Full license status from the California Department of Social Services - HCO Number 374700002

Member Rights and Responsibilities

Care1st_logoMember Rights and Responsibilities

What are your health care rights?

You have the right to know.

  • 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.