You have rights to:
- Be treated with respect, dignity, and consideration for privacy.
- Get services you need 24 hours a day, seven days a week. This includes emergencies.
- Be told about your health problems.
- Get information about treatments, your treatment choices, and how they will help or harm you.
- Participate with providers in making decisions about your health care.
- Refuse treatment. Get information about what might happen if you refuse treatment.
- Refuse care from specific providers.
- Know that we will keep your records private according to law.
- Request and receive a copy of your medical records. You also have the right to ask to correct the records.
- Get notice of our decisions if we deny, reduce, or stop a service, or deny payment for a service.
- File a complaint with the Minnesota Department of Health. For information, contact the Minnesota Department of Health at 651-282-5600 or toll free at 1-800-657-3916. Ask for HMO information. To access the TDD phone for the hearing impaired, call MN Relay Service at 1-800-627-3529.
- File a grievance or appeal with Medica or request a State fair hearing with the Minnesota Department of Human Services (also referred to as “the State”). You may request a State fair hearing before or at any time during Medica’s grievance or appeal process. You do not have to file a grievance or appeal with Medica before you request a State fair hearing. For information, contact Medica Customer Service or the Department of Human Services at 651-431-2660 or 1-800-657-3729. You also may call the State Ombudsman at 651-431-2660 or 1-800-657-3729. To access the TDD phone for the hearing impaired, call MN Relay Service at 1-800-627-3529 or 711.
- A clear explanation of covered home care services.
- Give written instructions that inform others of your wishes about your health care. This is called a “health care directive.” It allows you to name a person (agent) to decide for you if you are unable to decide, or if you want someone else to decide for you.
- Choose where you will get family planning services.
- Get a second opinion for medical, mental health, and chemical dependency services.
- Be free of restraints or seclusion used as a means of: coercion; discipline; convenience; or retaliation during your health care visits.
- Request a copy of the Certificate of Coverage at least once a year.
- Get the following information from Medica, if you ask for it:
• Whether we use a physician incentive plan that affects the use of referral services;
• The type(s) of incentive arrangement used;
• Whether stop-loss protection is provided; and
• Results of a member survey if one is required because of our physician incentive plan.
- Get the results of an external quality review study from the State, if you ask for them.
- Make recommendations about our rights and responsibilities policy.
- Exercise the rights listed here.
- Receive information about Medica, its services and providers, and member rights and responsibilities.
You have the responsibility to:
- Read the Certificate of Coverage and know which services are covered under the Plan and how to get them.
- Show your Medica member card and your Minnesota Health Care Programs card every time you go for health care. Also, show the cards of any other health coverage you have, such as Medicare or private insurance.
- Establish a relationship with a Medica network primary care doctor before you become ill. This helps you and your primary care doctor understand your total health condition.
- Give information asked for by your doctor. Share information about your health history.
- Follow all your doctor’s instructions. If you have questions about your care, ask your doctor.
- Work with your doctor to understand your total health condition. It is important to know what to do when a health problem occurs, when and where to seek help, and how to prevent health problems.
- Practice preventive health care. Have tests, exams, and shots recommended for you based on your age and gender.
Let us know if you have any questions, concerns, problems, or suggestions. If you do, please call Customer Service at 952-992-2322 or 1-800-373-8335.