Opt-Out Information & Forms


Opting Out of Sharing health information with your PCP, Hospital or Specialist who Manages Your Care

The HUSKY Health Program gives Primary Care Providers (PCPs), the hospital you visit and specialist who manages your care secure computer access to certain information. A PCP is the provider you chose or based on our records, where you get your primary health care. Your PCP both provides and manages your health care. Your PCP treats you and also helps make sure that you and your family get all of the health screenings and immunizations that you need. Unless you tell us otherwise, your PCP, the hospital you go to for care and the specialist who manages your care will have secure computer access to certain health information about you that HUSKY Health has from some of your other health providers, such as other hospitals, specialists and pharmacies. Your PCP, hospital and specialist may use this information for treatment purposes only. If you do not want them to have computer access to this information, you will need to complete an Opt-Out Request Form and send it back to us.

Please see the important information below

Frequently Asked Questions

If you have questions about the Opt-Out process, please look at our Opt-Out Frequently Asked Questions by clicking here.

Sharing your General Health Information with your PCP, Hospital or Specialist who Manages your Care

If you want your PCP, hospital or specialist who manages your care to be able to have secure computer access to certain health information, you don’t need to fill out any forms. Please see below for sharing sensitive data with your PCP, hospital or specialist who manages your care.

Opt-Out Request Form

If you don’t want your PCP, hospital or specialist who manages your care to have computer access to your health information from other providers, please click here for the Opt-Out Request form. You will need to read the directions on the form carefully, fill out the information and send it back to the address on the bottom of the form. If you want your PCP, hospital or specialist who manages your care to be able to have secure computer access to your health information, you don’t need to do anything.

Cancelling your Opt-Out Request

If you have sent us an Opt-Out Request form, but have changed your mind and want your PCP, hospital or specialist to have secure computer access to your health information, you will need to send us a form to cancel your request. Please click here for the form. You can change your mind at any time.

Sharing your Sensitive Data with your Health Care Provider

Unless you sign a special consent form, your PCP, hospital or specialist will NOT see electronic health information about you that HUSKY Health has from your behavioral health providers, including substance abuse treatment programs, nor will the PCP, hospital or specialist see any HIV-related information that HUSKY Health has about you. It is your choice if you want your health care provider to see this information. You can get this special consent form from your health care provider, by clicking here or by calling Member Engagement Services at 1.800.859.9889.

Cancelling your Request to Share Sensitive Data with your Health Care Provider

If you sign this special consent form and then change your mind and you do not want this sensitive information shared with your PCP, hospital or specialist, you must complete a special form. You may do this at any time using a special revocation of consent form that you may get in the same ways that are described above. Please click here for the form.

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