Blue Cross members
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Your rights as a health plan member:
- To be treated with respect, dignity and privacy
- To receive quality health care that is friendly and timely
- To have available and accessible medically necessary covered services, including emergency services, 24 hours a day, seven (7) days a week
- To be informed of your health problems and to receive information regarding treatment alternatives and their risk in order to make an informed choice regardless if the health plan pays for treatment
- To participate with your health care providers in decisions about your treatment
- To give your provider a health care directive or a living will (a list of instructions about health treatments to be carried out in event of incapacity)
- To refuse treatment
- To have privacy of medical and financial records maintained by Blue Cross and its health care providers in accordance with existing law
- To receive information about Blue Cross, its services, its providers, and your rights and responsibilities
- To make recommendations regarding these rights and responsibilities policies
- To have a resource at Blue Cross or at the clinic that you can contact with any concerns about services
- To file a complaint with Blue Cross and the Commissioner of Commerce and receive a prompt and fair review
- To initiate a legal proceeding when experiencing a problem with Blue Cross or its providers
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Your responsibilities as a health plan member:
To know your health plan benefits and requirements
- To provide, to the extent possible, information that Blue Cross and its providers need in order to care for you
- To understand your health problems and work with your doctor to set mutually agreed upon treatment goals
- To follow the treatment plan prescribed by your provider or to discuss with your provider why you are unable to follow the treatment plan
- To provide proof of coverage when you receive services and to update the clinic with any personal changes
- To pay copays at the time of service and to promptly pay deductibles, coinsurance and, if applicable, charges for services that are not covered
- To keep appointments for care or to give early notice if you need to cancel a scheduled appointment
