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  • Member Rights & Responsibilities

Member Rights & Responsibilities

You have the right to receive information from us and your providers.
Information we supply will help you understand our organization, your rights and responsibilities as a member, the network of providers included in your plan, and the services and benefits available to you and how to use them. Information supplied by your providers will help you understand your condition and plans for care.

You have the responsibility to read the information we give you and ask questions when you need to know more.
We urge you to read all the materials we give you and keep them for future reference. You should know your benefits and responsibilities under your plan and ask us if you don't understand them. You should also ask as many questions of your providers as you need until you understand all aspects of your condition and treatment plans.

You have the right to access quality care.
High-quality physicians, hospitals, and wellness programs are available to you as a member. Each of our plans has a large network of providers, and choosing a provider included in your plan helps ensure that you will receive maximum coverage under your plan. Visit Find a Doctor to search for a provider in your network.

You have the responsibility to follow plan rules and instructions for care.
To receive care or services, you must identify yourself as a member to providers and follow the policies and procedures described in your member handbook, subscriber certificate, and other plan materials. When you and your providers have agreed to a treatment plan, you should follow the instructions for care given.

You have the right to communicate with your providers.
Your providers want to know about your health needs and concerns, so they can help you make decisions about your care. You have a right to a candid discussion of appropriate or medically necessary treatment options for your condition regardless of cost or your benefits.

You have the responsibility to keep your providers informed.
So that providers can effectively treat you and manage your care, tell them and others involved in coordinating care about your medical history and current health, and participate in developing treatment goals to the degree possible. Understand the risk of not giving information others might need to treat you most effectively.

You have the right to be treated with respect, dignity, and privacy.
We should treat you with respect and courtesy. We will keep your records confidential, as described in the notice, Our Commitment to Confidentiality.

You have the responsibility to treat your providers and us with respect.
We expect the same courteous treatment from you that you expect from us.

You have the right to appeal our decisions, voice complaints, and recommend changes.
We want to hear if you disagree with a decision, are unhappy with the care or service you receive, or if you would like to recommend changes, including to this Member Rights and Responsibilities statement.

You have the responsibility to let us know when you disagree.
Your first step when you have any complaint or concern is to call Member Service at the number on the front of your ID card.