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What is HIPAA, and what rights does it grant me?

HIPAA stands for the Health Insurance Portability and Accountability Act of 1996. HIPAA established special protections for certain people -- called "federally eligible individuals" or "HIPAA eligible individuals" -- when they lose group health coverage. Once people become HIPAA-eligible, they are guaranteed an offer of at least two health insurance policies that do not impose pre-existing condition exclusion periods. HIPAA is silent on what people can be charged for such coverage.

HIPAA's requirement to guarantee issue coverage with no pre-existing conditions varies between states. In some states, HIPAA rules apply to all private insurance companies that sell coverage in the individual health insurance market. Some states, however, have made alternative arrangements to guarantee these HIPAA protections only from the state high-risk pool. Private insurers in these states are still free to medically underwrite their policies and deny applicants and impose pre-ex periods, even for HIPAA eligible individuals.

A number of states also limit how much insurers can charge HIPAA eligible individuals (and often other residents) for coverage.
Dr. Michael Roizen, MD
Internal Medicine

HIPAA, though it sounds like it might be a female hippo, is actually short for the Health Insurance Portability and Accountability Act of 1996. HIPAA protects the privacy of your medical records since the law states that it is illegal to share your health information with anyone not involved with your care, unless you give the A-OK in writing.

HIPAA also gives you a number of important rights, including:

  • The right to see and get a copy of your healthcare records.
  • The right to get written information that tells you how your health
           information may be used and shared.
  • The right to know when and why your healthcare information was
           shared.
  • The right to have your healthcare records corrected.
  • The right to decide if you want to allow your healthcare information
           to be used or shared for purposes such as for marketing.

 

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Important: This content reflects information from various individuals and organizations and may offer alternative or opposing points of view. It should not be used for medical advice, diagnosis or treatment. As always, you should consult with your healthcare provider about your specific health needs.