Members Rights And Responsibilities

OneCare (HMO SNP) must:

  • Provide information in a way that works for you

  • Treat you with fairness and respect at all times

  • Ensure that you get timely access to your covered services and drugs

  • Protect the privacy of your personal health information

  • Give you information about the plan, its network of providers and your
    covered services

  • Support your right to make decisions about your care

  • Ensure your right to make complaints and to ask us to reconsider decisions we have made

  • Advise you if you think you are being treated unfairly or your rights are not
    being respected

  • Give you more information about your rights

  • Tell you about procedures, including appeals and grievances, with
    OneCare

You are responsible for:

  • Getting familiar with your covered services and the rules you must follow to get these covered services

  • Telling us if you have any other health insurance coverage or prescription drug coverage besides OneCare

  • Telling your doctor and other health care providers that you are enrolled in OneCare

  • Helping your doctors and other providers help you by giving them information, asking questions, and following through on your care

  • Being considerate

  • Paying what you owe

  • Telling us if you move

  • Calling Customer Service for help if you have questions or concerns

Date Revised September 29, 2017

To file a complaint with Medicare, click on the following link to complete a complaint form on the Medicare website: Medicare Complaint Form.

H5433_WEB18_001 Approved (10/19/17)

OneCare (HMO SNP) is a Medicare Advantage organization with a Medicare contract. Enrollment in OneCare depends on contract renewal. Eligible beneficiaries can enroll at any time. Eligible beneficiaries must have Part A and Part B to enroll in the plan. This information is not a complete description of benefits. Contact the plan for more information. Limitations, copayments, and restrictions may apply. Benefits, premiums and/or co-payments/co-insurance may change on January 1 of each year. Co-pays, co-insurance, and deductibles may vary based on the level of Extra Help you receive. Please contact the plan for further details. Other Pharmacies/Physicians/Providers are available in our network. Medicare beneficiaries may also enroll in OneCare (HMO SNP) through the CMS Medicare Online Enrollment Center located at http://www.medicare.gov. Medicare has neither reviewed nor endorsed this information. The Formulary, pharmacy network, and/or provider network may change at any time. You will receive notice when necessary. OneCare complies with applicable Federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, or sex. This information is available for free in other languages. Please call our customer service number at 1-877-412-2734, 24 hours a day, 7 days a week. TDD/TTY users should call 1-800-735-2929.

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