October 01, 2022
Minnesota Medicaid member rights and responsibilities
Minnesota Medicaid members have several rights and responsibilities when engaging with UnitedHealthcare and contracted providers. Review the following information, and feel free to share with your patients to help keep them informed regarding their Minnesota Medicaid member rights and responsibilities.
Member rights
- Be treated with respect, dignity and consideration for privacy
- Get the services you need 24 hours a day, 7 days a week. This includes emergencies.
- Be told about your health problems
- Get information about treatments, your treatment choices and how treatments will help or harm you
- Participate with providers in making decisions about your health care
- Have a candid discussion about appropriate or medically necessary treatment options for conditions, regardless of cost or benefit coverage
- Refuse treatment and get information about what might happen if you refuse treatment
- Refuse care from specific providers
- Know that your records will be kept private according to law
- Ask for and get a copy of your medical records. You also have the right to ask to correct the records.
- Get notice of our decisions if we deny, reduce or stop a service, or deny payment for a service
- File a grievance or appeal with us. You can also file a complaint with the Minnesota Department of Health.
- Request a State Appeal (Fair Hearing with the state) with the Minnesota Department of Human Services (also referred to as “the state”). You must appeal to us before you request a State Appeal. If we take more than 30 days to decide your plan appeal and we have not asked for an extension, you do not need to wait for our decision to ask for a State Appeal.
- Receive a clear explanation of covered home care services
- Give written instructions that inform others of your wishes about your health care. This is called a “health care directive.” It allows you to name a person (agent) to make decisions for you if you are unable to decide, or if you want someone else to decide for you.
- Choose where you will get family planning services, diagnosis of infertility, sexually transmitted disease testing and treatment services, and AIDS and HIV testing services
- Get a second opinion for medical, mental health and substance use disorder services
- Be free of restraints or seclusion used as a means of coercion, discipline, convenience or retaliation
- Request a written copy of the Member Handbook at least once a year
- Get the following information from us if you ask for it. Call Member Services at 888-269-5410, TTY 711
- Whether we use a physician incentive plan that affects the use of referral services, and details about the plan if we use one
- Results of an external quality review study from the state
- The professional qualifications of health care providers
- Make recommendations about our rights and responsibilities policy
- Exercise the rights listed here
Member responsibilities
- Show your health plan member ID card and your Minnesota Health Care Program card every time you get health care. Also show the cards of any other health coverage you have, such as Medicare or private insurance.
- Establish a relationship with a Plan network Primary Care Provider before you become ill. This helps you and your Primary Care Provider understand your total health condition.
- Give information asked for by your Primary Care Provider or health plan so the right care or services can be provided to you. Share information about your health history.
- Work with your Primary Care Provider to understand your total health condition. Develop mutually agreed-upon treatment goals when possible. Follow plans and instructions for care that you have agreed to with your doctor. If you have questions about your care, ask your Primary Care Provider.
- Know what to do when a health problem occurs, when and where to seek help and how to prevent health problems
- Practice preventive health care. Have tests, exams and vaccinations recommended for you based on your age and gender.
Questions?
Contact Member Services at 888-269-5410, TTY 711 if you have any questions, concerns, problems, or suggestions.
View the UnitedHealthcare Community Plan of Minnesota Families and Children Member Handbook for more information.
