If your co-worker is less than discreet, that trip to the psychiatrist in 1992 could become common knowledge in the lunchroom. Even if you dig deep into your own pockets for the cost of health insurance, avoiding insurance altogether, your medical records could still end up in the hands of a managed care company. That's because most doctors are part of a healthcare network. They want access to all records, not just enrollees. But that doesn't change the fact that a company like Aetna could have access to the medical files of someone who doesn't even have Aetna health insurance.
Hospitals also keep records on patients they've served.
If you file a claim for an emergency room visit, chances are your insurance company will also send that information to the Medical Information Bureau. In one famous case, an Iowa woman sought treatment in an emergency room after an incident of domestic violence. Later, she was turned down for life insurance because of it. Regulators have since taken steps to protect domestic violence victims, but protection varies from state to state. Pharmacies also store information about the kinds of medication that customers use.