Member Rights and Responsibilities
As a member of GEMCare Health Plan you have basic rights and protections under Medicare to help protect you. The following is a summary list of your rights:
- Your right to be treated with dignity, respect and fairness;
- Your right to privacy of your medical records and personal health information;
- Your right to see network providers, get covered services, and get your prescriptions filled within a reasonable period of time;
- Your right to timely access to your prescriptions at any network pharmacy;
- Your right to know your treatment options and participate in decisions about your health care;
- You right to refuse treatment;
- Your right to use advance directives (such as a living will or a power of attorney);
- Your right to get information about our Plan;
- Your right to get information in other formats;
- Your right to get information about our network pharmacies and/or providers;
- Your right to get information about your prescription drugs, Part C medical care or services, and costs; and,
- Your right to make complaints.
At the same time, you have certain obligations and responsibilities. Your responsibilities as a member of our Plan include:
- Being familiar with your coverage and the rules you must follow to get care as a member.
- Using all of your insurance coverage as you obtain health care. If you have additional insurance coverage besides our Plan, it is important that you use your other coverage in combination with our Plan to pay your health care or prescription drug expenses. This is called “coordination of benefits” because it involves coordinating all of the health or drug benefits that are available to you.
- You are required to tell our Plan if you have additional health insurance or drug coverage. Call Member Services if you do. Information to Contact Us
For more details about your rights and responsibilities, please refer to your Evidence of Coverage document or click on the following link to our web site document. Evidence of Coverage Document
If you have questions, you may contact member services. Information to Contact Us