Does ones health insurance provider get the details on the activities during a routine Dr. visit including any prescriptions written?

The reason I ask is as an engineering contractor I had to purchases my own medical insurance. When I originally attempted to get coverage in the spring BCBS tripled my initial premium estimate because I had a certain prescription filled within the last 12 months. They wanted $240 for a $5000 deductable, 30% co-pay plan. Talking to some friends in the medical industry, apparently this prescription can be seen by a liability and was given by BCBS for why I was given the increased premium.

I take this prescription As-Needed and very infrequently. Hence I did not have to lie about this medication on the application for health insurance company B earlier this month (when asked about medications in the last 12 months). Thus I got a reasonable price of $140 for a $2,500 20% co-pay plan. I need this prescription filled again and was trying to decide if I should just pay for the visit out of pocket or wait for my insurance to kick in 9/1 to only pay the co-pay ($20 versus $120+).

Thoughts?

8/23/2013 11:29:59 AM

yes, they can see all the details

8/23/2013 1:06:44 PM

Yes, every diagnosis and service, no matter how small, is coded I think. It's to be assumed the federal government has had complete access to insurance company databases for years now. There's no such thing as doctor-patient confidentiality.

8/23/2013 2:09:02 PM