Member Rights & Responsibilities

1. A right to receive information about Medica, its services, its practitioners and providers, and your rights and responsibilities;
   
   
2. A right to be treated with respect and recognition of your dignity and the right to privacy;
   
   
3. A right to participate with providers in decision-making regarding your health care, including the right to refuse treatment recommended to you by Medica or any provider;
   
   
4. A right to information about your health condition, appropriate or medically necessary treatment options and risks, regardless of cost or benefit coverage, so you can make an informed choice about your health care;
   
   
5. A right to file a complaint or an appeal about Medica or the care it provides. You may do so by contacting Medica Customer Service at the number on the back of your Medica ID card. Please refer to your coverage document for more information on your complaint and appeal rights;
   
   
6. A right to make recommendations regarding Medica members’ rights and responsibilities statement;
   
   
7. A responsibility to provide the necessary information to health care professionals needed to determine appropriate care. This objective is best obtained when you share:
   
   

   a. Information about lifestyle practices, and
   

   b. Personal health history;

8. A responsibility to follow the instructions given by those providing health care; and
   
   
9. A responsibility to participate in understanding your health problems, participate in developing mutually agreed-upon treatment goals to the degree possible and to follow the plans that you have agreed on with your health care professional.

Other Required Notices

Following is additional regulatory information that we’re required by law to provide you.

• Privacy notice: Medica is committed to protecting and maintaining the privacy and confidentiality of your protected health information. This notice describes Medica's privacy practices and related legal duties. It also describes your rights regarding your personal health information. Read Medica’s Privacy Notice.
  
  
• Post-mastectomy coverage: The Women’s Health and Cancer Rights Act is a federal law that requires health insurers and group health plans that cover mastectomies to provide certain benefits if a member chooses reconstructive surgery after a mastectomy. Learn more in this notification.
  
  
• Advance directive information: The Patient Self-Determination Act requires health plans to provide information about members’ decision-making rights regarding their health care using an advance directive or living will. Learn more in this notice.
  

Your Guide to Medica

Find helpful information about your plan in the How to Get the Care You Need guide. The guide helps you understand what your coverage includes, how to access care, what health plan services are available to you, and more.

View How to Get the Care You Need (Fully insured plans).

View How to Get the Care You Need (Self-insured plans).