Know your Patient Rights!
Prior to his doctor visit, Jason contacted his doctor and requested a sign language interpreter. This service was provided at no cost to Jason.
Use your rights to get the best health care for you and your family.
Topics on this page
Treatment
As a Patient you have the right to:
Ask questions about your health care.
You can ...
Prepare questions for your doctor visit. For example:
- What do I have?
- What will happen next?
- How does the treatment work?
- Are there side effects?
- Does it interfere with my other medicines?
- Are there other treatments available?
- Request that your doctor explain your options until you understand.
- Ask that your diagnosis and treatment plan be written down
- Let your doctor know if your symptoms change or if the treatment is not working
Get the care you need and when it is needed.
You can ...
- Expect to see a HMO primary care doctor within 10 business days and a specialist within 15 business days
- Expect a returned call from your HMO doctor’s office within 30 minutes of leaving a message
- Ask to see a specialist, if you need one.
- Go to the emergency department if you need emergency care.
- Question a diagnosis or treatment plan (including surgery).
- Request a second opinion
- Request a copy of your medical record
- Give written permission for your medical record to be shared with other doctors or family members
Doctors
As a Patient you have the right to:
Select a doctor you can trust and work with.
You can ...
- Pick a primary care doctor on your health plan's list
- Request to change your doctor by calling the health plan
- Choose an Ob/Gyn as your primary care doctor
- Ask to see a specialist, if you need one
Talk about your care and treatment in the language you know best.
You can ...
- Tell your health plan or doctor that you want services in your language
- Ask for an interpreter when you make your doctor appointment
- Request written materials in your language
Cost
As a Patient you have the right to:
Ask what services are covered by your plan and about the costs.
You can ...
- Call your health plan to know which tests and procedures require pre-approval
- Ask your health plan to help you clearly understand the covered services
- Verify that the bills you receive have correct charges that you need to pay
New Patient Rights with Health Care Reform
On March 23, 2010, the Patient Protection and Affordable Care Act became law. This new health care
reform law will provide many new patient rights and protections over the next 4 years.
You and your family may be eligible for important preventive services which can help you avoid illness
and improve your health at no additional cost to you. Ask your Health Plan representative about this
new right. For more information click here.
Improve Access to Private Health Insurance for Persons with Pre-existing Medical Conditions
Uninsured Californians who have a pre-existing medical condition can purchase health insurance
- California is creating a new program – the Pre-Existing Condition Insurance Plan (PCIP) -- to make health coverage available to individuals who have been denied health insurance by private insurance companies because of a pre-existing medical condition.
- For more information about the California program offered by the Managed Risk Medical Insurance Board, go to www.mrmib.ca.gov.
Improve the Quality and Security of Private Health Insurance
- Children who are sick or have a disability can not be denied insurance
- Job-based health plans and new individual plans won’t be allowed to deny or exclude coverage from children (under age 19) based a pre-existing medical condition, inlcuding a disability.
- Young adults can stay insured
- Young adults who do not have coverage through an employer (or an offer of coverage) will be allowed to stay on their parents’ health insurance policy until their 26th birthday.
- To find out more, visit http://www.healthcare.gov/foryou/youngadults/index.html or contact your health plan
- No longer are there lifetime dollar limits on health insurance
- Insurance companies can no longer limit the amount of money they will pay for benefits over an individual’s lifetime.
- Health coverage can not be dropped when a person gets sick
- Insurance companies can’t take away your coverage based on an unintentionial mistake on an application (this actjion is referred to as “recissions”) or if a person gets sick.
Language Access (SB 853)
Health Care Language Assistance Act
Beginning January 2009, the Health Care Language Assistance Act (SB 853) requires health plans to conduct a needs
assessment to assess the cultural and linguistic needs for their enrollees. Health plans will identify their threshold
languages and any racial and ethnic disparities within a plan. The goal of the Health Care Language Assistance Act is
to provide individuals who are limited-English proficient with the proper resources so they can obtain quality treatment
and care.
As a Patient you have the right to:
Interpreter services at no cost to ensure you obtain quality treatment and care.
You can ...
- Request vital documents be written in your language.
- Ask for an interpreter to accompany you to a doctor appointment, lab test or other health plan service. To find out the threshold languages of your health plan, click here.
Ask for Help
As a Patient you have the right to:
File a compliant if you feel that you were wrongly denied care.
You can ...
- Contact your health plan for help or to file a complaint
- Ask the health plan for a written explanation of the decisions about your complaint
- Request a fast review of your complaint by the health plan, if your health problem is urgent.
- Contact the Help Center of the California Department of Managed Health Care to request their assistance in reviewing the health plan’s decision regarding your complaint.
Call the Help Center at 1-888-466-2219 or email them at helpline@dmhc.ca.gov.
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