Derechos y responsabilidades
Meridian wants you to know that you have certain rights and responsibilities. You should always be treated with respect and dignity by us and by your doctor. Meridian staff and its network health care providers strive to comply with all requirements concerning your rights.
You have the right to:
- Receive healthcare services consistent with Meridian's contract with the state and all state and federal regulations
- Receive basic information about Meridian, Meridian services, your person-centered plan of care (if applicable), Meridian practitioners and providers and enrollee rights and responsibilities
- Have basic Meridian information be accessible in alternative formats that meet your communication needs
- Request information on the structure and operation of Meridian. Have your questions about Meridian answered
- Be treated with respect and recognition of your dignity and right to privacy
- Confidentiality of your personal and medical information
- Request and receive a copy of your medical records and request that they be amended or corrected
- Participate with practitioners in making decisions about your health care, including the right to refuse treatment and express preferences about treatment options
- Receive a clear explanation from your provider and Meridian of your condition(s) and your plan of care, proposed treatment options and alternatives, benefits and drawbacks for potential treatment plans and the possible consequences for noncompliance with a recommended care plan regardless of Meridian coverage or provider panel
- A candid discussion of appropriate or medically necessary treatment options for your conditions, regardless of cost or benefit coverage
- Voice complaints or appeals about Meridian or the care it provides
- Make recommendations regarding Meridian's policies and procedures
- Be free from any form of restraint or seclusion used as a means of coercion, discipline, convenience or retaliation
- Be free to exercise all of these rights without adversely affecting the way Meridian, providers or the state treats you
- Get information on our provider incentive programs. Meridian may give incentives to providers to help make sure you get the care you need when you need it. We will give you this information upon your request
- Be free from receiving bills, cost-sharing or co-payments for Meridian covered medical services, including those provided to an American Indian/Alaskan Native by an American Indian provider or medical provider
- Be free from other discrimination prohibited by state and federal regulation, including race, color, religion, sex, national origin, ancestry, age, physical or mental disability, claims experience, receipt of health care, medical history, genetic information and evidence of insurability, including but not limited to, the Federal Civil Rights Act of 1964, the Americans with Disabilities Act of 1990, the Federal Rehabilitation Act of 1973, Title IX of the Education Amendments of 1972, the Age Discrimination Act of 1975, the State's Human Rights Act, and Executive Orders 11246 and 11375. Members have the right to appeal to or file directly with the United States Department of Health and Human Services Office of Civil Rights any complaints of discrimination
- Have access to doctors, other healthcare providers, specialists and hospitals including American Indian providers in and out of the state
- To get emergency care when and where you need it
- To get a decision about healthcare payment, services or prescription drug coverage
- To request a fair hearing and to file grievances and appeals as described in the new member material
- Right to reasonable accommodation
You have the responsibility to:
- Learn about your rights and responsibilities as a Meridian member
- Give Meridian and your providers as much information about your health as possible
- Learn about your health problems
- Work with Meridian and your provider to set and achieve healthcare plans and goals
- Follow the care plans and orders that you agreed on with your providers
- Live a healthy lifestyle and make responsible healthcare decisions
- Tell Meridian if your contact information (like your address or phone number) changes
To receive more information about your rights and responsibilities:
1. Call our Member Services Department at 1-855-580-1689 (TTY: 711), Monday - Friday from 8 a.m. - 8 p.m. On weekends and on state or federal holidays, you may be asked to leave a message. Your call will be returned within the next business day.
2. Visit the Medicare website to review and download "Your Medicare Rights & Protections."
3. Call 800-MEDICARE (1-800-633-4227). TTY users should call 1-877-486-2048, 24 hours a day, 7 days a week.
Learn more about your rights and responsibilities upon disenrollment.