In California, health plan members have many rights, and we have some new rights under health care reform.
1. Your Health Care Rights
- To have an appointment when you need one. There are limits on how long you have to wait for an appointment.
- To have an appointment with a specialist when you need one.
- To request continuity of care if your doctor or medical group leaves your plan.
- To receive treatment for certain mental health conditions.
- To get a second doctor's opinion.
- To know why your plan denies a service or treatment.
- 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.
Timely Access to Care
Continuity of Care
Mental Health Care
Care of Illness
2. You Have the Right to File a Complaint and Ask for an Independent Medical Review
3. 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 or specialist.
You and Your Doctor
Referrals and Approvals
4. You Have the Right to Services in Your Language
- To ask for a provider or have an interpreter who speaks your language when you receive health care services.
- To receive written information in the main languages spoken by the members of your health plan.
5. Your Medical Records Rights
- To get a copy of your records (you may be charged for the copying).
- To add your own notes to your records.
6. 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.
7. Disability Access Rights
- Accessible and usable medical equipment at a provider's office or facility. For example, your doctor or health plan should help you find accessible weight scales, exam tables, and diagnostic medical equipment such as mammography and MRI.
- Have most physical barriers removed that make it hard for you to use your health care services.
- Extra time for visits if you need it.
- Health information you can use if you are blind, deaf, or have low vision.
- Take your service animal into exam rooms with you.
8. 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. For more information, contact the California Attorney General's office toll free at 1-800-952-5225.
9. You Have New Rights Under Health Care Reform
- To purchase health insurance or determine Medi-Cal eligibility through the California Health Benefit Exchange, Covered California.
- 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 annual or lifetime dollar limits on basic health care services.
Types of Coverage