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Confidential communications request template for insurance mail

Use this to ask your plan to send Explanations of Benefits and other communications to your own address, email, or portal rather than to the policyholder's. Most plans have a process. Ask what it covers, because paper mail and online portal access are often handled separately.

Applies to Anyone covered as a dependent or spouse. Requirements differ by insurer and state.

What to do

  1. Ask what your plan requires before you send anything

    Some plans grant the request on request. Others ask you to state that disclosure could endanger you. Ask first so you do not volunteer more than needed.

  2. Send the request in writing and keep a copy

    Written requests create a record you can point to if a mailing goes to the wrong address later.

  3. Ask explicitly about the portal

    Redirecting paper mail does not necessarily remove claims from a policyholder's online account. This is the gap that surprises people.

  4. Get written confirmation before you rely on it

    Ask for confirmation of the effective date and of exactly which communications are covered.

The request

[Your name] · [Member ID] · [Date of birth] · [Today's date]

To: [Insurer or plan, member services or privacy officer]

Re: Request for confidential communications

I am requesting that all communications about my health care — including Explanations of Benefits, claim correspondence, and any notices about services I receive — be sent only to me at the address below, and not to the policyholder or any other person on this policy.

Preferred method and address: [your mailing address, email, or portal account].

[If your plan requires a statement: Disclosure of this information to others on the policy could endanger me.]

Please confirm in writing: (1) that this request has been accepted; (2) its effective date; (3) exactly which communications it covers; and (4) whether claims involving my care remain visible in any other person's online account for this policy, and what is required to change that.

[Signature] · [Phone]

Common questions

Do I have to give a reason?
It depends on the plan and the state. Ask what is required before providing anything beyond the request itself.
Does this cover the policyholder's online account?
Often not. Ask about it as a separate question and get the answer in writing.
Last updated 2026-08-06Not legal or medical advice