Take Charge of Your Health Care: Know Your Rights
Not long ago, your family doctor decided the type of care you needed and made the necessary arrangements. Today, health care is much more complicated. Not only is your primary doctor involved in your medical care and treatment, there may be other doctors, nurses and other health care professionals and administrators who have a say in the type of care you receive, where you get it and who provides it to you.
If you live or work in Sacramento, Yolo, Placer or El Dorado counties, you do have a place to get help if you have a question or a problem with your health care. The Health Rights Hotline is an independent service that provides free assistance and information about your rights as a health care consumer. Trained health care advocates can answer your questions, help you resolve problems, and help you take charge of your health care.
No matter how you get your health coverage, you have rights. Whether you’re covered through your employer, or Medi-Cal or Medicare, or if you buy your own coverage, the Health Rights Hotline can help you.
Here are a few tips that will make it easier for you to take charge and get the health care you need:
- Understand your coverage. You should have a copy of the contract that describes your health plan benefits, policies and procedures. This document is often called an “Evidence of Coverage” (EOC) or “Summary Plan Description.” If there are parts you don’t understand, or if you can’t find your EOC, call your health plan’s customer service department, your employer, or your insurance agent or broker.
- Keep good records. Get in the practice of keeping a written record of your contacts with your doctor, your medical group and your health plan. Make a note of the date you called, who you talked to and what you were told. This will help you get what you need if a problem develops. You should organize your medical records, health plan documents and billing records so that they are easy to find.
- Understand your medical condition. It is important to be able to describe your medical condition in detail. Talk to your doctor about treatment options. You also can research your medical condition at local public libraries, through support groups and on the Internet.
If you have a problem, there are a number of steps you can take. No matter what you do, be persistent and take notes. If you don’t get a timely response to your question or problem, call again. You may want to write to your medical group or health plan if you aren’t able to get an answer over the phone.
- Talk to your doctor. Your most important health care relationship is the one you have with your doctor, nurse, or other health care provider who should be your partner in health care. Choose a doctor that you feel comfortable with, who answers your questions and fully explains your treatment options. If you feel you can’t talk to your doctor, you have the right to change doctors.
- Contact the medical group. Most medical groups have patient assistance departments that can help you find a doctor, work out billing problems, or help you obtain necessary referrals and authorizations for services.
- Call your health plan. A customer service representative at your health plan should be able to explain the health plan’s policies and procedures. Many problems can be resolved if you work with your health plan.
- Consider getting someone to help you. When you are sick, you may not be your own best advocate. Consider having a family member or friend make calls for you or go with you to appointments.
- Call the Health Rights Hotline. The Health Rights Hotline is a totally free service that is not affiliated with the health care industry. Because health care can be complicated, the Health Rights Hotline is here to help. Trained advocates provide free information and assistance about your health care rights to help you take charge of your health care.
For free assistance and information about your rights,
call the Health Rights Hotline.
In Sacramento, call 551-2100.
Toll free at (888) 354-4474
TTY/TDD (916) 551-2180