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Member Rights & Responsibilities All Wellmark members are encouraged to know their rights and responsibilities. Informed members have greater control over their health care decisions and well-being.

Your Rights

• You have the right to receive accurate information about your health plan, its services, its network of providers, and your rights and responsibilities.
   
• You have the right to receive accurate information on notification requirements and case management services.
   
• You have the right to be treated with respect, in a manner that preserves your dignity and recognizes your right to privacy.
   
• You have the right to fair and equitable treatment. In the delivery of health management and other relevant services, members are not discriminated against on the basis of race, ethnicity, national origin, religion, sex, age, mental or physical disability, sexual orientation, genetic information, veteran status or source of payment.
   
• You have the right to participate fully, with your providers, in decision-making that affects your health care.
   
• You have the right to expect a candid discussion of all appropriate or medically necessary treatment options pertaining to your condition, regardless of cost or benefit coverage.
   
• You have the right to voice complaints or appeals about your health plan or the care delivered by any of its providers.
   
• You have the right to make recommendations regarding our members’ rights and responsibilities policy.

Your Responsibilities

Likewise, you share responsibility for maintaining your own good health.

• You have the responsibility to provide, to the extent possible, information that the health plan needs to process claims and information your providers need to provide care for you.
   
• You have the responsibility to participate in understanding your health problems and participate in developing mutually agreed upon treatment goals to the degree possible.
   
• You have the responsibility to follow the plans and instructions for care that you have agreed to with your providers.
   
• You have the responsibility to present your ID card prior to receiving services.