As an Aetna Better Health member, you have rights and responsibilities. If the member is a child, the rights, responsibility and liability are given to the member’s parents, caretaker or legal guardian.

You Have These Rights

• You have a right to fair treatment and respect.
• You can get covered services. Your race, ethnic group, original country, language, religion, gender and age do not matter. Your mental or physical problems, sexual orientation and family medical history do not matter. Your ability to pay does not matter.
• You have a right to get good quality medical services. These services support your personal beliefs, medical condition and background.
• You have a right to get language services if you do not speak English or if you have hearing problems. You can get written information in a different form.
• You have a right to make decisions about your health care. You can have a friend or family member help you with health care decisions when needed. Your rights include many things:
  • Choose your own participating primary care provider (PCP)
  • Know about all your treatment choices and risks
  • Know if care or treatment is part of a research experiment before you have it
  • Say no to experimental (unproven) treatments
  • Get health information from your PCP
  • Get information about medical procedures and who will do them
  • Choose who can be with you for treatments and examinations
  • Ask to have a female in the room for breast and pelvic exams
  • Refuse a treatment, including leaving the hospital
  • Ask what happens if you refuse treatment. You do not have to follow a treatment plan to be eligible for medical care.
  • Stop taking medications
  • Obtain a second opinion at no cost to you
• You have a right to be free from any form of restraint or seclusion as a means of force, discipline, revenge or convenience.
• You have a right to privacy. Your personal and medical information will only be given out as allowed by law. You have a right to:
  • Receive a copy of your medical records
  • Ask for additions or corrections to the records
  • Ask how health care information is used
  • Talk to health care professionals and case managers in private
• You have the right to use all your member rights without being treated differently or losing any health care services.
• You have the right to have an Advance Directive (living will). An Advance Directive says what medical care you want if you are not able to speak for yourself.
• You have a right to report concerns to Aetna Better Health. You may:
  • File a grievance and/or an appeal and get a timely answer
  • Ask for changes to policies and services
  • Find out why an Aetna Better Health provider has denied care

You Have These Responsibilities

• Know the name of your PCP and your case manager if you have one
• Know about your health care and the rules for getting care
• Respect the health care professionals who are giving you care
• Tell Aetna Better Health about your concerns, questions or problems
• Give your health care providers all the information they need
• Ask for more information if you do not understand your treatment or health condition
• Follow your health care provider’s advice
• Protect your member ID card and show it when you get services
• Tell us about any other insurance you have
• Tell us if you are applying for other health care benefits
• Make appointments during office hours
• Be on time for appointments
• Call the provider’s office 24 hours before you need to cancel an appointment
• Bring immunization (shots) records to all appointments for children under 18 years old