Rights & Responsibilities

Our plan must honor your rights as a member of the plan.

Member Rights

• We must provide information in a way that works for you (in languages other than English, in Braille, in large print or other alternate formats, etc.).
• We must treat you with fairness and respect at all times.
• We must ensure that you get timely access to your covered services and drugs.
• We must protect the privacy of your personal health information.
• We must give you information about the plan, its network of providers, and your covered services.
• We must support your right to make decisions about your care.
• You have the right to make complaints and to ask us to reconsider the decisions we have made.

Member Responsibilities

You have some responsibilities as a member of the plan. Things you need to do as a member of the plan are listed below. If you have any questions, please call Member Services. We’re here to help.

• Get familiar with your covered services and the rules you must follow to get these covered services.
• If you have any other health insurance coverage or prescription drug coverage in addition to our plan, you are required to tell us.
• Tell your doctor and other health care providers that you are enrolled in our plan.
• Help your doctors and other providers help you by giving them information, asking questions and following through on your care.
• Be considerate.
• Pay what you owe.
• Report suspected fraud or abuse to CareSource.
• Tell us if you move. If you move outside of our plan service area, you cannot remain a member of our plan. If you move within our service area, we still need to know so we can keep your membership record up to date and know how to contact you.
• For more information about your rights and responsibilities as a member of our plan, see Chapter 8 in your Evidence of Coverage.