Member RightsYou have the right to:
- Be treated with courtesy, dignity, and respect.
- Receive accurate and easily understood information about your benefit, your network of pharmacies, your covered drugs, and your rights and responsibilities.
- Access services or information regardless of literacy levels, language differences, cultural differences, or cognitive and/or physical impairment. You have the right to request further information concerning anything you do not understand.
- Participate in decisions regarding your health care. Parents, guardians, family members, or other individuals that you designate can represent you if you cannot make your own decisions.
- Privacy and non-discrimination, as required by law.
- Voice complaints; receive instructions on how to use the complaint process or file an appeal of a decision, and to receive a response to your complaint or appeal within a reasonable period of time.
Member ResponsibilitiesYou have the responsibility to:
- Become involved in specific health care decisions.
- Work with doctors and pharmacists by giving them information, asking questions, and following through on your care.
- Use the complaint and appeal process to address concerns that may arise.
- Become familiar with your covered drugs and the rules you must follow to get these covered drugs.
- Inform your doctor and pharmacist about the plan in which you are enrolled.
- Call Customer Service or visit your member portal for help if you have questions or concerns.
- Show respect for patients, doctors, and pharmacists.
- Make a good-faith effort to meet financial obligations.
- Report wrongdoing and fraud to appropriate resources or legal authorities.