom had to do was have a simple form on file giving the doctor's permission to speak to your dad. It really isn't a big deal.

My grandmother and my father had my grandfather sign a form giving them permission to discuss his case before things got serious enough that they would need to intervene.  

DH is my healthcare proxy and I am his.  Secondary for me is my mother, secondary for him is his mother.   Once the girls are old enough we will switch and they will become our proxies in the event that something happens to both of us at the same time.

Took us less than five minutes to fill out the forms and send them back.   It's one of those things like living wills that you really need to take care BEFORE the situation arises.

I need to talk to my parents, I believe my mom has things set up so I am a proxy but I am not 100% certain.  Thanks to this thread for making me think, that's something we need to address.

[cronewitch]

I took my aunt to the doctor after she fell. She was old and blind so I went in with her. The doctor asked if she had any surgeries, she asked what. So I told her he wants to know if you have a pacemaker and she said she did then I asked her about a couple other operations, then if she had other operations. She needed xrays so I figured he mostly wanted to know about the pacemaker but getting her thinking about other things might have help clarify the question. Now they probably wouldn't have let me stay with her

[Willing Sniper]

Feb 11, 2015 10:30:50 GMT -5 GRG a/k/a goldenrulegirl said:

ODS is 19.

Without going into the gory details, ODS is still in high school at 19.

So, ODS is still very much my dependent.  I cook for him, I do his laundry, I give him spending money, he drives MY car using MY gas.  

Under the Affordable Care Act, I can carry him on my health insurance until he is 26.

But, HIPPA says he is free to make his own health decisions as of the age of 18.

So, thanks to the usual gubmint stupidity, I can pay for ODS's health care but I have no say and don't even get to know what kind of care he is getting if he doesn't want me to.  

How STUPID is this??!!

He is about to have knee surgery.  The surgery will take approximately an hour.  He will be under general anesthesia.  We have to complete a Health Care Proxy so that if any issues arise during surgery, I, the patient's freaking mother, can make decisions for him.  Stupid.  Just stupid.  He couldn't even fill out the medical history paperwork on his own without my help (and I am going to go out on a limb and say that most kids his age can't).  

Oy.  Why is so difficult to simply align complementary laws??!!

Out on a limb! Now that's humor.

[NastyWoman]

I remember my friend telling me about this many years ago --- her DD needed to give permission for her doctor to tell mom anything.  DD was 13 yrs old at the time!!! And this was way before Obamacare was even discussed (friend passed from breastcancer before that time so I am sure of my timing here). She and her DD had a good relationship so friend did keep fully in the loop, but still.  Friggin' 13yrs old?

[MN-Investor]

Feb 11, 2015 15:16:43 GMT -5 NastyWoman said:

I remember my friend telling me about this many years ago --- her DD needed to give permission for her doctor to tell mom anything.  DD was 13 yrs old at the time!!! And this was way before Obamacare was even discussed (friend passed from breastcancer before that time so I am sure of my timing here). She and her DD had a good relationship so friend did keep fully in the loop, but still.  Friggin' 13yrs old?

13 years old... junior high. Yeah, I can see it.

Children need a safe place they can go to discuss issues without fear that it will get back to their parents. Ideally children can talk to their parents, but you know that some children live in awful sexually, physically or verbally abusive situations. Or it can just be an embarrassing question the child doesn't want to ask the parent - is my period normal, should I be worried about this lump in my breast, etc.

[tskeeter]

Feb 11, 2015 14:48:37 GMT -5 The Walk of the Penguin Mich said:

Feb 11, 2015 12:44:02 GMT -5 tskeeter said:

It's just as complicated trying to manage the care of a sick spouse.

Mom was having problems and Dad took her to the emergency room.  Since Mom didn't appear to be lucid, Dad was able to provide information, learn about and direct her medical care.  As soon as Mom appeared to be lucid, none of the medical staff would talk with Dad.

Now, think about a situation like I described when you are dealing with an aging spouse who may suffer from periods of dementia.  The spouse suffering from demetia may appear to be lucid, but may not provide the appropriate answers to medical inquiries (Mom did this even though she did not suffer from dementia).  The spouse may be given care instructions that they do not remember or do not comprehend (hey, that's a problem for those of us who are not suffering from dementia, already).

