Members

Member Rights & Responsibilities

rights

Rights and Responsibilities

As a Member of Affinity Health Plan you will have the right to:

  1. Get quality health services with care and respect no matter what your race, color, religion, sex, age, homeland, sexual orientation, physical or emotional state.
  2. Get information that is clear, complete, and in your language from your Primary Care Physician (PCP) and other doctors. It will say what is wrong, and what can be done for you.
  3. Get a second opinion about your care and treatment.
  4. Name someone to decide about your care, if you are too sick to know what to do.
  5. Know what is to be done in any surgery and have the chance to agree to it before anything is started.
  6. Say no to treatment when the law allows and be told clearly what will happen if you do so.
  7. Get a copy of your health record and talk about it with your doctor.
  8. Have your treatment and records kept private (except as the law or a contract may call for).
  9. Get thoughtful and respectful care in a clean and safe setting free of unwanted restraints.
  10. Say your views to Affinity Health Plan staff, including any complaints you may have, and get a thoughtful, helpful answer.
  11. Make a written or spoken complaint to Affinity Health Plan at any time.
  12. Make a written or spoken complaint to the New York State Department of Health or your Local Department of Social Services.
  13. Use the State Fair Hearing process.

As a Member of Affinity Health Plan, you have the responsibility to:

  1. Use the hospital Emergency Room only for real emergencies that might cause death or lasting harm.
  2. Keep your medical appointment. And to call if you are either going to be late or must can cancel your appointment.
  3. Talk over your health care needs with your Affinity doctor and follow the care you both agree on.
  4. Listen to your PCP’s advice and ask questions when you’re in doubt.
  5. Call or go back to your PCP if you do not get better, or ask for a second opinion.
  6. Call your PCP or Affinity Health Plan if you need care at night or on the weekend.
  7. Tell us if you have problems with any health care staff. Call Customer Service.
  8. Tell Affinity Health Plan if your address and/or phone number changes.
  9. Learn how your health care system works.
  10. Follow the rules in your Member Handbook.
  11. Tell Affinity if you become eligible for Medicare or get other insurance coverage.
  12. Let Affinity Health Plan staff know if your rights have not been honored.

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