Rights and responsibilities

MercyCare offers members a three-way partnership between you, your doctors and your health plan. Our goal is to assure you receive appropriate, quality health care and develop a relationship with a Primary Care Physician (PCP) who coordinates and manages your medical care. Your rights and responsibilities as part of the MercyCare partnership are described below.

As a member, you have the right to:

  • Receive information about the MercyCare organization, services, practitioners, hospitals, other providers and member rights and responsibilities
  • Be treated with respect and recognition of your dignity and right to privacy
  • Take part in decisions regarding your treatment
  • Discuss openly and freely all planned treatments, procedures and services
  • Confidentiality of your personal health information as described in your Health Insurance Portability and Accountability Act (HIPAA) notice of privacy practices
  • Know how to obtain health care services
  • Know what your benefits are
  • Understand the purpose and probable results and risks of treatment
  • Initiate a complaint about care or service you receive as a MercyCare member and receive a timely response when you call customer service at (800) 895-2421
  • Make recommendations regarding the organization’s member rights and responsibilities policies by contacting customer service at (800) 895-2421

As a member, you are responsible to:

  • Provide information about your past illnesses, hospitalizations, medications and other matters concerning your health that will help your practitioner understand your health care needs and provide appropriate care
  • Understand any health problems you may experience and develop mutually agreed upon treatment goals and plans with your practitioner
  • Cooperate as much as possible with mutually agreed upon treatment goals and advice of your health care practitioner
  • Read and understand your MercyCare member handbook, certificate of coverage, schedule of benefits and provider directory
  • Choose a PCP with whom you will coordinate your care
  • Identify yourself as a MercyCare member by presenting your insurance card before receiving health care services
  • Pay your co-payments at the time of your visit
  • Keep your appointments
  • Discuss any questions you have about your health with your practitioner
  • Notify MercyCare of address, telephone or other status changes within 30 days of any change

For more information about your rights and responsibilities, contact MercyCare by phone at (800) 895-2421 or email mcare@mhsjvl.org.