Rights & Responsibilities

You have many rights as a CareSource member. The full list of rights is also in your member handbook. You can get a printed copy sent to if you call Member Services.

• To receive information about CareSource, our services, practitioners and providers, and your rights and responsibilities.
• To receive all services that CareSource must provide.
• To be treated with respect and with regard for your dignity and privacy.
• To work with providers in making decisions relating to your health care.
• To discuss medically necessary treatment options for your condition(s), no matter the cost or benefit coverage.
• To be sure that your medical information will be kept private.
• To get information about your health. This information may also be available to someone who you have legally authorized to have this information.
• To request information at any time on our physician incentive plan or marketing materials.
• To be able to take part in decisions about your health care unless it is not in your best interest.
• To get information about any medical care treatment in a way that you understand.
• To get care that is culturally sensitive and respectful.
• To be sure that others cannot hear or see you when getting medical care.
• To be free from restraint or seclusion used as a means of force, discipline, or revenge as specified in federal regulations.
• To ask and get a copy of your medical records. To be able to ask for the record to be changed or corrected if needed.
• To be able to say yes or no to having any information about you given out unless CareSource has to by law.
• To be able to say no to treatment or therapy. If you say no, the provider or CareSource must tell you what could happen. A note will also be placed in your record about the treatment refusal.
• To be able to file an appeal or a grievance (complaint).
• To voice complaints about the organization or the care it provides.
• To get all CareSource written member information from us at no cost in the prevalent non-English languages of our service area.
• To be able to get help with sign language if you are hearing impaired.
• To be told if the provider is a student and to be able to refuse their care.
• To be told of any experimental care and to be able to refuse to be part of the care.
• To make an advance directive (a living will) and file a complaint if the advance directive is not followed.
• To be free to carry out your rights and know that CareSource, our providers, or the State will not hold this against you.
• To know that CareSource must follow all federal and state laws and other laws about privacy that apply.
• If you are a female, you have the right to see a CareSource provider specializing in women’s health.
• To get a second opinion about your care from a provider in our network. If one is not available, we must set up a visit with a provider outside of our network.
• To go out of network for care if CareSource cannot provide a covered service within 60 miles of your home in our network.
• To get information about CareSource’s structure and operation.
• To make recommendations about our member rights and responsibilities policy.

As a member of CareSource you also have the responsibility to:

• Use providers in the CareSource network.
• Keep the visits you make with your providers and be on time. Call at least 24 hours before the visit if you need to cancel.
• Follow the advice and instructions for care you have agreed to with your providers.
• Always carry your ID card. Show it when getting care. Never let others use your ID card.
• Tell your county caseworker and CareSource if you move or have a new phone number or email.
• Contact your providers after you go to urgent care or hospital for emergency care. They can help with any follow-up care you need.
• Tell your county caseworker and CareSource if you are covered by other health insurance.
• Give as much information as you can that CareSource and your providers need in order to provide care.
• Tell us of suspected fraud as described through the Fraud, Waste, and Abuse
• Understand as much as possible about your health issues and take part in reaching the goals agreed to with your providers.