Changing the way you
receive healthcare

  • Member Rights and Responsibilities

    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.

    You will need the Adobe Acrobat Reader program to view the above forms. To download this free program click here or use the link above – the link will open a new window and take you to the Adobe website.

    H5852_4006 101520_2021