All new and existing Martin's Point members receive communications regarding rights and responsibilities in their annual Evidence of Coverage Document.
For questions regarding our member rights and responsibilities, or to request a paper copy, please call Member Services at 1-866-674-8734.
Martin's Point members have the right to:
- Receive information about covered benefits and cost sharing.
- Receive information about Martin’s Point Health Plans, our services, licensure, certification, and accreditation status.
- Receive information about our practitioners, providers, and health care facilities, including information about the composition of our network.
- Receive information in a way that works for you, including in alternate languages and formats.
- Have a choice of health care providers that is sufficient to ensure access to appropriate high-quality health care.
- Have a right to a candid discussion of all medically necessary treatment options, regardless of cost of benefit coverage.
- Receive information on member satisfaction and rights and responsibilities.
- Be informed of the processes for accessing specialists and emergency services.
- Receive considerate and respectful care, with recognition of your personal dignity at all times.
- Have access to all of the health care and treatment services we provide, including care management information, consistent with available resources and generally acceptable standards.
- Have access to emergency health care services when and where the need arises.
- Refuse treatments to the extent permitted by law and government regulations and the right to be informed of the consequences of such refusal of treatment.
- Question the adequacy of care being provided.
- Have privacy and confidentiality concerning your medical care and records to the extent permitted by law. You have the right, and will be afforded the opportunity, to approve or refuse the release of such information, except when release is required by law or the federal government.
- Know the identity and professional status of the health care provider primarily responsible for providing and managing your care, as well as other health care personnel involved in your treatment.
- Participate in decisions involving your health care including mutually agreed-upon goals to the degree possible. Members who are unable to fully participate in treatment decisions have the right to be represented by parents, guardians, family members, or other conservators.