Your Rights & Responsibilities

This section of your online member handbook explains:

What are my rights as a Priority Health member?
Do I have any responsibilities as a member?

Q: What are my rights as a Priority Health member?
A: As a Priority Health member, you have the right to:

• Privacy

• Prompt medical care that's appropriate for your condition

• Information about your doctors, Priority Health and our services

• See your medical records

• File a complaint or legal proceeding

Q: Do I have responsibilities as a member?
A: You can find a complete list of your responsibilities as a Priority Health member in your Certificate of Coverage (COC) or insurance policy. (See the standard coverage documents.) These responsibilities include:

• Getting a physical within one year of joining the plan

• PriorityHMO^SM, PriorityEPO^SM and PriorityPOS^SM members: Contacting your Primary Care Physician any time you need medical care (except in emergencies) 
• PriorityPPO^SM members: Using in-network providers, facilities and services to receive benefits under the Network Benefits level.
  

• Using doctors, hospitals and other facilities listed in here or in our Provider Directory
  

• Paying your copayments and deductibles when they're required

• Showing your ID card every time you receive care

• Telling us if you are covered by another health plan (such as that of a spouse)

• Reading your Certificate of Coverage (COC) or insurance policy and other plan materials. See the standard coverage documents.

• Calling Priority Health for approval before getting some services. (A list of services needing our approval is in your Certificate of Coverage or insurance policy.)