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Other Patient Rights
Use your rights to get the best health care for you and your family. Most health care patients in California have the following rights. If you have questions about your rights, look at your plan handbook or contact the agency that oversees your plan.
Doctors and Treatment Options
You have the right to choose a doctor you trust and can work with. You can…
- Choose a primary care doctor in your plan’s network.
- Choose an internist, pediatrician, family doctor, or Ob/Gyn as your primary care doctor.
- Change your doctor if you are not satisfied with your care. To change your doctor, call your health plan.
- See a specialist if you need one.
- Get a second opinion about a serious health problem.
- Ask questions about your health care.
You have the right to get information about your health care options.
- You can ask that your diagnosis and treatment options be explained to you so that you understand it. You can ask for this information to be written down.
- When you ask questions about a treatment or medicine, you should get complete answers that you understand.
- Do not sign a consent form for treatment if you do not understand it.
You have the right to know if a service is covered by your plan and what it will cost you. You can…
- Call your health plan to find out if a test or procedure is covered and if it requires pre-approval.
- Ask your health plan to help you clearly understand the services it covers.
- Ask your health plan to explain your bills and make sure that the charges are correct.
You have the right to see your medical records or get a copy of your records from your doctor (CA Health and Safety Code sections 123100 – 123149.5).
- You must make a written request to your doctor to get a copy of your medical records sent to you.
- Your doctor must provide the copies to you in 15 days after receiving your written request.
- Your doctor can charge a fee for the copies. They can withhold the copies until the fee is paid.
- Learn more about your rights to your medical records on the Medical Board of California website.
HIPAA and Patient Privacy
The federal Health Insurance Portability and Accountability Act (HIPAA) and California law give you rights to:
- Ask to see and get a copy of your health records.
- Have corrections added to your health information.
- Receive a notice that tells you how your health information may be used and shared in the future.
- Decide if you want to give your permission before your health information can be used or shared.
- Get a report on when and why your health information was shared.
- Visit the California Attorney General’s website on Privacy Protections for more information about your rights.
- Also view the California Office of Health Information Integrity website for more information about federal and state health laws.
Filing Complaints or Appeals
You have the right to file a complaint (grievance) if you have a problem with your health plan, provider, or health care facility, or if you feel that you were wrongly denied care.
- File an appeal with your health plan if your plan denies a service or rejects a claim.
- Request a fast (expedited) review of your complaint or appeal if your health problem is urgent.
- Ask the health plan for a written explanation of the decisions about your complaint.
- If your plan denies your complaint or appeal, contact the agency that oversees your health plan to get assistance or file an appeal. This external appeal is sometimes called an Independent Medical Review.