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Rights and responsibilities

MercyCare offers members a three-way partnership between you, your doctors and your health plan. Our goal is to assure you receive appropriate, quality health care and develop a relationship with a primary care physician (PCP) who coordinates and manages 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 Health Insurance Portability and Accountability Act (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 about care or service you receive as a MercyCare member and receive a timely response when you call customer service at 800.895.2421
  • Make recommendations regarding the organization’s member rights and responsibilities policies by contacting customer service at 800.895.2421

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
  • Understand any health problems you may experience 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 and understand your MercyCare member handbook, certificate of coverage, schedule of benefits and provider directory
  • Choose a PCP with whom you will coordinate your care
  • Identify yourself as a MercyCare member by presenting your 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 any change

For more information about your rights and responsibilities, contact MercyCare by phone at 800.895.2421 or email