Members’ Rights and Responsibilities
Health Alliance Medicare members have certain rights and responsibilities. These are listed below and in the Evidence of Coverage you receive when you become a member. If you have any questions about these items, please contact Health Alliance Medicare Services.
Members have the right to
- Be treated with respect and recognition of their dignity and right to privacy.
- Receive information about Health Alliance Medicare, its services, its contracted providers and members’ rights and responsibilities.
- Participate with contracted providers in making decisions about their health care.
- A candid discussion of appropriate or medically necessary treatment options for their conditions, regardless of cost or benefit coverage.
- Voice complaints or appeals about Health Alliance Medicare or the care provided.
- Make recommendations regarding the Health Alliance Medicare Rights and Responsibilities policies.
- Reasonable access to health care.
Members have the responsibility to
- Provide, to the extent possible, information Health Alliance Medicare and its contracted providers need in order to provide care.
- Follow the plans and instructions for care they have agreed on with their providers.
- Understand the status of their health and participate in developing mutually agreed-upon treatment goals with their providers, to the degree possible.
- Read and understand their Evidence of Coverage and any attached riders or amendments and to follow the rules of membership.
- Know the providers in their network.
- Notify Health Alliance Medicare in a timely manner of any changes in their status as a member or that of any of their covered dependents, such as name, address or martial status.