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Freedom Health Member Rights and Responsibilities |
MEMBER RIGHTS
As a member of Freedom Health you have the right to:
- Be treated with courtesy and respect, with appreciation of your dignity, and protection of your need for privacy.
- A prompt and reasonable response to questions and requests.
- Know who is providing medical services and who is responsible for your care.
- Know what patient support services you can get, and if an interpreter is available if you do not speak English.
- Know what rules and laws apply to the conduct of staff of Freedom Health and contracted providers.
- Be provided by Freedom Health providers, information about diagnosis, planned course of treatment, alternatives, risks and prognosis.
- Refuse any treatment, except as provided by law.
- If eligible for Medicare, know upon request and in advance of treatment, if the health care provider or health care facility accepts the Medicare assignment rate.
- Receive, before treatment, a reasonable estimate of charges for medical care.
- Receive a copy of a reasonable, clear, and understandable detailed bill and, upon request, to have the charges explained.
- Access to medical treatment or accommodations, regardless of race, national origin, religion, physical handicap, or source of payment.
- Treatment for any emergency medical condition that will get worse from failure to provide treatment.
- Know if medical treatment is for experimental research and to grant consent or refusal to take part in such experimental research.
- Private handling of medical records and, expect when required by law, be given the chance to approve or refuse their release.
- voice complaints or appeals about the organization or the care it provides.
- Express grievances about any violation of their rights, as stated in Florida law, through the Freedom Health grievance and appeals system, and your right to appeal to a state grievance and appeal oversight entity, or for Medicare members through the CMS established appeal process.
- Participate with practitioners in making decisions about your health care, and provide input into your proposed treatment plan.
- Receive information about Freedom Health, its services, practitioners and providers, and members’ rights and responsibilities.
- Participate with practitioners in making decisions about your health care.
- Have a candid discussion of appropriate or medically necessary treatment options for your conditions, regardless of cost or benefit coverage.
- Make recommendations regarding Freedom Health’s member rights and responsibilities policies.
MEMBER RESPONSIBILITIES
As a member of Freedom Health your provider expects you to:
- Provide your health care provider, to the best of your knowledge, correct and complete information about present complaints, past illnesses, hospital stays, medicines and other health matters.
- Report unexpected changes in your condition to your health care provider.
- Understand their health problems and participate in developing mutually agreed-upon treatment goals, to the degree possible.
- Discuss with your health care provider if you do not comprehend a course of treatment and/or what is expected of you.
- Follow the treatment plan suggested by your health care provider and agreed upon with you.
- Keep appointments, and when you are unable to do so for any reason, notify your health care provider or the health care facility.
- Answer for your actions if you refuse treatment or do not follow the health care provider’s instructions.
- Assure that the financial obligations of your health care are fulfilled as promptly as possible.
- Follow health care facility rules and laws that affect patient care and conduct.
Potential for contract termination:
Freedom Health may terminate or refuse to renew its contract with the Centers for Medicare and Medicaid Services (CMS), or reduce the service area included in its current contract. More information on your Medicare coverage may be found in the “Medicare & You Handbook” published each year by CMS or at the CMS web site at http://www.medicare.gov.
Member “rights and responsibilities” at disenrollment:
Disenrollment from Freedom Health ends your membership with the Freedom Health Medicare Advantage Plans. If you leave the Freedom Health Medicare Advantage Plans, it takes some time for your membership to end and your new way of getting Medicare to take effect. Until your membership officially ends, you must keep receiving your Medicare services through the Freedom Health Medicare Advantage Plans or you will have to pay for these services yourself--with a few exceptions. These exceptions are urgently needed care, care for a medical emergency, out-of-area renal (kidney) dialysis services, and care that has been approved by Freedom Health. One other possible exception is if you happen to be hospitalized on the day your membership ends. If this occurs, you should contact Member Services to find out if your hospital care will be covered by the Freedom Health Medicare Advantage Plans. You may contact our Grievance and Appeals Department from 8:00 a.m. to 6:00 p.m. Monday to Friday. |
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