California PHP

PHP (HMO SNP) must honor your rights as a member of the plan:

• We must provide information in a way that works for you (in languages other than English that are spoken in the plan service area, in Braille, in large print, or other alternate formats, etc.)
• We must treat you with fairness and respect at all times
• We must ensure that you get timely access to your covered services and drugs
• We must protect the privacy of your personal health information
• We must give you information about the plan, its network of providers, and your covered services
• We must support your right to make decisions about your care
• You have the right to make complaints and to ask us to reconsider decisions we have made
• What can you do if you think you are being treated unfairly or your rights are not being respected?

Plan members have responsibilities too:

• Get familiar with your covered services and prescription drug benefit and the rules you must follow to get these covered services and prescription drugs
• If you have any other health insurance coverage or prescription drug coverage besides our plan, you are required to tell us
• Tell your doctor and other health care providers that you are enrolled in our plan
• Help your doctors and other providers help you by giving them information, asking questions, and following through on your care
• Be considerate
• Pay what you owe
• Tell us if you move
• Call Member Services for help if you have questions or concerns.

The complete text on member rights and responsibilities can be found in Chapter 8 of the 2021 Evidence of Coverage.

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