Your Membership Rights
As a member of CareSource you have the following rights:
· To receive all services that CareSource must provide.
· To be treated with respect and with regard for your dignity and privacy.
· To be sure that your medical record information will be kept private.
· To be given information about your health. This information may also be available to someone who you have legally okayed to have the information or who you have said should be reached in an emergency when it is not in the best interest of your health to give it to you.
· To be able to take part in decisions about your health care unless it is not in your best interest.
· To get information on any medical care treatment, given in a way that you can follow.
· To be sure that others cannot hear or see you when you are getting medical care.
· To be free from any form of restraint or seclusion used as a means of force, discipline, ease, or revenge as specified in Federal regulations.
· To ask, and get, a copy of your medical records, and to be able to ask that the record be changed/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 doctor or MCP must talk to you about what could happen and they must put a note in your medical record about it.
· To be able to file an appeal, a grievance (complaint) or state hearing. See [fill in page when designed] of this handbook for information.
· To be able to get all MCP written member information from the MCP:
- at no cost to you;
- in the prevalent non-English languages of members in the MCP’s service area;
- in other ways, to help with the special needs of members who may have trouble reading the information for any reason.
· To be able to get help free of charge from CareSource and its providers if you do not speak English or need help in understanding information.
· To be able to get help with sign language if you are hearing impaired.
· To be told if the health care provider is a student and to be able to refuse his/her care.
· To be told of any experimental care and to be able to refuse to be part of the care.
· To make advance directives (a living will). See the pamphlet in your new member packet which explains about advance directives. You can also contact member services for more information.
· To file any complaint about not following your advance directive with the Ohio Department of Health.
· To change your primary care provider (PCP) to another PCP on CareSource's panel at least monthly. CareSource must send you something in writing that says who the new PCP is by the date of the change.
· To be free to carry out your rights and know that the MCP, the MCP’s providers or ODJFS will not hold this against you.
· To know that the MCP must follow all federal and state laws, and other laws about privacy that apply.
· To choose the provider that gives you care whenever possible and appropriate.
· If you are a female, to be able to go to a woman’s health provider on CareSource panel for covered woman’s health services.
· To be able to get a second opinion from a qualified provider on CareSource panel. If a qualified provider is not able to see you, CareSource must set up a visit with a provider not on our panel.
· To get information about CareSource from us.
· To contact the United States Department of Health and Human Services Office of Civil Rights and/or the Ohio Department of Job and Family Services Bureau of Civil Rights at the addresses below with any complaint of discrimination based on race, color, religion, sex, sexual orientation, age, disability, national origin, veteran's status, ancestry, health status or need for health services.
Office for Civil Rights
United States Department of Health and Human Services
233 N. Michigan Ave. – Suite 240
Chicago, Illinois 60601
(312) 886-2359 (312) 353-5693 TTY
Bureau of Civil Rights
Ohio Department of Job and Family Services
30 E. Broad St., 37th Floor
Columbus, Ohio 43215
(614) 644-2703 1-866-227-6353 1-866-221-6700 TTY
fax: (614)752-6381
CareSource may not discriminate on the basis of race, color, religion, sex, sexual orientation, age, disability, national origin, veteran’s status, ancestry, health status, or need for health services in the receipt of health services.
Member Responsibilities
As a member of CareSource you must also be sure to:
· Use only approved providers.
· Keep scheduled doctor appointments, be on time, and if you have to cancel, call 24 hours in advance.
· Follow the advice and instructions for care you have agreed upon with your doctors and other health care providers.
· Always carry your ID card and do not let anyone else use your ID card.
· Notify your county caseworker and CareSource of a change in your phone number or address.
· Contact your PCP after going to an urgent care center or after getting medical care outside of CareSource’s covered counties or service area.
· Let us know if any member of your family has other health insurance coverage.
· Provide the information that CareSource and your health care providers need in order to provide care for you.
· Understand as much as possible about your health issues and take part in reaching goals that you and your health care provider agree upon.