Citizens Choice Healthplan HMO Members have the right:
- To be treated with fairness, respect, dignity, and consideration for privacy; including
protection from release of any information that identifies them to anyone other
than those having an “identified need for the information”.
- To the privacy of their medical records and personal health information. To have
health and medical records, as well as any other information, treated with confidentiality,
regardless of the format of that information (i.e., spoken communications, written
materials, electronic records, or facsimiles).
- To have access to their medical records in accordance with law.
- To be free from discrimination based on race, ethnicity, national origin, religion,
sex, age, mental or physical disability, sexual orientation, genetic information,
or source of payment.
- To see plan providers and get covered services within a reasonable period of time.
- To have services accessible and available to them.
- To access emergency health care services without prior authorization.
- To choose providers for both primary and specialty care, from among those affiliated
with Citizens Choice Healthplan HMO and/or the Medical Group and to refuse care from
any specific providers.
- To know treatment choices and participate in decisions about their health care.
- To use an advance directive (such as a living will or a power of attorney).
- To choose a representative to facilitate care or treatment decisions, including
withholding resuscitative services or to forego or withdraw life-sustaining treatment,
when they are unable to do so.
- To receive information on available treatment options (including the option of no
treatment) or alternative courses of care in a language they understand.
- To make complaints and obtain a prompt resolution of issues (including complaints,
grievances or appeals) relating to authorization, coverage, or payment of services.
- To get information about their health care coverage and costs.
- To get information about Citizens Choice Healthplan HMO, their Medical Group and any
contracted providers.
- To get more information about their rights.
Citizens Choice Healthplan HMO Members have the responsibility:
- To become familiar with their coverage and the rules that must be followed to get
care as a member.
- To give doctors and other health care providers the information they need to provide
health care.
- To pay any applicable copayment, deductible, co-insurance or charge for non-covered
services when requested by their Citizens Choice Healthplan HMO/Medical Group physician.
- To act in a way that supports the care given to other patients and helps the smooth
running of the doctor’s office, hospital, and other offices.
- To let us know if they have any questions, concerns or suggestions.
H3815_09143EN (10/2009)