Blue Cross members

  • 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
     
  • 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