All-in-all, HIPPA may protect people's privacy.  But it may also put their lives and health at risk.

There are ways around this.  All your mom had to do was have a simple form on file giving the doctor's permission to speak to your dad.  It really isn't a big deal.

Once I filled it out for letting them talk to TD while I went through my medical nightmare, then I never had to do it again as it was always on file.  If you are having health issues, this is something you really do need to establish before it becomes pressing.  In fact, I believe this information is on any intake form I've filled out at just about every doctor I've seen.  

Even if you do not have health issues, this is something that needs to be on file with your regular doctor.  Normally, they will let you designate more than one person.  For me, it's now TD and my sister.  That means that when I was having all my surgeries, she was able to call the hospital and get an update on my status and inform the rest of the family.  It's really not a big deal and something you DO have control over.

Yes, the solution was a signature on a release form.  Unfortunately, none of the care providers offered that option and Dad didn't know to request it.  All the care providers said is "she is competent, HIPAA prevents us from talking with you."  Took until late in the second day and a conversation with SIL, the retired nurse, to get the release form so that Dad could help with the medical care requriements.

Just a heads-up that medical powers of attorney and medical directives are not always permanent.  Mom and Dad had completed and filed medical directives with the hospital nearest their home.  When Mom went into cardiac arrest, the ER staff asked Dad if they should recussitate Mom.  When Dad said what does the medical directive say, he was told that the directive had expired.  It was only good for a year.  So he made the decision that he was asked to make.  Then he asked for a copy of the directive the hospital had on file.  Sure enough, in small type, buried in with other boiler plate was a statement that the directive was only effective for a year from the date it was signed.  Everybody might want to check any powers of attorney and medical directive they have or are signing to make sure they are durable, rather than short term. 

[weltschmerz]

Feb 11, 2015 11:27:37 GMT -5 cronewitch said:

Adults deserve some privacy. Many might for example want birth control pills or other birth control but not to tell the parents. If a girl is 18 and thinks she is pregnant she needs to see a doctor even if her parents think she is a virgin who would never have that problem. As a loving parent you would want to know and help your child but not all parents are loving. Imagine a girl having to tell her dad she was pregnant and not married thinking he would kill her or her knowing her parents were anti abortion and she wanted to have one. Birth control and babies aren't the only private medical issues people might not want to tell anyone about.

Exactly! The age of medical consent here is 14. I can't even begin to tell you how many young girls want the Gardasil vaccination, but terrified their parents will find out.

The conversation goes like this.

-I'm going to become sexually active soon. Maybe not all the way, but my boyfriend and I have been fooling around. I want to protect myself from cancer. My parents refuse to sign the permission slip. Will they find out?

-First of all, congratulations for wanting to protect yourself. My job is to give you the shot and give you the paper saying you had it. What you do with that certificate of vaccination after you leave here is none of my business. It will still be in the school records, which your parents have no access to.

 Keep in mind that the shot doesn't protect you from pregnancy or other STDs. Please use a condom and have a nice day.

[teen persuasion]

Feb 11, 2015 17:49:22 GMT -5 weltschmerz said:

Feb 11, 2015 11:27:37 GMT -5 cronewitch said:

Adults deserve some privacy. Many might for example want birth control pills or other birth control but not to tell the parents. If a girl is 18 and thinks she is pregnant she needs to see a doctor even if her parents think she is a virgin who would never have that problem. As a loving parent you would want to know and help your child but not all parents are loving. Imagine a girl having to tell her dad she was pregnant and not married thinking he would kill her or her knowing her parents were anti abortion and she wanted to have one. Birth control and babies aren't the only private medical issues people might not want to tell anyone about.

Exactly! The age of medical consent here is 14. I can't even begin to tell you how many young girls want the Gardasil vaccination, but terrified their parents will find out.

The conversation goes like this.

-I'm going to become sexually active soon. Maybe not all the way, but my boyfriend and I have been fooling around. I want to protect myself from cancer. My parents refuse to sign the permission slip. Will they find out?

-First of all, congratulations for wanting to protect yourself. My job is to give you the shot and give you the paper saying you had it. What you do with that certificate of vaccination after you leave here is none of my business. It will still be in the school records, which your parents have no access to.

 Keep in mind that the shot doesn't protect you from pregnancy or other STDs. Please use a condom and have a nice day.

