As a CareMore Health patient, you have rights and responsibilities when receiving health care. As your health care team, we want to make sure your rights are respected. That means giving you access to our network of providers and the information you need to make the best decisions for your health. As a patient, you should also take an active role in your care.
You have the right to:
- Speak freely and privately with your care team about all health care options and treatment needed, no matter what the cost or whether it is covered with CareMore.
- Work with your doctors to make choices about your health care.
- Be treated with respect and dignity.
- Be safe from discrimination based on race, disability, religion, sex, sexual orientation, health, ethnicity, creed, age or national origin.
- Get healthcare services in your preferred spoken or written language or alternative format you understand.
- Have your health information kept private. We follow our privacy policies and State and Federal laws.
- Get a copy of your medical record if you request it.
- Get the information you need to make sure you get the most from your health care, and share your feedback. This includes information on:
- Our company’s programs and services
- How to opt in or out of programs
- Our network of health care providers
- Your rights and responsibilities
- Make a complaint or file an appeal
- Say no to care, for any condition, sickness or disease, without having it affect any care you may get in the future. This includes asking your doctor to tell you how that may affect your health, now and in the future.
- Get the most up-to-date information from a health care provider about the cause of your illness, your treatment and what may result from it. You can ask for help if you do not understand this information.
You have the responsibility to:
- Read all information about your health benefits and ask for help if you have questions.
- Follow all rules and policies
- Use in-network healthcare providers, including your personal doctor.
- Treat all doctors, health care providers and staff with respect.
- Keep all scheduled appointments. Call your provider’s office if you may be late or need to cancel.
- Understand your health problems as well as you can and work with your health care providers to make a treatment plan that you all agree on.
- Ask your provider if you do not understand any type of care you are getting or what they want you to do as part of your care plan.
- Follow the health care plan that you have agreed upon with your provider.
- Use the Emergency Room only in the case of true emergencies or as directed by your provider.
- Tell providers that you are are part of CareMore Health. Present your membership card before care is provided.
- Give providers the information needed to help you get the best possible care. This may include information about other health insurance benefits you have along with coverage from us.
- Pay co-payments for your covered services. You must pay for services that are not covered.
- Call Member Services if you have any changes to your name, address or telephone number.
If you would like more information, have comments, would like a copy of the Rights and Responsibilities in other formats, or would like to contact us, please go to CareMore.com or call the Member Services number on the back of your card.
- CareMore UM decision-making is based only on appropriateness of care and services and existence of coverage
- CareMore Health does not specifically reward practitioners or other individuals for issuing denials of coverage or service care
- Financial incentives for UM decision makers do not encourage decisions that result in underutilization.
Affirmative Statement (PDF)