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.