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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.