Your Rights and Responsibilities

AmeriHealth Caritas VIP Care Plus must honor your rights as a member of the plan.

Rights

• You have the right to get information from AmeriHealth Caritas VIP Care Plus in a way that works for you (including in languages other than English, in Braille, in large print, or in other alternate formats).
• You have the right to be treated with fairness and respect at all times.
• You have the right to get timely access to your covered services and drugs.
• You have the right to have the privacy of your personal health information protected.
• You have the right to get information about the plan, its network of providers, and your covered services.
• You have the right to make decisions about your care and for AmeriHealth Caritas VIP Care Plus to support those decisions.
• You have the right to make complaints and to ask us to reconsider decisions we have made.
• You have the right to disenroll from the plan.
• You have the right to know your treatment options and participate in decisions about your health care.
• You have the right to give instructions about what is to be done if you are not able to make medical decisions for yourself.

You also have some responsibilities as a member of our plan.

Responsibilities

• If you have any other health insurance coverage or prescription drug coverage besides our plan, you are required to tell us.
• Tell your primary care provider (PCP) and other health care providers that you are enrolled in our plan. Show your plan membership card and your Medicaid card whenever you get your medical care or Part D prescription drugs.
• Help your doctors and other providers help you by giving them information, asking questions, and following through on your care.
• Be considerate. We expect all our members to respect the rights of other patients. We also expect you to act in a way that helps the smooth running of your doctor's office, hospitals, and other offices
• Pay what you owe. As a plan member, you are responsible for these payments:
  • Medicare Part A and Medicare Part B premiums. For almost all AmeriHealth Caritas VIP Care Plus members, Michigan Medicaid pays for your Part A premium and for your Part B premium.
  • A Patient Pay Amount (PPA) for nursing facility services as determined by the Michigan Department of Health and Human Services.
  • If you get any services or drugs that are not covered by our plan, you must pay the full cost.
  • If you disagree with our decision to not cover a service or drug, you can make an appeal.
• Tell us if you move. If you are going to move, it's important to tell us right away. Call Member Services at 1-888-667-0318 (TTY 711), 8 a.m. to 8 p.m., seven days a week.