Derechos y responsabilidades del miembro

As a member of this plan, you have many rights you can count on. These include your right to:

• Be treated fairly and with respect. This includes your right to privacy.

• Not be discriminated against for any reason.

• Be treated with dignity. 

• Request a copy of your medical records. And make changes if allowed.

• Be given clear information about the plan and its services.

• Make recommendations regarding our member rights and responsibilities policy

You have the right to play an active part in your health care. This includes:

• Working as a team with your primary care physician (PCP) to make decisions about your health

• Being able to say yes or no to the care or treatment your PCP recommends

• Being able to have a candid discussion about treatment options regardless of the cost or benefit coverage

You have the right to make a complaint or file an appeal and to get a timely response. This includes the right to:

• File:

  • Apelaciones

  • Grievances

  • Audiencias estatales imparciales

• Ask that your benefits continue during your appeal process. You may have to pay for the continued benefits.

You have the right to health care that does not have any barriers. This includes:

• Getting a second opinion from another doctor in our network. 

• Having information that explains your health plan rules. This includes what is covered and how to get services.

• Having the right to not be restrained or isolated for someone else’s convenience. Or to not be forced to do something you don’t want to do.