YOUR RIGHTS

Universal Care has commitment to treating you in a manner that respects your rights as Universal Care Members. You have the right:

• To be treated with respect and recognition of your dignity and need for privacy

• To be provided with information about Universal Care, its services, its practitioners and providers and your rights and responsibilities

• To voice grievances or appeals about Universal Care or care provided by its Contracting Providers

• To have a candid discussion of appropriate or medically necessary treatment options for your conditions, regardless of cost or benefit coverage

• To make recommendations regarding Universal Care Members’ rights and responsibilities policies

• To choose a Primary Care Physician who has primary responsibility for coordinating your medical care

• To receive as much information about any proposed treatment or procedure, as you need in order to give or withhold informed consent

• To participate actively in decisions regarding your medical care

• To full consideration of privacy concerning your medical care program. Case discussion, consultation, examination and treatment are confidential and should be conducted discreetly

• To confidential treatment of all communications and records pertaining to your care. Your (or your parent’s, legal guardian’s or authorized caretaker relative’s) written authorization will be obtained before medical records can be made available to anyone not directly concerned with your medical care, except as permitted or required by law

• To receive reasonable responses to any reasonable requests you may make for service

• To reasonable continuity of care and to know in advance the time and location of an appointment as well as the Physician or other Contracting Provider providing the care

• To be advised if a Physician proposes to engage in or perform human experimentation affecting your care or treatment. You have the right to refuse to participate in such experimentation

• To be informed of continuing health care requirements

• To know the rules and policies that apply to obtaining benefits/Covered Services

• To exercise the foregoing rights without regard to age, sex, marital status, sexual orientation, race, color, religion, ancestry, national origin, disability, health, status or the source of payment or utilization of services

YOUR RESPONSIBLITIES

Universal Care also has expectations of your responsibilities as a Member of Universal Care. You are responsible for:

• Participating actively with practitioners in decision-making regarding your medical care

• Following plans and instructions for care that you have agreed on with your practitioner

• Providing, to the extent possible, information needed by Universal Care’s professional staff, Contracting Medical Groups, Primary Care Physicians, and other practioners who care for you

• Participating in understanding the terms, conditions and provisions of this Health Plan and abiding by them

• Informing the Member Services Department regarding any change in residence and any circumstance, which may affect your entitlement to coverage or eligibility

• Learning about your medical condition and its significance to your overall well-being

• Following preventive health guidelines, prescribed treatment plans and guidelines given by those providing medical care

• Scheduling or rescheduling appointments and informing the Contracting Medical Group or Primary Care Physician when it is necessary to cancel an appointment

• Being considerate and respectful to the medical staff and other Members

• Expressing grievances through the Universal Care Grievance and Appeals Procedure regarding Universal Care for care which was provided