Member Rights & Responsibilities
Your Membership Rights
As a member of CareSource you have the following rights and responsibilities. These are also listed in your Member Handbook.
You have the right to:
- Receive information about CareSource, our services, our network providers and member rights and responsibilities
- Be treated with respect and dignity by CareSource personnel, network providers and other health care professionals
- Privacy and confidentiality for treatments, tests and procedures you receive
- Participate with your doctor in making decisions about your health care
- Candidly discuss with your doctor the appropriate or medically necessary treatment options for your conditions, regardless of cost or benefit coverage
- Voice complaints or appeals about the plan or the care it provides
- Make recommendations regarding the plan’s member rights and responsibilities policy
- Choose an advance directive to designate the kind of care you wish to receive should you be unable to express your wishes
- Be able to get a second opinion from a qualified network provider. If a qualified network provider is not able to see you, CareSource will set up a visit with a provider not in our network.
You have the responsibility to:
- Provide information needed, to the extent possible, in order to receive care
- Follow the plans and instructions for care that you have agreed to with your doctors
- Understand your health problems and participate in developing mutually agreed-upon treatment goals, to the degree possible
- Be enrolled and pay any required premiums
- Pay an annual deductible, copayments and coinsurance
- Pay the cost of limited and excluded services
- Choose network providers and network pharmacies
- Show your ID card to make sure you receive full benefits under the plan
CareSource may not discriminate on the basis of race, color, religion, gender, sexual orientation, age, disability, national origin, veteran’s status, ancestry, health status, or need for health services in the receipt of health services. Consult our website or newsletters annually for any updates to member rights and responsibilities.