BlueCross BlueShield of Tennessee wants you to have the personalized, quality health care you deserve. For that to happen, it is important that you understand how your health plan works, and that you become involved and informed about the care you receive. As a plan member, you have certain rights, responsibilities, and expectations. By understanding and upholding these rights and responsibilities, you will help us arrange and coordinate the type of care you deserve.

You have the right to:

• Be treated with respect and dignity
• Expect that any information you give to your practitioner or to the plan will be treated in a confidential manner
• Receive services without discrimination due to age, sex, race, color, religion and national origin
• Receive information about policies and services of your plan network, including structure, operation, quality improvement activities and member rights and responsibilities
• Receive information regarding the practitioners in your plan network
• Receive medically necessary and appropriate care
• Receive information regarding health care and access to medical records as stated in federal and state laws
• Request medical records be corrected as stated in federal and state laws
• Participate with practitioners in making decisions about your health care
• Voice appeals, grievances or complaints about your health care practitioners, the care you receive, or your plan network, with the expectation of an answer within a reasonable timeframe. You also have the right to formally appeal this answer if it is not acceptable
• A candid discussion of appropriate medically necessary treatment options for your condition, regardless of cost or benefit coverage
• Formulate a living will (or advance directive)
• Approve (consent) or deny an employer access to member-identifiable health information
• Be informed about the associated cost of care
• Make recommendations regarding the organization's member rights and responsibilities policy

You are expected to:

• Consult your practitioner for all medical services to be covered by the plan
• Provide, to the extent possible, all information concerning your health to those providing your health care
• Follow the instructions and advice of those providing you health care services, or immediately question what you do not understand or do not agree with
• Show your member identification (ID) card each time you seek health care
• Ensure that you are the only person who uses your ID card. (A parent or legal guardian must present the ID card for dependents under the age of 18 each time health care is sought)
• Notify the plan if there is a change in employment, address or dependents
• Keep health appointments and call the health caregiver's office to cancel if you cannot make the appointment
• Treat your caregiver with respect and dignity
• Read the benefit booklet, Evidence of Coverage
• Pay any copayment, deductible, coinsurance, or any charges for non-covered and out-of-network services if required as part of the your health plan
• Be a part of decision making about your health care
• Seek understanding of your health benefit plan and your responsibility to pay for out-of-network services you agree to receive