How does the bolded part work?  Our school gets the immunization records from me, the parent, not the doctors office.  I have to provide a new copy each year, they apparently purge their files every summer or something ridiculous like that.

[weltschmerz]

Feb 11, 2015 19:26:03 GMT -5 teen persuasion said:

Feb 11, 2015 17:49:22 GMT -5 weltschmerz said:

Exactly! The age of medical consent here is 14. I can't even begin to tell you how many young girls want the Gardasil vaccination, but terrified their parents will find out.

The conversation goes like this.

-I'm going to become sexually active soon. Maybe not all the way, but my boyfriend and I have been fooling around. I want to protect myself from cancer. My parents refuse to sign the permission slip. Will they find out?

-First of all, congratulations for wanting to protect yourself. My job is to give you the shot and give you the paper saying you had it. What you do with that certificate of vaccination after you leave here is none of my business. It will still be in the school records, which your parents have no access to.

 Keep in mind that the shot doesn't protect you from pregnancy or other STDs. Please use a condom and have a nice day.

How does the bolded part work?  Our school gets the immunization records from me, the parent, not the doctors office.  I have to provide a new copy each year, they apparently purge their files every summer or something ridiculous like that.

We vaccinate in the schools...Tetanus, MMR, DPT, Gardasil, the works.

It's one of my jobs: going from school to school, giving vaccinations and boosters.

The shots given at the doctor's office are for very small children, and we get that paperwork from the parents. Up to the age of 14, the parents have to sign a consent form.

[DagnyT]

I don't understand why parents who vaccinate their children  would not want to give them the Gardasil vaccination. It protects them, and the earlier the better. When my daughter was scheduled to get it, she didn't want it, so I asked the doctor to please speak to her about the benefits of the vaccination. She did listen to the doctor, but she still says that she only got it because the doctor and I made her feel like she had too. She felt like she did not need it since she was a virgin, but did not want to listen to me when I told her that the vaccination worked best if you had never had sex, thus why she should get it then. She was 15 or 16 when the doctor recommended it. I'm glad I asked the doctor to talk to her about it, and that the doctor did. Maybe the doctor would have without me asking, but I am glad that my daughter consented, even if some would say I bullied her.

[Deleted]

Feb 11, 2015 20:58:17 GMT -5 DagnyT said:

I don't understand why parents who vaccinate their children  would not want to give them the Gardasil vaccination. It protects them, and the earlier the better. When my daughter was scheduled to get it, she didn't want it, so I asked the doctor to please speak to her about the benefits of the vaccination. She did listen to the doctor, but she still says that she only got it because the doctor and I made her feel like she had too. She felt like she did not need it since she was a virgin, but did not want to listen to me when I told her that the vaccination worked best if you had never had sex, thus why she should get it then. She was 15 or 16 when the doctor recommended it. I'm glad I asked the doctor to talk to her about it, and that the doctor did. Maybe the doctor would have without me asking, but I am glad that my daughter consented, even if some would say I bullied her.

because they don't feel the benefits outweigh the risks.

[DagnyT]

Feb 12, 2015 10:21:04 GMT -5 @singlemominmd said:

Feb 11, 2015 20:58:17 GMT -5 DagnyT said:

I don't understand why parents who vaccinate their children  would not want to give them the Gardasil vaccination. It protects them, and the earlier the better. When my daughter was scheduled to get it, she didn't want it, so I asked the doctor to please speak to her about the benefits of the vaccination. She did listen to the doctor, but she still says that she only got it because the doctor and I made her feel like she had too. She felt like she did not need it since she was a virgin, but did not want to listen to me when I told her that the vaccination worked best if you had never had sex, thus why she should get it then. She was 15 or 16 when the doctor recommended it. I'm glad I asked the doctor to talk to her about it, and that the doctor did. Maybe the doctor would have without me asking, but I am glad that my daughter consented, even if some would say I bullied her.

because they don't feel the benefits outweigh the risks.

What risks? Ovarian cancer is bigger risk than any side effects that I am aware of with the Gardasil shot. Neither of my children had any reactions, not even a fever or sore arm.

ETA; Oops. That should have been cervical cancer, not ovarian. Sorry, late night and caffeine must not have set it yet.