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As a Cigna member, you have certain rights and responsibilities, as outlined below.
You have the right to:
- Receive coverage for the benefits and treatment available under your health plan when you need it and in a way that respects your privacy and dignity.
- Receive the understandable information you need about your health benefit plan, including information about services that are covered and not covered and any costs that you will be responsible for paying.
- Obtain understandable information about Cigna's programs and services, including the qualifications of staff that support Cigna wellness and similar programs and any contractual relationships related to such programs.
- Have access to current information on in-network doctors, health care professionals, hospitals and places you can receive care and information about a particular health care professional’s education, training and practice.
- Select a primary care doctor for yourself and each covered member of your family, and change your primary care doctor for any reason. However, many benefit plans do not require that you select a primary care doctor.
- Have your personal identifiable data and medical information kept confidential by Cigna and your health care professional, know who has access to your information, and know the procedures used to ensure security, privacy and confidentiality. Cigna honors the confidentiality of its customers’ information and adheres to all federal and state regulations regarding confidentiality and the release of personal health information
- Participate with your health care professional in health decisions and have your health care professional give you information about your condition and your treatment options, regardless of coverage or cost. You have the right to receive this information in terms and language you understand.
- Learn about any care you receive. You should be asked for your consent for all care, unless there is an emergency and your life and health are in serious danger.
- Refuse medical or behavioral care. If you refuse care, your health care professional should tell you what might happen. We urge you to discuss your concerns about care with your doctor or other health care professional. Your doctor or health care professional will give you advice, but you will have the final decision.
- Be advised of who is available to assist you with any special Cigna programs or services you may receive and who can assist you with any requests to change or disenroll from programs or services offered by or through Cigna.
- Be heard. Our complaint-handling process is designed to: Hear and act on your complaint or concern about Cigna and/or the quality of care you receive from health care professionals and the various places you receive care in our network; provide a courteous, prompt response; and guide you through our grievance process if you do not agree with our decision. Cigna strives to resolve your complaint on initial contact and in a manner that is consistent with your applicable benefit plan. Language interpretation and TTY services are available for complaint and appeal processes.
- Know and make recommendations regarding our policies that affect your rights and responsibilities. If you have recommendations or concerns, please call Customer Service at the toll-free number on your ID card.
You have the responsibility to:
- Review and understand the information you receive about your health benefit plan. Please call Customer Service when you have questions or concerns.
- Understand how to obtain services and supplies that are covered under your plan - including any emergency services needed outside of normal business hours or when you are away from your usual place of residence or work, by using the indicated number on your Cigna ID card or by accessing Cigna on-line resources.
- Show your ID card before you receive care.
- Schedule a new patient appointment with any in-network health care professional; build a comfortable relationship with your health care professional; ask questions about things you don’t understand; and follow your health care professional’s advice. You should understand that your condition may not improve and may even get worse if you don’t follow your health care professional’s advice.
- Understand your health condition and work with your health care professional to develop treatment goals that you both agree upon and to follow the treatment plan and instructions.
- Provide honest, complete information to us and the health care professionals caring for you.
- Know what medicine you take, why, and how to take it.
- Pay all copays, deductibles and coinsurance for which you are responsible, at the time service is rendered or when they are due.
- Keep scheduled appointments and notify the health care professional’s office ahead of time if you are going to be late or miss an appointment.
- Pay all charges for missed appointments and for services that are not covered by your plan.
- Voice your opinions, concerns or complaints to Cigna Customer Service and/or your health care professional.
- Notify your plan administrator and treating health care professional as soon as possible about any changes in family size, address, phone number or status with your health benefit plan if you decide to disenroll from Cigna's programs and services.