Member Rights and Responsibilities

• Know your rights and responsibilities
• Know about our services, doctors, and specialists and be informed when your doctor is no longer contracted with Care1st Health Plan.
• Know about all our other caregivers.
• Be able to see your medical records. You have to follow the State and Federal laws that apply.
• Have an honest talk with your doctor about all treatment options for your condition, regardless of cost or benefit coverage.

You have the right to be treated well.

• Always be treated with respect.
• Have your privacy kept safe by everyone in our health plan.
• Know that we keep all your information private.

You have the right to be in charge of your health care.

• Choose your primary care doctor.
• Say no to care from your primary care doctor or other caregivers.
• Be able to make choices about your health care.
• Make a living will (also called an advance directive).
• Voice complaints or appeals about Care1st or the care it provides including the right to file a grievance if you do not receive services in the language you request.

You have the right to get a range of services.

• Get family planning services.
• Get preventative health care services
• Get minor consent services
• Be treated for sexually transmitted diseases (STDs).
• Get emergency care outside of our network.
• Get health care from a Federally Qualified Health Center (FQHC).
• Get health care at an Indian Health Center.
• Get a second opinion.
• Get interpreter services at no cost. This includes services for the hearing-impaired.
• Get informing materials in various languages or alternative formats and large size print upon request.

You have the right to suggest changes to our health plan.

• Tell us what you don’t like about our health plan.
• Tell us what you don’t like about the health care you get.
• Question our decisions about your health care.
• Tell us what you don’t like about our right and responsibilities policy.
• Ask the Department of Social Services for a Fair Hearing.
• Ask the Department of Managed Health Care for an Independent Medical Review.
• Choose to leave our health plan.

What are your responsibilities as a health care member?We hope you will work with your doctors as partners in your health care.

• Make an appointment with your doctor within 120 days of becoming a new member for an initial health assessment.
• Tell your doctors what they need to know to treat you.
• Learn as much as you can about your health.
• Follow the treatment plans you and your doctors agree to.
• Follow what the doctor tells you to do to take good care of yourself.
• Do the things that keep you from getting sick.
• Bring your ID card with you when you visit your doctor.
• Treat your doctors and other caregivers with respect.
• Use the emergency room for emergencies only. Your doctor will provide most of the medical care that you need.
• Report health care fraud.

We want you to understand your health plan.

• Know and follow the rules of your health plan.
• Know that laws guide our health plan and the services you get.
• Know that we can’t treat you different because of, age, sex, race, national origin, culture, language needs, sexual orientation and/or health.

 

AT YOUR HOME FAMILYCARE DOES NOT DISCRIMINATE AGAINST ANY PERSON BY VIRTUE OF AGE, RELIGION, RACE, COLOR, SEX, SEXUAL ORIENTATION, PREFERRED SEXUAL IDENDITY OR DISABILITY.