Member Rights and Responsibilities

Members have a right to:

• Information about Health Advantage
• An explanation of their benefits
• Access to healthcare providers
• Be treated with respect and dignity
• Participate in decisions regarding their healthcare coverage and communicate their preferences
• Confidentiality of information
• Change healthcare providers
• Appeal adverse claim decisions

Members have a responsibility to:

• Become familiar with the terms, requirements and procedures of their health insurance plan
• Present their member ID card to healthcare providers when seeking care
• Provide information in connection with their submitted claims, including information about other healthcare coverage, when requested by Health Advantage
• Meet all copayments, deductible and coinsurance obligations
• Notify Health Advantage of any change in eligibility status
• Communicate to Health Advantage any complaint or grievance immediately

NOTE: Information on Member Rights and Responsibilities is provided annually in our member magazine, Blueprint.