employer-based insurance

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If you have insurance through an employer, does the HR person in charge of benefits managements see what expenses are put on insurance or need to be part of any surgery pre-approval process? As in, will using work-based insurance for trans surgeries essentially out you to HR people?

[Miharu Barbie]

Not a chance.  The Health Insurance Portability And Accountablity Act (or HIPPA) which is enforced by the US Office for Civil Rights has the entire health care industry running scared.  Everyone is so terrified of violating the HIPPA rules that your wife, husband, mother, father, sister, brother or caregiver (nevermind your employer) cannot get medical information about you without your express permission and direct instructions to the medical provider.  Period.

[E-Brennan]

Miharu Barbie is right.  Your employer cannot access your medical records or see any kind of information relating to treatments you have sought under your employer-provided medical insurance without express written permission from you.  Nobody in HR can call up the insurance company and ask what you've sought treatment for, and simply seeking treatment will not out you to your employer.

But...

Your employer has certain rights to request information to verify that your sick leave is being used for appropriate purposes and that you're not using it as vacation time.  Taking a large chunk of time off for surgery is going to raise some questions, and there's a chance that they'll need some documentation to confirm, at the very least, that you are having surgery and what the recovery time is expected to be (and that you're not off on a cruise somewhere).  You might want to discuss this with the HR department and liaise with your surgeon to make sure any letter he sends to the employer is generic enough for the exact procedure to remain hidden.

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But...

Your employer has certain rights to request information to verify that your sick leave is being used for appropriate purposes and that you're not using it as vacation time.  Taking a large chunk of time off for surgery is going to raise some questions, and there's a chance that they'll need some documentation to confirm, at the very least, that you are having surgery and what the recovery time is expected to be (and that you're not off on a cruise somewhere).  You might want to discuss this with the HR department and liaise with your surgeon to make sure any letter he sends to the employer is generic enough for the exact procedure to remain hidden.

It is my partner's insurance, and he recently added me to it- I would just rather not out myself to them, or drag his workplace into all of it if possible.

Not a chance.  The Health Insurance Portability And Accountablity Act (or HIPPA) which is enforced by the US Office for Civil Rights has the entire health care industry running scared.  Everyone is so terrified of violating the HIPPA rules that your wife, husband, mother, father, sister, brother or caregiver (nevermind your employer) cannot get medical information about you without your express permission and direct instructions to the medical provider.  Period.

This is reassuring. I think we had to sign something waiving something with the word HIPPA in it, which concerns me. I don't have the paperwork, unfortunately, and didn't think to care at the time.  I hope it doesn't mean they can take a peek if they want. I know expensive surgeries can increase the cost of what they pay too.

I'm over the moon about the possibility of having coverage - but also getting way ahead of myself on this. I am basing this on a search of what the insurance company covers, but not sure about our specific plan yet.

I got worried because there was that thing in the news awhile back where a CEO of some random company blamed insurance coverage cuts for employees on someone's baby needing expensive surgery in an announcement to the company. That was probably just the CEO being awful though, and a one time case that caused a big media storm.

[Miharu Barbie]

Yup, those HIPPA waiver forms are typical.  Basically they serve 2 purposes, 1) the waiver is to inform you of your rights under HIPPA, and 2) the waiver authorizes the medical provider to release just enough information about your health care to the insurance company so that they can get paid.  Health care providers and health insurance companies are held to strict privacy standards under HIPPA; so your waiver allows them to communicate with each other, but does not allow for either to communicate with the employer that pays the insurance premiums.

I don't know about the case you mentioned where the CEO shoots off his mouth, but I've worked in enough office environments to know that office workers tend to know each others business that way because people talk.  The parent of the baby spoke to someone else in the office who spoke to someone else who spoke to someone else, next thing people are pooling money to send flowers, etc., etc.  I sincerely doubt that the CEO got his information via the company's insurance carrier.  It just doesn't happen.

As long as your partner doesn't talk about your medical procedures with co-workers around the water cooler, your surgeries and procedures will remain your own private business.

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Yup, those HIPPA waiver forms are typical.  Basically they serve 2 purposes, 1) the waiver is to inform you of your rights under HIPPA, and 2) the waiver authorizes the medical provider to release just enough information about your health care to the insurance company so that they can get paid.  Health care providers and health insurance companies are held to strict privacy standards under HIPPA; so your waiver allows them to communicate with each other, but does not allow for either to communicate with the employer that pays the insurance premiums.

That's good to hear - thanks for the replies