As a Member of one of the above mentioned groups, you have

RIGHTS:

  • The right to have a fair and comprehensive assessment of your health.
  • The right to easily obtain all necessary health services.
  • The right to participate in the decision-making regarding your healthcare.
  • The right to be treated with respect and dignity.
  • The right to privacy and confidentiality.
  • The right to know the price of services prior to having them rendered.
  • The right to be informed of medical services rendered.
  • The right to cleanliness of the provider’s office.
  • The right to the prompt return of test results.
  • The right to obtain a second opinion by another participating provider in your group.
  • The right not to be abandoned.
  • The right to your groups best effort in providing quality services.
  • The right to voice complaints or file appeals in the event of dissatisfaction.
  • The right to a candid discussion of appropriate or medically necessary treatment options for your conditions, regardless of cost or benefit coverage.
  • The right to be provided with information about your groups; covered services, benefit limitations and exclusions; the practitioners and providers; and member rights and responsibilities.
  • The right to be notified of termination or change in services, benefits or providers.

RESPONSIBILITIES:

  • The responsibility of following instructions and guidelines for care that you have agreed to with your practitioners.
  • The responsibility of notifying your group and the healthcare staff of any changes that affect your continuation of enrollment and benefits.
  • The responsibility of permitting only the person named on the identification card to use the card to obtain healthcare services.
  • The responsibility to keep scheduled appointments or give adequate notice of delay or cancellation.
  • The responsibility to read and understand the materials provided by your assigned health plan on how to use the health plan services, what services are covered by the Plan, and the exclusions and limitations of the Plan.