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Member Rights and Responsibilities

MoreCare Member Rights

MoreCare will honor your rights as a member of MoreCare. MoreCare Members have specific rights and responsibilities when it comes to their care. The Member rights and responsibilities are provided to Members in the Member’s Evidence of Coverage booklet and are outlined below.

  1. Have information provided in a way that works for them including information that is available in alternate languages and formats.
  2. Be treated with fairness, respect, and dignity.
  3. See MoreCare Providers, obtain covered services, and get their prescriptions filled in a timely manner.
  4. Privacy and to have their personal health information (PHI) protected. This is further outlined in the MoreCare Notice of Privacy Practices.
  5. Obtain information about MoreCare, its network of providers and practitioners, their covered services, and their rights and responsibilities.
  6. Know their treatment choices and participate in decisions about their health care.
  7. Use Advance Directives (such as a living will or a durable health care power of attorney).
  8. Make complaints about MoreCare or the care provided and feel confident it will not affect the way they are treated.
  9. Appeal medical or administrative decisions MoreCare has made by using the grievance process.
  10. Make recommendations about MoreCare’s Member rights and responsibilities policies.
  11. Talk openly about care needed for their health, regardless of cost or benefit coverage, as well as the choices and risks involved. The information must be given to Members in a way they understand.

MoreCare Member Responsibilities

A Member has certain responsibilities under MoreCare. These include the responsibility to:

  1. Become familiar with their coverage and the rules they must follow to get care as a Member.
  2. Tell MoreCare and Providers if they have any additional health insurance coverage or prescription drug coverage.
  3. Tell their PCP and other health care Providers that they are enrolled in MoreCare.
  4. Give their PCP and other Providers complete and accurate information to care for them, and to follow the treatment plans and instructions that they and their Providers agree upon.
  5. Understand their health problems and help set treatment goals that they and their doctor agree upon.
  6. Ask their PCP and other Providers questions about treatment if they do not understand.
  7. Make sure their doctors know all of the drugs they are taking, including over-the-counter drugs, vitamins, and supplements.
  8. Act in a way that supports the care given to other patients and helps the smooth running of their doctor’s office, hospitals, and other offices.
  9. Pay their plan premiums and any co-payments or coinsurance they owe for the Covered Services they get. Members must also meet their other financial responsibilities as described in the Evidence of Coverage booklet.
  10. Inform MoreCare if they move.
  11. Inform MoreCare of any questions, concerns, problems or suggestions by calling the Member Services Department listed in their Evidence of Coverage booklet.

 

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