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Rights & Responsibilities

As a Medicaid member, there are many things that you need to know in order to keep your benefits and get the most out of the services that are available to you.  This section outlines your rights and responsibilities as a member and provides detail on how to report changes and how to best utilize your benefits.

Member Rights

As a member, you have the RIGHT to:

  • Be treated with dignity and respect when getting health care services;
  • Be given privacy for you and your medical records;
  • Be given easy-to-understand explanations of your medical problems and treatment choices;
  • Stay involved in decisions about your treatment choices;
  • Get care 24 hours a day, 7 days a week;
  • Get timely answers to your complaints or appeals;
  • Appeal decisions made about health care you receive;
  • Use buildings and services that meet the standards of the Americans With Disabilities Act (ADA). This means that persons with disabilities or physical problems can get into medical buildings and use important services;
  • Get a second opinion from a different doctor;
  • Request and receive a copy of your medical records and request that they be changed or corrected;
  • Be free from any action of being held against your will or cut off from others when these actions are intended to pressure you into doing something, punish you, or show revenge against you or make it easier for the medical personnel.

Member Responsibilities

As a member, you have the RESPONSIBILITY to:

  • Tell your doctor (PMP) about your medical conditions to the best of your ability;
  • Call your personal doctor (PMP) for all your medical care;
  • Keep all of your appointments. If you cannot keep an appointment, call to cancel or reschedule as soon as you can;
  • Tell your doctor if you do not understand what he or she tells you about your condition, care, or what you need to do;
  • Get regular checkups for you and your children;
  • Get all childhood shots for your children;
  • Call your doctor if you are not sure you are having a true emergency;
  • Follow the rules of your doctor's office.

If you disagree with any decisions made about your health care, you have the right to file an appeal. To file an appeal, contact the FSSA Office of Hearings and Appeals at 1-317-232-4404.

Notice of Privacy Practices

Notificación sobre las Prácticas de Manejo de la Privacidad