Enhanced Care (Medicaid Managed Care) Member Rights and Responsibilities

As a member of EmblemHealth Enhanced Care, you have a right to:

• Be cared for with respect, without regard for health status, sex, race, color, religion, national origin, age, marital status or sexual orientation.
• Be told where, when and how to get the services you need from EmblemHealth Enhanced Care.
• Be told by your PCP what is wrong, what can be done for you, and what will likely be the result in language you understand.
• Get a second opinion about your care.
• Give your OK to any treatment or plan for your care after that plan has been fully explained to you.
• Refuse care and be told what you may risk if you do.
• Get a copy of your medical record, and talk about it with your PCP, and to ask, if needed, that your medical record be amended or corrected.
• Be sure that your medical record is private and will not be shared with anyone except as required by law, contract, or with your approval.
• Use the EmblemHealth Enhanced Care complaint system to settle any complaints, or you can complain to the New York State Department of Health or the local Department of Social Services any time you feel you were not fairly treated.
• Use the State Fair Hearing system.
• Appoint someone (relative, friend, lawyer, etc.) to speak for you if you are unable to speak for yourself about your care and treatment.
• Receive considerate and respectful care in a clean and safe environment free of unnecessary restraints.