Quality

Rights and responsibilities of a Magellan Complete Care of Arizona (MCC of AZ) member

As an MCC of AZ member, you have the right to:

  • Be treated carefully, with respect and privacy for his or her dignity and privacy.
  • Be treated fairly, whatever your:
    • Race.
    • Religion.
    • National origin.
    • Gender.
    • Age.
    • Ethnic background.
    • Disability.
    • Behavioral health condition (intellectual).
    • Sexual preference.
    • Genetic information.
    • Source or ability of payment.
  • Have your treatment and other information kept private. We share treatment records without your okay only when the law allows it.
  • Get care easily and when you need it.
  • Be able to get an emergency/replacement caregiver for critical services within two hours.
  • Learn about treatment options and in a way that:
    • Respects your culture.
    • You can understand.
    • Fits your needs.
  • Take part in making your plan of care.
  • Get information in a language you can understand. Know about providers who speak languages other than English. And get things translated at no cost.
  • Get information in other ways if you ask for it.
  • Get information about MCC of AZ and its:
    • Providers.
    • Programs.
    • Services.
    • Role in the treatment process.
  • Get information about clinical rules followed in your care.
  • Ask your providers about their work history and training.
  • Not be kept alone or forced to do something you do not want to do. This is based on a federal law.
  • Give your thoughts on the Rights and Responsibilities policy.
  • Ask for a certain type of provider.
  • Have your provider make care decisions based on the treatment you need.
  • Get healthcare services that obey state and federal laws about your rights.
  • Help make decisions about your healthcare. This includes the right:
    • To get a second medical opinion from a qualified healthcare provider within the network or have a second opinion arranged outside the network at no cost to you.
    • To say no to treatment. This is your right unless the court says otherwise.
  • File a complaint or grievance about:
    • MCC of AZ.
    • A provider.
    • The care you receive.
  • File an appeal about a Magellan action or decision. You can ask for a State Fair Hearing if you are not happy with the result of the appeal.
  • Sign a form saying that you know your health information may be shared in a public way during the State Fair Hearing process. this applies if your provider asks for a State Fair Hearing for you. Your provider will need you to sign this form.
  • Request and receive a copy of your medical records at no cost once year:
    • If there are any changes needed to your medical records, you may request these be changed and/or amended at any time.
    • We will respond to the request within [30 days] with either delivery of the medical records or a written denial that includes why the request was denied. If you receive a denial, you will get information about how to seek review of the decision.
  • Use your rights. This will not affect the way Magellan and its providers treat you.
  • Get written information on advance directives and your rights under state law. We can get you information on how to create your own advance directive. (An advance directive tells doctors the kind of care you would want if you become too sick to decide.)
  • Talk with your provider about the types of treatment that are right for you. The cost or benefit coverage do not affect this.
  • Get information about how and where to access benefits from the state that are not covered under your plan. This could include cost-sharing. It could also include transportation.
  • Ask for information in a way that you can get to it easily. This applies if you have a visual, hearing or physical disability. This will help you know what benefits and services you have access to.
  • Receive information about Magellan Complete Care, its services, its practitioners and providers and member rights and responsibilities.
  • Be free from any form of restraint or seclusion as a means of coercion, discipline, convenience or retaliation.
  • Receive treatment for any emergency medical condition at any hospital or other setting that may lead to more harm if you don’t get treatment right away.
  • Request information about a doctor’s contract status, including physician incentive plans or other compensation arrangements, use of referral services, member survey results and whether stop-loss insurance is required. To get this information, please call Member Services at 1-800-424-5891 (TTY 711).
  • Exercise his or her rights and that the exercise of those rights shall note adversely affect service delivery to the member 42 CFR 438.100(c).