Rights and Responsibilities

As a Blue Cross and Blue Shield of Louisiana or HMO Louisiana member, you have certain rights and responsibilities regarding your health plan.

Your Rights

  • You have the right to be provided with information on your health plan, its services, the practitioners providing care and your rights and responsibilities in clear, understandable language.
  • You have the right to receive medically necessary care that is covered under your benefit plan and is provided or arranged by your health care provider.
  • You have the right to be informed by your health care provider about your diagnosis, treatment options and prognosis in clear, understandable language.
  • You have the right to participate with practitioners when making decisions regarding your health care.
  • You have the right to refuse treatment.
  • You have the right to be treated with respect and recognition of your dignity and privacy.
  • You have the right to the confidentiality of information concerning your medical treatment.
  • You have the right to express verbal or written complaints about Blue Cross/HMO Louisiana or the medical care provided, and to a timely response when appropriate.
  • You have the right to a candid discussion of all appropriate, medically necessary options for your condition(s).
  • You have the right to know how your physician and other health care professionals are compensated by Blue Cross/HMO Louisiana.
  • Members who participate in Case Management should view the Case Management Rights as well.
  • Members who participate in Disease Management should view the Disease Management Rights and Responsibilities as well.

Your Responsibilities

  • You are responsible for reading and understanding all material concerning your health benefits.
  • You are responsible for complying with all terms of membership with your health plan.
  • You are responsible for developing and maintaining a satisfactory physician-patient relationship.
  • You are responsible for following instructions and guidelines as agreed upon by you and your health care provider.
  • You are responsible for engaging in a healthy lifestyle and in safety practices.
  • You are responsible for providing, to the extent possible, complete and accurate information that Blue Cross/HMO Louisiana and its practitioners and providers need in order to care for you.
  • You are responsible for making and keeping appointments, or canceling in advance if unable to make your appointment.
  • You are responsible for paying copayment and/or coinsurance amounts required under your health plan.
  • You are responsible for notifying your employer or Blue Cross of any other health care coverage of which you are a beneficiary, and for cooperating in coordinating benefits.