Rights and Responsibilities
Missouri Care Believes That Our Members are Important.Below is a list of member rights and responsibilities. If we both agree to follow them, it will help us work together.
Your Rights as a MO HealthNet Managed Care Health Plan Member.You have the right to:
- Be treated with respect and dignity.
- Receive needed medical service.
- Privacy and confidentiality (including minors) subject to state and federal laws.
- Select your own PCP.
- Refuse treatment.
- Receive information about your health care and treatment options.
- Participate in decision making about your health care.
- Have access to your medical records and to request changes, if necessary.
- Have someone act on your behalf if you are unable to do so.
- Get information on our physician incentive plan, if any, by calling 1-800-322-6027.
- Be free of restraint or seclusion from a provider who wants to:
- Make you do something you should not do.
- Punish you.
- Get back at you.
- Make things easier for him or her.
- Be free to exercise these rights without retaliation.
- Receive one copy of your medical records once a year at no cost to you.
Missouri Care Members Have Additional Rights to:
- Voice grievances or appeals about Missouri Care or the care it provides.
- Make recommendations regarding the member rights and responsibilities policy for Missouri Care.
- Receive information about Missouri Care, its services, its providers and their rights and responsibilities.
- An open discussion of appropriate or medically necessary treatment options for their conditions, regardless of cost or benefit coverage.
You have a responsibility to:
- Read and follow the member handbook.
- Show your Missouri Care ID card and your MO HealthNet red or white card to each health care provider before you get medical services.
- Know the name of your PCP. Get approval from your PCP before you get services from any other provider unless it is an emergency. There are exceptions like family planning. Call Member Services at 1-800-322-6027 if you have questions.
- Make appointments ahead of time for all PCP visits or transportation.
- Be on time for appointments or cancel the day before your appointment.
- Give your PCP your past health information. Your PCP needs to see shot (immunization) records for members up to age 21.
- Tell your PCP if you do not understand your medical care.
- Follow your PCP’s instructions and guidelines.
- Tell Missouri Care and your Family Support Division Eligibility Specialist if you have changes or your family has changes that will change your eligibility or enrollment.
- Pay for services you get without approval from Missouri Care or your PCP.
- Tell Missouri Care and your Family Support Division Eligibility Specialist if you have an accident at work, car accident, or are involved in a personal injury or malpractice lawsuit.
- Give a copy of your Living Will or Advance Directives to your PCP to include with your medical records.