Member 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.