Rights and Responsibilities

YOUR RIGHTS

As a member of MetroPlus Health Plan, you have a right to:
  • Be cared for with respect, without regard for health status, sex, race, color, religion, national origin, age, marital status or sexual orientation.
  • Be told where, when and how to get the services you need from MetroPlus.
  • Be told by your Primary Care Provider (PCP) what is wrong, what can be done for you and what will likely be the result, in a language you understand.
  • Get a second opinion about your care.
  • Give your OK to any treatment or plan for your care after that plan has been fully explained to you.
  • Refuse care and be told what you may risk if you do.
  • Get a copy of your medical record, and talk about it with your PCP, and to ask, if needed, that your medical record be amended or corrected.
  • Be sure that your medical record is private and will not be shared with anyone except as required by law, contract or with your approval.
  • Use the MetroPlus complaint system to settle any complaints, or you can complain to the NY State Department of Health or the local Department of Social Services any time you feel you were not fairly treated.
  • Use the State Fair Hearing system.
  • Appoint someone (relative, friend, lawyer, etc.) to speak for you if you are unable to speak for yourself about your care and treatment.
  • Receive considerate and respectful care in a clean and safe environment free of unnecessary restraints.

YOUR RESPONSIBILITIES

As a member of MetroPlus Health Plan, you agree to:
  • Work with your PCP to guard and improve your health.
  • Find out how your health care system works.
  • Listen to your PCP’s advice and ask questions when you are in doubt.
  • Call or go back to your PCP if you do not get better, or ask for a second opinion.
  • Treat health care staff with the respect you expect yourself.
  • Tell us if you have problems with any health care staff. Call Member Services.
  • Keep your appointments. If you must cancel, call as soon as you can.
  • Use the emergency room only for real emergencies.
  • Call your PCP when you need medical care, even if it is after hours.