Members have the following rights under Wisconsin law.
Along with your rights under the Certificate of Coverage, you also have these
rights under law:
-
To choose
Members have the right to choose a personal healthcare provider from the Plan's
network of healthcare providers. Health Tradition encourages you to establish a
relationship with that network healthcare provider.
-
To information
Members have the right to information about the benefit plan relating to covered
services and excluded healthcare benefits; available healthcare providers; preventive
care; their illness and its care; the process to make known a complaint or request;
and policies/procedures relevant to their care.
-
To privacy and confidentiality
Members have the right to privacy and confidentiality of all communications and
records on covered services received.
-
To participate in their care
Members have the right to be active in decisions about their treatment. Members
have the right to a candid discussion of appropriate or medically necessary treatment
options for their condition, regardless of cost of benefit coverage. Members have
the right to be informed about the risks and benefits of treatment and to refuse
care.
-
To present a complaint/grievance
Members have the right to voice concerns about their care and to receive a prompt
and fair review of any complaints.
-
To be treated with respect and dignity
Members have the right to be treated with respect and dignity regardless of race,
age, gender, or creed.
Members have the following responsibilities under Wisconsin law.
As a member of Health Tradition Premier, you have the following responsibilities
under the plan:
-
To know their benefits and responsibilities
Members have a responsibility to understand their health plan benefits, follow the
required procedures, know how to use the Plan's provider network, and ask questions
about things they don't understand.
-
To provide accurate information
Members have a responsibility to provide accurate and complete information about
their health history and eligibility/enrollment. Members have a responsibility to
show their membership card each time they receive services and to fulfill any financial
obligations they may incur.
-
To participate in their care
Members have a responsibility to participate in their care by asking questions to
understand their illness, following the recommended/agreed upon treatment plan,
and making healthy lifestyle choices to try to maintain their health and prevent
illness.
-
To keep their appointments
Members have a responsibility to keep their appointments or to give early notice
if they must cancel.
-
To show consideration and respect
Members have a responsibility to show consideration and respect to healthcare providers
and staff.