Unison Health Plan - RightsandResponsibilities

Rights and Responsibilities

Member Rights

Unison Health Plan
of Pennsylvania

Member Rights and Responsibilities PDF

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As a member of Unison Health Plan, you have the right:

to pick your own: dental, vision, routine OB/GYN and prenatal care, emergency care, family planning services, chemotherapy, dialysis, radiation therapy, mammograms or mental health and substance abuse services. You do not need a referral form
to ask for and get information about Unison Health Plan, information on how to use your Unison Health Plan.
to get good care and to be treated with respect and due consideration for your dignity and privacy
to know the names, titles and education backgrounds of all physicians and others helping you
to understand your medical and health needs, what should be done for you, what choices you have, and what risks are involved
to be part of any decisions made about your health
to be told about what you should do after a hospital or office visit
to say that you do not want to take part in any medical research projects
to suggest changes in Unison, and tell Member Services if you are unhappy
to look at all your medical records in accordance with applicable federal and state laws, also to have these records kept private
to have an Advance Directive
to get this list so you know your rights and can share ideas to make Unison Health Plan better
to file a complaint or grievance regarding any medical or administrative decisions if you disagree. To do this, you need to follow the Complaint and Grievance Procedures of Unison Health Plan
to give your rights to another person. This would be a person who the law says can make decisions for you about your health care
to be sure your Primary Care Physician and the staff of Unison Health Plan know your rights
to receive information on treatment options/alternatives
to have these rights with no discrimination of gender, culture, economic, educational, or religious background
to exercise your rights. Exercising these rights will not adversely affect the way Unison Health Plan, its providers and state agencies may treat you
to file a Fair Hearing with the Department of Public Welfare at anytime during the grievance process.
Unison Health Plan members are guaranteed the right to be free from any form of restraint or seclusion used as a means of coercion, discipline, convenience or retaliation.

Member Responsibilities

As a member of Unison Health Plan, you have the responsibility:

to understand how Unison Health Plan works by reading this book
to carry your Unison Health Plan card and ACCESS card. You must show both cards when receiving services. You also must inform Unison Health Plan of any other insurance you may have, and to present current insurance information to your Primary Care Physician
to make appointments with your Primary Care Physician for non-emergency treatment each time you need health care services
to get a referral form to make an appointment with a specialist. You need to get this paper from your Primary Care Physician
to be on time for all appointments
to tell your PCP’s office or any medical office if you need to change an appointment
to respect the rights and property of your PCP, other healthcare workers, and other patients
to do what your PCP tells you, to ask questions if you don’t understand your health problems, and to work with you doctor or Unison Health Plan to make goals about your health when you can
to know when to take your medicine, how to take your medicine and to follow your doctor’s instructions
to give up-to-date medical information about yourself
to take full responsibility and consequences of your decision if you refuse (say no) to treatment
to be sure that your Primary Care Physician has all your medical records – This includes all medical records from other doctors
to let Unison Health Plan know if you are in the hospital or in an emergency room – Do this in 24 hours or as soon as possible
to consent to the proper use of your health information.