Member Rights & Responsibilities

Your Membership Rights

As a member of CareSource you have the following rights and responsibilities. These are also listed in your Member Handbook.

You have the right to:

• Receive information about CareSource, our services, our network providers and member rights and responsibilities.
• Be treated with respect and dignity by CareSource personnel, network providers and other health care professionals.
• Privacy and confidentiality for treatments, tests and procedures you receive.
• Participate with your doctor in making decisions about your health care.
• Candidly discuss with your doctor the appropriate or medically necessary treatment options for your conditions, regardless of cost or benefit coverage.
• Voice complaints or appeals about the plan or the care it provides.
• Make recommendations regarding the plan’s member rights and responsibilities policy.
• Choose an advance directive to designate the kind of care you wish to receive should you be unable to express your wishes.
• Be able to get a second opinion from a qualified network provider. If a qualified network provider is not able to see you, CareSource will set up a visit with a provider not in our network.

You have the responsibility to:

• Provide information needed, to the extent possible, in order to receive care.
• Follow the plans and instructions for care that you have agreed to with your doctors.
• Understand your health problems and participate in developing mutually agreed-upon treatment goals, to the degree possible.
• Be enrolled and pay any required premiums.
• Pay an annual deductible, copayments and coinsurance.
• Pay the cost of limited and excluded services.
• Choose network providers and network pharmacies.
• Show your ID card to make sure you receive full benefits under the plan.