Rights & Responsibilities

Aetna Better Health of New York members have rights. Here is a list of your rights.

  • You have the right to be treated with respect and dignity.
  • You have the right to receive medically necessary care.
  • You have the right to request to change your care manager.
  • You have the right to timely access to care and services.
  • You have the right to privacy about your medical record and when you get treatment.
  • You have the right to get information on available treatment options and alternatives presented in a manner and language you understand.
  • You have the right to get information in a language you understand; you can get oral translation services free of charge.
  • You have the right to get information necessary to give informed consent before the start of treatment.
  • You have the right to get a copy of your medical records and ask that the records be amended or corrected.
  • You have the right to take part in decisions about your health care, including the right to refuse treatment.
  • You have the right to be free from any form of restraint or seclusion used as a means of coercion, discipline, convenience or retaliation.
  • You have the right to get care without regard to sex, race, health status, color, age, national origin, sexual orientation, marital status or religion.
  • You have the right to be told where, when and how to get the services you need from your managed long-term care plan, including how you can get covered benefits from out-of-network providers if they are not available in the plan network.
  • You have the right to complain to the New York State Department of Health or your Local Department of Social Services; and, the right to use the New York State Fair Hearing System and/or a New York State External Appeal, where appropriate.
  • You have the right to appoint someone to speak for you about your care and treatment.

 Member Responsibilities 

As an Aetna Better Health member it is your responsibility to:

  • Learn and understand each right you have under this Managed Long Term Care program.
  • Ask questions if you do not understand your rights.
  • Know the name of your primary care provider (PCP) and your care manager.
  • Know about your health care and the process for getting care.
  • Use providers who work with Aetna Better Health for covered services.
  • Get approval from your PCP, care manager or care management team, as required, before getting a covered service.
  • Know when you should and should not go to the emergency room.
  • Contact your care management team any time you use the emergency room, are hospitalized, get new prescriptions or receive a referral for another medical provider.
  • Treat the health care professionals who are giving you care respectfully.
  • Tell Aetna Better Health about your care needs, 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(s).
  • Participate in managing your own health by telling your provider about your health care concerns and needs.
  • Notify Aetna Better Health when you go away or out of town.
  • Make all required payments to Aetna Better Health.
  • Follow your care manager’s advice or talk to your care manager if you are unable or are unwilling to follow the care plan.
  • Protect your member ID card and show it when you get service.
  • Tell Aetna Better Health about any other insurance you have.
  • Tell Aetna Better Health if you are applying for other health care benefits.
  • Contact Member Services toll-free at 1-855-456-9126 right away if your address or phone number changes.