Commonwealth Community Care

One Care

Members » Rights & Responsibilities

Rights & Responsibilities

Member Rights

  • To receive information in a way that works for you (in languages other than English, in Braille, in large print, audio CD or other alternate formats, etc.)
  • To be treated with fairness and respect at all times
  • To get timely access to your covered services and drugs
  • To have the privacy of your personal health information protected
  • To receive information about the plan, its network of providers, and your covered services
  • To be supported in your right to make decisions about your care
  • To make complaints and to ask us to reconsider decisions we have made

 Member Responsibilities

  • Get familiar with your covered services and the rules you must follow to get these covered services.
  • Tell us if you have any other health insurance coverage or prescription drug coverage in addition to our plan.
  • Tell your doctor and other healthcare providers that you are enrolled in our plan.
  • Help your doctors and other providers help you by giving them information, asking questions, and following through on your care.
  • Tell us if you move.
  • Call Member Services at 1-866-610-2273 (TTY 711) for help if you have questions or concerns. We are available 8 a.m. to 8 p.m., 7 days a week.

Click here for complete list of Member Rights and Responsibilities

Click here for Notice of Privacy Practice

If you are treated unfairly or your rights are not respected

If you believe you have been treated unfairly or your rights have not been respected due to your race, disability, religion, sex, health, ethnicity, creed (beliefs), age, or national origin, you should call the Department of Health and Human Services’ Office for Civil Rights at 1-800-368-1019 (TTY 1-800-537-7697), or call your local Office for Civil Rights.

If you believe you have been treated unfairly or your rights have not been respected, and it is not about discrimination, you can get help dealing with the problem by contacting:

  • Commonwealth Care Alliance Member Services at 1-866-610-2273 (TTY 711)
  • Serving the Health Information Needs of Elders (SHINE) at 1-800-243-4636 (TTY 1‑800‑872‑0166)
  • Medicare at 1-800-633-4227 (TTY 1-877-486-2048), 24 hours a day, 7 days a week or contacting Medicare/Medicaid by using their online form*

 

To view the PDF files above, you may need to download a free copy of Adobe® Acrobat Reader software on your computer. (This link takes you away from the Commonwealth Care Alliance website pages.) Click here for more information about Adobe Acrobat.

*When you click this link, you will leave Commonwealth Care Alliance’s website.