Your rights as a Priority Health plan member

Your rights as a member of a medical coverage plan

• You may receive prompt medical care appropriate for your condition, including emergency care if necessary.
• You may receive information regarding appropriate or medically necessary treatment options, which will enable you to make an informed decision about the treatment you receive, regardless of cost or benefit coverage.
• You may receive information about us, our services, our health care providers and your rights and responsibilities.
• You may participate in decisions regarding your health care.
• We will treat you with respect.
• We will protect your privacy.
• We will keep your medical and financial records maintained by us confidential, whether in electronic or written form. We will not disclose information from your medical records without your consent, except when permitted or required by law, in connection with the administration of Priority Health, or for anonymous use in statistical studies and medical research.
• You may inspect your medical records and those of your minor dependents at the office of your primary care physician or other participating health care provider during normal business hours. Doctors, hospitals, and other health care providers may limit a parent's or legal guardian's access to a minor's medical records without the minor's consent, as provided by law.
• You may contact us to discuss concerns about the quality of care you have received from a participating health care provider.
• You may register a complaint or file a grievance with us, or the Commissioner of the Office of Financial and Insurance Regulation, if you experience a problem with us, or a health care provider. For more information, go to the Grievances & appeals section of this website.
• You may initiate a legal proceeding if you experience a problem with us or with health care providers after you have exhausted the grievance process.
• We will notify you in a timely manner if we release personal information about you in response to a court order.
• You may review a summary of Priority Health's annual report, and inspect the full report on file with the Office of Financial and Insurance Regulation.
• You may suggest changes to our Member Rights and Responsibilities policies.
  

In addition, wellness program members have the right to:

• Information about Priority Health (including programs and services provided on behalf of your employer or plan sponsor), Priority Health staff and its qualifications, and any contractual relationships
• Decline participation or disenroll from programs and services offered by Priority Health
• Be supported by Priority Health in making health care decisions with your doctors, therapists, and other health care practitioners
• Be treated courteously and respectfully by the Priority Health staff
• Complain to Priority Health and receive instructions on how to use the complaint process, including being informed of the organization's standards of timeliness for responding to and resolving issues of quality and complaints. For more information, go to the Grievances & appeals section of this website.
• Receive understandable information.