Member rights & responsibilities
As a Prevea360 Health Plan member you have the right to:
- Be treated with respect and recognition of your dignity and right to privacy.
- Receive a listing of Prevea360 participating practitioners in order to choose a Primary Care Physician.
- Present a question or complaint or grievance to Prevea360, about the organization or the care it provides, without fear of discrimination or repercussion.
- Receive information on procedures and policies regarding their health care benefits.
- Timely responses to requests regarding your health care plan.
- Request information regarding Advance Directives.
- Participate with practitioners in making decisions about your health care.
- A candid discussion of appropriate or medically necessary treatment options for your conditions, regardless of cost or benefit coverage.
- Receive information about the organization, its services, its practitioners and providers, and members' rights and responsibilities.
- Make recommendations regarding the organization's members' rights and responsibilities policies.
You have the responsibility to:
- Read and understand the materials provided by Prevea360 concerning your health care benefits. Prevea360 encourages members to contact us if you have any questions.
- Present your ID Card in order to identify yourself as a Prevea360 member before receiving health care services.
- Notify DHP of any enrollment status changes such as family size or address.
- Supply information (to the extent possible) that the organization and its practitioners and providers need in order to provide care.
- Follow plans and instructions for care that you have agreed to with your practitioners.
- Understand your health problems and participate in developing mutually agreed upon treatment goals to the degree possible.
- Fulfill financial obligations as it relates to any copays, deductibles and/or premiums as outlined in your policy.