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Are doctor visits for substance abuse kept confidential?

Hi everyone. I'm 24/F. I want to visit a doctor for suboxone treatment because I've developed an opiate addiction. I've found a place that takes insurance. I didn't think it was going to be a big deal...until I tried to quit cold turkey :-O Tapering also hasn't worked.

I want to use my insurance for the visit and the medication while keeping everything private. My mother is the policy holder for our insurance policy. Will she find out or be notified that I've visited a doctor for a substance abuse problem or been prescribed suboxone? Who would inform her...the doctor or the insurance company?

I spoke to the receptionist and she informed me that the policy holder will be notified(Maybe she thought I was a minor?) I really hope she won't be because I don't want to hurt my family.

Also will it affect the insurance policy in any way?

I asked this question on the "Ask a doctor" forum but I didn't get a clear answer. Any experiences or knowledge would be so helpful.

Thanks!
13 Responses
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1248235 tn?1268881737
ok so i work at a insurance agency and due to the hippa law the medication names should not be on a soba or yearly summary. This is against the law if you are over 18. I am not saying they will not find out because not everyone does everything perfect 100% of the time. THis is one of the MAIN REASONS for that law. The only way your parents should by law be able to get your medical info is to provide the info first and show knowledge of it. I am not saying it is the best way to go. dependents of 18 should NOT have there info sent to parents regardless major rule that should be followed. major rules to follow sending anyone a summary of benefits. youhave to be talking to the patient ver all info for it to even be printed with medicationnames.
Helpful - 0
Avatar universal
i know this is alot of different answers and everyones opinon...I do beleive everyone's insurance is different...I do know a few here that work for insurance companies if you would like me to pm them...

I am sorry to hear about your brother, and I can see where that would make your mom very sad...I am an addict, and i have a daughter who just made a yr clean...I also thought my son ws using, and I will tell you that it very stressfull...but As a mother I would want to know., and I would stand by my kids sides to get them the help they need...I really think telling her woud be a good idea..
We are all here to help you..
how much are you using a day?  and for how long?
r2r
Helpful - 0
Avatar universal
Thanks xerinmichelle and also LateAugust for you replies! It is clear to me now what will happen with the insurance. I'm going to think about it over the weekend and decide whether I'm going to go to the Doctor for the Sub or not (although I don't really see any alternatives).

I will probably end up telling my mother, but it won't be easy. It's really going to hurt and scare her. I think I'll do it after I'm in treatment so that she knows I'm ok and not still using. I know having some support like out-patient or NA is important too so I'll do that.

Its so unbelievable when I look back and think, How did this happen? Why did I think this would be a good idea? I should have known better. Even now I'm fighting my mind which is trying to figure out plans to keep using. Opiates have to be the most cruel things in the world. They make you burn sooo bright, high above the world, care-free...only to snatch it all away and cast you down into an angry, filthy pit of emptiness.
Helpful - 0
Avatar universal
hey u i hav a question for u about the outpatient program , what exactly is it i kno what in opatiennt but what is the out cause i cant do in but out sounds like sumthn i can def use i thnk.thansk
Helpful - 0
Avatar universal
IF you are over 18   what you say or see  your doctor about is confidential due to the Hippa Law, and the doctor cannot discuss your treatment unless you sign a waver for them to do so...........  however  your mom will get the info on her insurance statement  for the meds....  and it will show the doctor you went to, so if she looks in the yellow pages for him/her and they are an addiction specialist, she will again obviously know..

I can only recommend to you to talk to your mom.  My daughter is an oxy addict and after 3 times of in-patient treatment  and addiction councelors, psychiatrists    you name it    she could make it thru W/D  no problem    after about 2 weeks  she would relapse.  I am not saying I am for or against Suboxone,  but I will tell you my daughter started it 2 weeks before her last in-patient treatment,  and has done great.  She is also in IOP treatment and attends NA 3-4 times a week.      I dont think Sub is a magic pill,  but with the other treatment it has given her the opportunity to begin to rebuild her life.      My daughter is 21  and dropped out of college full time, so I had to take her off my policy,  we have been paying out of pocket for the last year......which has been thousands of dollars.    Please get help now,  while your mom can insure you.........    Do it for you    for your mom  and for your brother.      I wish you only the best sweetheart,  and I know it will be hard to to talk to your mom,  but truly,  she deserves no less than your honesty.       My best thoughts are with you........
Helpful - 0
Avatar universal
Hi there! I think I may be able to help you out the most. I had the same fears about my parents finding out but wanting to go on suboxone as well. At the time, I believed suboxone to be a miracle drug, I would just take it and that was it, I was cured. It IS NOT like that. PLEASE please please dont think that suboxone is all you need, because this is false information. with suboxone treatment, your doctor (if he is a good one who cares about your sobriety) will HIGHLY suggest or even REQUIRE outpatient rehab, which also costs money. Not only will he suggest it, but you really do need it. Hearing about your family history (brothers OD) you are definetly at risk for long term drug use and/or chronic relapse, and you probably have a very addictive personality. My brother and I too are both addicts of oxycontin. I have 10 months sober and for the first 6 months I saw a therapist 4 times a week, two hours each session. I also was enrolled in an outpatient program which required many meetings, as well as being prescribed suboxone, and I still fight demons every day. The cravings are so bad some days that I have to lay in bed all day and sleep. NOW to answer your questions,

YESSSS the policy holder will be notified. Maybe not right away, but most insurance companies do contact policy holders at the end of the year to review the usage. It will say the Dr's name, or the office name, if he has one, and it will also say the name of the drug (suboxone), how much of it you got each month, the name of the pharmacy you filled your suboxone at, and any other cost details. it is very important to the insurance companies to do things like this in case mistakes were made, insurance companies will do all they can do to get off about paying things!

