Member Handbook - Los Angeles County Department of Health ...

Medi-Cal Member Handbook / Benefit Year 2006-2007As a Member of L.A. Care Health Plan,you have a right to…Respectful and courteous treatment. You have theright to be treated with respect, dignity and courtesyfrom your health plan’s providers and staff. You havethe right to be free from retaliation or force of any kindwhen making decisions about your care.Privacy and confidentiality. You have a right to havea private relationship with your provider and to haveyour medical record kept confidential. You also have aright to receive a copy of and request corrections toyour medical record. If you are a minor, you have aright to certain services that do not need your parent’sokay.Choice and involvement in your care. You have theright to receive information about your health plan andits services. You have the right to choose your PrimaryCare Physician (doctor) from the doctors and clinicslisted in your health plan’s provider directory. Youalso have the right to get appointments within areasonable amount of time. You have a right to talkwith your doctor about any care your doctor providesor recommends. You have the right to a secondopinion. You have a right to information abouttreatment regardless of the cost or what your benefitsare. You have the right to say “no” to treatment. Youhave a right to decide in advance how you want to becared for in case you have a life-threatening illness orinjury.Voice your concerns. You have the right to complainabout L.A. Care, the health plans we work with, or ourproviders without fear of losing your benefits. L.A.Care will help you with the process. If you don’t agreewith a decision, you have a right to ask for a review.You have a right to disenroll from your health planwhenever you want. As a Medi-Cal member, youhave a right to request a State Fair Hearing.Service outside of your health plan’s providernetwork. You have a right to receive emergency orurgent services as well as family planning and sexuallytransmitted disease services outside of your healthplan’s network. You have the right to receive emergencytreatment whenever and wherever you need it.Service and information in your language. You havea right to request an interpreter at no charge and notuse a family member or a friend to translate for you.You have the right to get the Member Handbook andother information in another language or format.Know your rights. You have the right to receiveinformation about your rights and responsibilities. Youcan make recommendations about these rights andresponsibilities.As a Member of L.A. Care Health Plan,you have a responsibility to…Act courteously and respectfully. You are responsiblefor treating your doctor and all providers and staffwith courtesy and respect. You are responsible forbeing on time for your visits or calling your doctor’soffice at least 24 hours before the visit to cancel orreschedule.Give up-to-date, accurate and complete information.You are responsible for giving correctinformation to all of your providers. You are responsiblefor getting regular check-ups and telling yourdoctor about health problems before they becomeserious.Follow your doctor’s advice and take part in yourcare. You are responsible for talking over your healthcare needs with your doctor and following the treatmentyou both agree on.Use the Emergency Room only in an emergency.You are responsible for using the emergency room incases of an emergency or as directed by your doctor.Report wrong doing. You are responsible for reportinghealth care fraud or wrong doing to L.A. Care. Youcan do this without giving your name by calling theL.A. Care Fraud and Abuse Hotline toll-free at 1-800-400-4889.Community Health Plan Member Services Department toll-free 1-800-475-5550L.A. Care Health Plan Member Services Department toll-free 1-888-4LA-Care or 1-888-452-2273