Member Rights Responsibilities

Last modified: June 22, 2020

Feel free to distribute the following information to your patients about their UnitedHealthcare member rights and responsibilities. If your patients have questions about their rights as UnitedHealthcare members, or need help communicating, such as assistance from a language interpreter, please ask them to call Member Services at the number on the back of their health plan member ID card.

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.
  • Privacy and confidentiality for treatments, tests and procedures you receive. See Notice of Privacy Practices in your benefit plan documents for a description of how UnitedHealthcare protects your personal health information.
  • Voice concerns about the service and care you receive.
  • Register complaints and appeals concerning your health plan and the care provided to you.
  • Get timely responses to your concerns.
  • Candidly discuss with your doctor the appropriate and medically necessary treatment options for your conditions, regardless of cost or benefit coverage.
  • Access doctors, health care professionals and other health care facilities.
  • Participate in decisions about your care with your 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 you wish to receive should you become unable to express your wishes.

Members have the responsibility to:

  • Know and confirm your benefits before receiving treatment.
  • Contact an appropriate health care professional when you have a medical need or concern.
  • Show your health plan member ID card before receiving health care services.
  • Pay any necessary copayment at the time you 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 your care.
  • Follow the agreed-upon instructions and guidelines of doctors and health care professionals.
  • Participate in understanding your health problems and developing mutually agreed-upon treatment goals.
  • Notify your employer of any changes in your address or family status.
  • Sign in to, or call us, when you have a question about eligibility, benefits, claims and more.
  • Sign in to, or call us, before receiving services to verify that the doctor or health care professional participates in the UnitedHealthcare network.