Bill of Rights & Responsibilities

Member Rights

You 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 Responsibilities

You 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.

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