Member Rights & Responsibilities

MercyCare Insurance is a partnership that consists of you, your doctors and MercyCare; whose goal is to assure that you receive appropriate quality health care. The foundation of MercyCare Insurance Company (MCIC) is to have each member develop a relationship with a Primary Care Physician (PCP) who will coordinate and manage your medical care. Your rights and responsibilities as part of the MercyCare partnership are described below.

As a member, you have the right to:

• Receive information about the MercyCare organization, services, practitioners, hospitals, other providers, and member rights and responsibilities
• Be treated with respect and recognition of your dignity and right to privacy
• Take part in decisions regarding your treatment
• Discuss openly and freely all planned treatments, procedures, and services
• Confidentiality of your personal health information as described in your HIPAA Notice of Privacy Practices
• Know how to obtain health care services
• Know what your benefits are
• Understand the purpose and probable results and risks of treatment
• Initiate a complaint by phoning Customer Service at 1-800-895-2421 about care or service that you receive as a MercyCare member and receive a timely response  
• Make recommendations regarding the organization's member rights and responsibilities policies by contacting Customer Service 

As a member, you are responsible to:

• Provide information about your past illnesses, hospitalizations, medications and other matters concerning your health that will help your practitioner understand your health care needs and provide appropriate care
• Participate in understanding any health problems you my be experiencing and develop mutually agreed upon treatment goals and plans with your practitioner
• Cooperate as much as possible with mutually agreed upon treatment goals and advice of your health care practitioner
• Read your MercyCare Member Handbook, Certificate of Coverage, Schedule of Benefits and Provider Directory so that you understand how to use the MercyCare Health Plan
• Choose a PCP with whom you will coordinate your care
• Identify yourself as a MercyCare member by presenting your MCHP insurance card before receiving health care services
• Pay your co-payments at the time of your visit
• Keep your appointments
• Discuss any questions you have about your health with your practitioner
• Notify MercyCare of address, telephone or other status changes within 30 days of the change
  

For more information about your Rights and Responsibilities, contact MercyCare by phone at (800) 895-2421 or email mcare@mhsjvl.org