Rights and Responsibilities

Your Responsibilities

  • You are responsible for reading and understanding all material concerning your health benefits.
  • You are responsible for complying with all terms of membership with your health plan.
  • You are responsible for developing and maintaining a satisfactory physician-patient relationship.
  • You are responsible for following instructions and guidelines as agreed upon by you and your healthcare provider.
  • You are responsible for engaging in a healthy lifestyle and in safety practices.
  • You are responsible for providing, to the extent possible, complete and accurate information that Louisiana Blue/HMO Louisiana and its practitioners and providers need in order to care for you.
  • You are responsible for supplying information to the organization as needed to access health benefits.
  • You are responsible for learning how to use health benefits and access member assistance to ask questions about benefits.
  • You are responsible for making and keeping appointments, or canceling in advance if unable to make your appointment.
  • You are responsible for paying copayment and/or coinsurance amounts required under your health plan.
  • You are responsible for notifying your employer or Louisiana Blue of any other healthcare coverage of which you are a beneficiary, and for cooperating in coordinating benefits. 
  • You are responsible for understanding your health conditions and participate in developing mutually agreed-upon treatment goals, to the degree possible.

Your Rights

  • You have the right to be provided with information on your health plan, its services, the practitioners and providers providing care and your rights and responsibilities in clear, understandable language.
  • You have the right to receive medically necessary care that is covered under your benefit plan and is provided or arranged by your healthcare provider.
  • You have the right to be informed by your healthcare provider about your diagnosis, treatment options and prognosis in clear, understandable language.
  • You have the right to participate with practitioners when making decisions regarding your healthcare.
  • You have the right to refuse treatment.
  • You have the right to be treated with respect and recognition of your dignity and right to privacy.
  • You have the right to the confidentiality of information concerning your medical treatment.
  • You have the right to express verbal or written complaints about Louisiana Blue/HMO Louisiana or the medical care provided, and to a timely response when appropriate.
  • You have the right to a candid discussion of all appropriate, medically necessary options for your condition(s), regardless of cost or benefit coverage
  • You have the right to know how your physician and other healthcare professionals are compensated by Louisiana Blue/HMO Louisiana.
  • You have the right to make recommendations to your health plan on its member rights and responsibilities policy.
  • You have the right to culturally and linguistically appropriate services as long as these services do not violate applicable government laws and regulations.

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