In California, health plan members have many rights, including 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, including one with a specialist.
- To request continuity of care if your doctor or medical group leaves your health plan.
- To receive treatment for certain mental health conditions.
- To get a second doctor's opinion.
- To know why your health plan denies a service or treatment.
- 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.
Learn More:
Timely Access to Care
Continuity of Care
Behavioral Health Care
Care of Illness
2. Your Right to File a Complaint and Ask for an Independent Medical Review
3. Your Right to Choose Your Own Doctor
- To choose a doctor in your health plan's network.
- To change to another doctor in your health plan's network if you are not satisfied with your doctor or specialist.
Learn More:
You and Your Doctor
Referrals and Approvals
4. Your 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.
Learn More:
Language Assistance
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. Your 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. Your Disability Access Rights
- To have access to 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.
- To have most physical barriers removed that make it hard for you to use your health care services.
- To have extra time for visits if you need it.
- To have health information provided in a usable format if you are blind, deaf, or have low vision.
- To take your service animal into exam rooms with you.
8. Your 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. Your 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.
Learn More:
Types of Coverage
Preventive Care