Member rights & responsibilities

Members have a right to:

  • Be treated with respect and recognition of their dignity and right to privacy.
  • Receive information about the health Plan, its services, its practitioners and providers, and members' rights and responsibilities.
  • Participate with practitioners in decision making regarding their health care.
  • A candid discussion of appropriate or medically necessary treatment options for their conditions, regardless of cost or benefit coverage.
  • Make recommendations regarding the organization's members' rights and responsibilities policies.
  • Voice complaints or appeals about the health Plan or the care provided.
  • Provide, to the extent possible, information that the health plan and its practitioners and providers need in order to care for them.

Members have a responsibility to:

  • Understand their health problems and participate in developing mutually agreed upon treatment goals to the degree possible.
  • Follow the plans and instructions for care that they have agreed on with their practitioners.
  • Pay member copayments or coinsurance at the time of service.
  • Be on time for appointments and to notify practitioners/providers when an appointment must
    be canceled.