Now, I know you dont want to tell your mom, but you really should. you would be suprised by how supportive she will be. believe me, I promise. you will feel sooooo much better, I swear to you, I would be the first to tell you I was NEVER going to tell my parents! but guess what? they found out. and it was much worse at first, they were hurt, shocked, to hear about my addiction from someone else, and realized I had been lying, but in the end, it is so nice to talk to my parents about my cravings, about my suboxone, and other treatments. Another thing, it might benefit you to move back home with your mom, it could help you stop using.
Helpful - 0
Avatar universal
Thanks for the comments everyone. It helps to restore my faith in humanity when I see that there are total strangers that take time out of their day just to help someone out.

Unfortunately, I am just as confused as ever...

Worried878 says the bill won't go into detail and a friend of mine also said the same thing.

Holliee says the treatment and the med will be listed on the bill.

(If I give my address in the doctor's office will they send the bill to me? Also I'm going to pay any extra charges not covered.)

McTigerlily says the policy holder might be able to look online and get info from the insurance. I'm glad that it won't affect the policy. It stinks that my medical history will have a mark on it, but I can accept that. Also, I'm not going to tell her unless I have to. It will definitely be better if this never becomes known( see my 2nd post).

Cathy5841 says she will get a statement from the insurance with the diagnosis on it which I would assume reveals exactly what I wouldn't want(worst possible scenario).

Cathy, I looked at the health pages on Sub, lots of important + scary information. From what I've read, I'd want to be done with it in 21 days to avoid the worst of it. I haven't been able to successful taper or go cold turkey and I'm getting tired of it. I can't deal with the failures. They make it so much worse when I go back on.

I'm sorry if I'm being annoying and OCD but can I get a consensus on this? Is she going to receive information that will inform her that I've gone to a doctor for addiction or been treated for substance abuse with suboxone?

Also, if anyone can link me to a website with the info I'm looking for that would be great too.



Helpful - 0
340590 tn?1290952141
the insurance company will send a statement as to what they paid on your behalf and it will have the diagnosis on it.  please do not assume sub is the answer...it is a very powerful opiate and the w/ds from it are usually worse than the oc,s are.  please do the research and read this forum and check the health pages on the right you will find a thread of our members experiences on sub.  please read it.
Helpful - 0
262294 tn?1236176870
Hey there. Depending on your type of insurance, you can now go online and check pharmacy records (what you're taking, how much, when it was filled, and the doctor who prescribed it). That should in no way affect your mom's policy. If it's covered by the insurance, they don't care what you do as long as you pay your bills. It shouldn't hike up the price like what happens to car insurance after you have a wreck that you're responsible for, you know?

If I were you, I would tell her before she finds out on her own. Tell her that you're seeking help and need her support and that you know you shouldn't be on that stuff and you truly want to be clean. It would be worse if she got the bill or looked online at her own claims and then got confused or upset about some additional charges that she didn't know anything about.

Now, what WILL happen with your records is that when you fill out job applications in the future and it may ask if you've ever been treated for a drug addiction/substance abuse. You have to know that you want to get clean and be confident about it and know that there are consequences. It may affect your records but employers cannot EVER not hire you because of a past treatment. That is discrimination and it's against the law.
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Avatar universal
So the insurance will tell her that I was prescribed suboxone? I could probably handle that. Would it say that the treatment was for drug addiction? That would be bad...
Helpful - 0
662972 tn?1270166301
she could find out if she is over insurance b/c on insurance part it would be labled under treatment and script would be labled suboxone be easy for her to find out b/c when you use insurance and the doc and pharm send bill has name on it and what did and gave...
Helpful - 0
Avatar universal
I really need to do this and get off this garbage. Thanks for the reply and thanks for the encouraging words.

The reason it's so important that I keep this a secret from my family is because my brother died from an Oxycontin overdose. It would scare them so much if they knew about me...especially my mother. I really don't want to put them through all that for my dumb mistakes. Judging from the good things I've heard about Sub, if I can get on it I'll definitely be able to break myself free.

Do you know if the summary/bill would be sent to an address I give the doc or to the address for the insurance (because I don't live at home and I could give them my address). Also, very important if you know...Will this cause me to get dropped from the policy or cause my mom or family to lose theirs?

Thanks again!

Helpful - 0
401095 tn?1351391770
I dont know for sure...but if there are any extra charges etc then she will receive a bill..it wont go into detail but the doctor u saw will be stated on the summary/which most do not read unless they r billed a bunch of money...she may not look.....as far as anyone finding out..a doctor later on could find out cos they have access to ur records but unless u do sumpin suspicious like drug seeking, a doctor will not routinely check ur pharmacy records...this is important/u getting clean/and should outweigh any fears u have of being 'found out"  u r doing what u need to do to get clean...if u dont get clean now it can get alot worse/in fact it will get worse cos it never gets better...and ur mom could be bailing u out of jail or even worse....dont worry over what u have done to help urself....u r moving forward in the direction u chose to go,..ur goals and ur needs which are very important right now...keep moving forward and keep posting
Helpful - 0
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