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Your rights
Your rights
As a member of this plan, you have many rights you can count on. These include your right to:
Get medical care regardless of race, color, religion, sex, age, disability, sexual orientation, gender identity or nationality
Be treated with respect and dignity and have your privacy protected
Be free from any form of restraint or seclusion used as a means of coercion, discipline, convenience or retaliation
Choose a primary care physician (PCP)
Get medical care when you need it no matter where you live
Ask questions and get complete information about your medical condition and treatment options
Be told that services aren’t covered before you get them
Make health care decisions, including refusing treatment
Ask for a second opinion about your health care
Have your care and medical records kept private
Get a copy of your health care record
File a grievance or an appeal with us and ask for a state fair hearing from the Department for Medicaid Services if you have problems with your eligibility or health care
Get help filing a grievance or an appeal
Understand information about your plan
Get free translation services if you need them
Prepare advance directives according to state laws
Ask for a description of the payment methods we use to pay our providers for your care
Know about a program or site change that affects you 30 days in advance
Make recommendations about our rights and responsibilities policy
Receive information about an organization’s services, providers, and members’ rights and responsibilities
Your responsibilities
Your responsibilities
As an Aetna Better Health of Kentucky member, you are responsible for:
Giving accurate information so providers can take care of you and your family
Following your PCP’s instructions and care plans
Participating in your health care decisions and making healthy choices
Calling your PCP when you need medical care
Going to providers in our network
Showing your Aetna Better Health and your Kentucky Medicaid ID cards every time you get care
Bringing other health insurance cards to your appointment if you have other health insurance coverage (including Medicare)
Keeping all appointments and being on time
Canceling an appointment if you can't get there
Following our policies and procedures
Following your doctor’s rules in their office
Asking your PCP questions if you do not understand something about your medical care
Telling the truth about yourself and your medical problems
Reporting suspected cases of fraud and abuse
Telling the Department for Community Based Services (DCBS) or the Social Security Administration (SSA) about changes to your name, address and telephone number
Notifying DCBS or SSA if you have a change, like a birth, death or marriage, or if you obtain other insurance
Learning the difference between an emergency and needing urgent care
Understanding your rights and responsibilities as a member
We have responsibilities, too
We put your health first when we make health care decisions. We don’t reward our providers for denying services. And we don’t encourage our providers to reduce your care in any way. We don’t let any employee hire, promote or fire providers that may support denying benefits.
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Call us
You can find out more about your rights and responsibilities by calling Member Services at 1-855-300-5528 (TTY: 711).
Read more here
You can find out more about your rights and responsibilities in your member handbook.