In California, health plan members have many rights, and we have some new rights under health care reform.
You Have the Right to Receive Care When You Need It
You Have the Right to Understand Your Health Problems and Treatments
- To see a written diagnosis (description of your health problem).
- To give informed consent when you have a treatment.
You Have the Right to File a Complaint and Ask for an Independent Medical Review
- To file a complaint (grievance or appeal) if you have a problem with your health plan.
- To ask for an Independent Medical Review of a decision your health plan makes about your care.
You Have the Right to Choose Your Own Doctor
- To choose a doctor in your health plan's network.
- To change to another doctor in the network if you are not satisfied with your doctor.
- To change your specialist or mental health care provider if you are not satisfied.
- To ask for a provider or interpreter who speaks your language if you are not comfortable speaking English.
You Have the Right to Services in Your Language
You Have the Right to See Your Medical Records
- To get a copy of your records (you may be charged for the copying).
- To add your own notes to your records.
You have the Right to Keep Your Medical Information Private.
- To ask your doctor or health plan to contact you only in certain ways or at certain locations.
- To set limits on who gets to see your personal health information.
- To be told to whom your personal health information has been given.
- To keep psychotherapy notes private.
You Have the Right to Have an Advanced Directive
An Advanced Directive tells your doctor, family, and friends about the health care you want if you can no longer make decisions for yourself. It explains the types of special treatment you want or do not want. The state Attorney General's office has more information. Call 1-800-952-5225.
You Have New Rights Under Health Care Reform
- To buy individual coverage for children under age 19 who have pre-existing conditions.
- To stay on a parent’s health plan until age 26.
- To get many preventive care services without a co-pay, co-insurance or deductible.
- To have no lifetime dollar limits on basic health care services.