Members' Rights and Responsibilities
As a covered member, you have the right to:
Available and accessible services, including emergency care services, 24 hours a day, 7 days a week.
Information about your health condition, treatment options and risks so you can make an informed choice about your health care with your doctor, including the right to participate with providers in decision-making regarding your health care.
Refuse treatment recommended to you by Medica or any provider.
Be treated with respect and recognition of your dignity and right to privacy of your medical and financial records maintained by Medica or any Medica network provider in accordance with existing law.
File a complaint with Medica and/or a state regulator, and you may begin a legal proceeding if you have a problem.
Receive information about Medica, its services, its practitioners and providers, and member rights and responsibilities.
A grace period as described in your coverage document (if you pay premiums on an individual basis).
Disenroll voluntarily from your plan and the right not to be requested or encouraged to disenroll except in circumstances specified in federal law.
A clear description of nursing home and home care benefits covered under your coverage document.
To increase the likelihood of maintaining good health and to ensure that the best quality care is received, it is important that you take an active role in your health care. As a result, you should:
Establish a relationship with a provider before becoming ill, as this allows for continuity of care.
Provide the necessary information to determine the appropriate care. This obejective is best obtained when you:
a) share information about lifestyle practices; and
b) share personal and family health history.
Follow the instructions given by those providing health care.
Practice self care by
a) having the appropriate tests and immunizations; and
b) engaging in healthy lifestyle choices (exercises, proper diet and rest).
Right to privacy.
Right to file an appeal regarding a decision that was made or about Medica.
Right to make recommendations regarding Medica's Members' Rights and Responsibilities Statements.
Right to a candid discussion of appropriate or medically necessary treatment options for your condition, regardless of cost or benefit.
Responsibility to follow plans and instructions for care that you have agreed upon with your health care practitioners.
Responsibility to understand your health problems and participate in developing mutually agreed-upon treatment goals to the degree possible.
You may have additional rights depending on your plan; see your coverage documents for more information or contact Medica Customer Services at the phone numbers listed at Contact Medica.