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Member Rights and Responsibilities

As a MedCost member, you have certain rights and responsibilities.

As a member, you have the right to:

  • Receive information about your coverage and health plan, including a list of doctors and health care services covered.

  • Be treated with respect from MedCost and the doctors who are part of the MedCost provider network.

  • Receive an explanation of why MedCost denied a request for treatment or health care service, and the guidelines used to reach that determination.

  • Receive information that is clear and factual to help you make your own health care choices.

  • Take an active role in your health care and discuss treatment options with your doctor without regard to cost or benefit coverage.

  • Engage with doctors in making decisions about your health care.

  • Expect that MedCost will take measures to maintain the privacy of your health information and protect your health care records, as outlined in the MedCost Notice of Privacy Practices.

  • Voice complaints and expect a fair and quick appeals process for addressing any concerns you may have with MedCost.

  • Make suggestions regarding MedCost's member rights and responsibilities policies.

  • Receive information about MedCost, its services, its health care providers and your rights and responsibilities.

  • Be treated with recognition of your dignity and right to privacy.

As a member, you have the responsibility to:

  • Present your MedCost ID card each time you visit a doctor or hospital, or receive any type of health care service.

  • Read your Summary Plan Description and all other materials provided to you by MedCost.

  • Call MedCost when you have a question.

  • Follow the treatment plan prescribed by your doctor and notify him or her if you choose not to comply.

  • Provide MedCost and your doctors with complete information about your illness, accident or health care issues, which may be helpful in determining a treatment plan.

  • Understand your health problems and participate in developing treatment goals.

  • Make appointments for non-emergency medical care and keep your appointments. If it is necessary to cancel an appointment, give the doctor's office at least 24-hours’ notice.

  • Play an active part in your health care.

  • Be courteous to network doctors, their staff and MedCost employees.

  • Tell your employer and MedCost if you have any other group coverage.

  • Tell your employer about new children under your care or other family changes.

  • Protect your MedCost ID card from improper use.

  • Comply with the rules outlined by your health plan.