Care Guide

Member’s Rights and Responsibilities

A member has the right to:

• be treated with dignity and respect.
• fair treatment. This is regardless of their race, religion, gender, ethnicity, age, disability, or source of payment.
• have their treatment and other member information kept private. Only where permitted by law, may records be released without member permission.
• easily access timely care in a timely fashion.
• know about their treatment choices. This is regardless of cost or coverage by the member’s benefit plan.
• share in developing their plan of care.
• information in a language they can understand.
• have a clear explanation of their condition.
• a clear explanation of their treatment options.
• information about Magellan, its practitioners, services and role in the treatment process.
• information about clinical guidelines used in providing and managing their care.
• ask their provider about their work history and training.
• give input on the Members' Rights and Responsibilities policy.
• know about advocacy and community groups and prevention services.
• freely file a complaint or appeal and to learn how to do so.
• know of their rights and responsibilities in the treatment process.
• receive services that will not jeopardize their employment.
• list certain preferences in a provider.

Statement of Member’s Responsibilities

• treat those giving them care with dignity and respect.
• give providers information they need. This is so providers can deliver the best possible care.
• ask questions about their care. This is to help them understand their care.
• follow the treatment plan. The plan of care is to be agreed upon by the member and provider.
• follow the agreed upon medication plan.
• tell their provider and primary care physician about medication changes, including medications given to them by others.
• keep their appointments. Members should call their providers as soon they know they need to cancel visits.
• let their provider know when the treatment plan isn’t working for them.
• let their provider know about problems with paying fees.
• report abuse.
• report fraud.
• openly report concerns about the quality of care they receive.