Member Rights & Responsibilities
To see information specific to your plan, please select your state and plan.
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