What are Member Rights?
Note: This information is shared with every member at time of enrollment.
A covered person has the right to:
- Receive information about the organization: its services; its practitioners and providers; and Covered Person rights and responsibilities.
- To be treated with respect and recognition of their dignity and their right to privacy.
- To participate with practitioners in making decisions about their health care.
- A candid discussion of appropriate or medically necessary treatment options for their conditions, regardless of cost or benefit coverage.
- Voice complaints or appeals about the organization or the care it provides.
- Make recommendations regarding the organization’s Covered Person rights and responsibilities policy.
What are Member Responsibilties?
A covered person has the responsibility to:
- Supply information (to the extent possible) that the organization and its practitioners and providers need in order to provide care.
- Follow plans and instructions for care that they have agreed to with their practitioners.
- Understandtheirhealthproblemsandparticipateindevelopingmutuallyagreed-upon treatment goals,to thedegreepossible.
If members need help understanding any of this information, call us at 855-447-2900