Medicare Member Rights and Responsibilities

Feel free to distribute the following information to your patients regarding their UnitedHealthcare Medicare member rights and responsibilities. 

Feel free to distribute the following information to your patients regarding their UnitedHealthcare Medicare member rights and responsibilities.

Member Rights and Responsibilities

Members have the right to:

  • Be treated with respect and dignity by UnitedHealthcare personnel, network doctors and other health care professionals.
  • Get help in a prompt, courteous, responsible and culturally competent manner.
  • Be given information about their health care benefits, and any limitations and services not covered by the plan.
  • Be told by their provider all their medical information in words they understand.
  • Privacy and confidentiality for treatments, tests and procedures they receive. See Notice of Health Plan Privacy Practices in the Evidence of Coverage (EOC) documents for a description of how UnitedHealthcare protects personal health information.
  • Voice concerns about the service and care they receive.
  • Register complaints and appeals concerning their health plan and the care provided to them.
  • Get timely responses to their concerns.
  • Candidly discuss with their doctor the appropriate and medically necessary treatment options for their conditions, regardless of cost or benefit coverage.
  • Access doctors, health care professionals and other health care facilities.
  • Participate in decisions about their care with their doctor and other health care professionals.
  • Get and make recommendations regarding the organization’s rights and responsibilities policies.
  • Get information about UnitedHealthcare, our services, network doctors and other health care professionals.
  • Be informed about, and refuse to participate in, any experimental treatment.
  • Have coverage decisions and claims processed according to regulatory standards, when applicable.
  • Choose an Advance Directive to designate the kind of care they wish to receive should they become unable to express their wishes.

Members have the responsibility to:

  • Know and confirm their benefits before receiving treatment.
  • Contact an appropriate health care professional when they have a medical need or concern.
  • Show their ID card before receiving health care services.
  • Pay any necessary copayment at the time they receive treatment.
  • Use emergency room services only for injuries and illnesses that, in the judgment of a reasonable person, require immediate treatment to avoid jeopardy to life or health.
  • Keep scheduled appointments.
  • Provide information needed for their care.
  • Follow the agreed-upon instructions and guidelines of doctors and health care professionals.
  • Participate in understanding their health problems and developing mutually agreed-upon treatment goals.
  • Notify UnitedHealthcare Member Services of any changes in address or status.

If members have any questions or concerns about their rights, they should call UnitedHealthcare Member Services at the phone number listed on the back of their member ID card. If they need help with communication, such as help from a language interpreter, Member Services can help.

They can contact Medicare. The Medicare program has written a booklet called Your Medicare Rights and Protection. To get a free copy, members can call toll-free 1-800-MEDICARE (1-800-633-4227) or TTY (1-877-486-2048) 24 hours a day, seven days a week. Or they can go to the Medicare website to order the booklet or print it from their computer.