HMO Members: Know Your Member Rights and Responsibilities

HMO Members: Know Your Member Rights and Responsibilities

This article is intended for HMO members enrolled in an employer health insurance plan.

Below is a list of your member rights and responsibilities. Please be sure to keep this information as a reference.

As a member of BlueLincs HMOSM, you have the right to:

  • Get information about BlueLincs, its services and providers, and your member rights and responsibilities.
  • Be treated with respect and dignity and have your privacy protected.
  • Be involved in making decisions about your health care and treatment.
  • Have a direct conversation about appropriate or medically necessary treatment choices for your conditions, no matter the cost or benefit coverage.
  • Make complaints about the organization or the care it provides or appeal a coverage decision.
  • Make recommendations about BlueLincs’ member rights and responsibilities policy.

As a member of BlueLincs HMO, it is your responsibility to:

  • Provide information (to the extent possible) that BlueLincs and its providers need in order to provide your health care.
  • Follow treatment plans and instructions for care that you and your providers have agreed on.
  • Understand your health problems and work with your providers to make treatment plans and set health goals, as much as possible.

If you have questions about your coverage, please call the customer service number on your member ID card.

Originally published 3/6/2020; Reviewed 2022, 2023, 2024

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