Member Rights and Responsibilities
PHP (HMO SNP) must honor your rights as a member of the plan:
- We must provide information in a way that works for you (in languages other than English that are spoken in the plan service area, in Braille, in large print, or other alternate formats, etc.)
- We must treat you with fairness and respect at all times
- We must ensure that you get timely access to your covered services and drugs
- We must protect the privacy of your personal health information
- We must give you information about the plan, its network of providers, and your covered services
- We must support your right to make decisions about your care
- You have the right to make complaints and to ask us to reconsider decisions we have made
- What can you do if you think you are being treated unfairly or your rights are not being respected?
Plan members have responsibilities too:
- Get familiar with your covered services and prescription drug benefit and the rules you must follow to get these covered services and prescription drugs
- If you have any other health insurance coverage or prescription drug coverage besides our plan, you are required to tell us
- Tell your doctor and other health care providers that you are enrolled in our plan
- Help your doctors and other providers help you by giving them information, asking questions, and following through on your care
- Be considerate
- Pay what you owe
- Tell us if you move
- Call Member Services for help if you have questions or concerns.
The complete text on member rights and responsibilities can be found in Chapter 8 of the 2024 Evidence of Coverage.