Oregon law guarantees you the right to have protected health information sent
directly to you instead of to the person who pays for your health insurance
plan (the primary account holder).
You can have this information shared with you directly through a number of
- At a different mailing address
To make this request, complete, sign, and send this form to your insurer. You
can send it by mail, fax, or email. Contact your insurance company to find out
where to send your form.
Download the Oregon
Request for Confidential Communication form.
PLEASE NOTE: If you change insurance companies, you must make
a new request to the new insurance company. Until your request is processed,
the insurance company may continue to send your protected health insurance to
the person who is paying for your health insurance.
What is protected health information?
Protected health information is individually identifiable health information
your insurer has or sends out in any form. Confidential communication of protected
health insurance covered under this request includes:
- The name and address of a provider, a description of services provided,
and other visit information
- An explanation of benefits notice
- Information about an appointment
- A claim denial
- A request for additional information about a claim
- A notice of a contested claim
- Any written, oral, or electronic communication described on this list
to a policyholder, certificate holder, or enrollee that contains protected