Member Rights and Responsibilities

In accordance with Michigan Public Health Code Act 368 of 1978, Section 333.20201 and 333.20202, the following are the vision plan member’s rights and responsibilities:

Members shall not be denied appropriate care on the basis of race, religion, color, national origin, sex, age, disability, marital status, sexual preference, or source of payment.
Members are entitled to inspect, or receive for a reasonable fee, a copy of their medical record upon request in accordance with the Medical Records Access Act, 2004 PA 47, MCL 333.26261 to 333.26271. Except as otherwise permitted or required under the Health Insurance Portability and Accountability Act of 1996, Public Law 104-191, or regulations promulgated under that act, 45 CFR parts 160 and 164, a third party shall not be given a copy of the member’s medical record without prior authorization of the member.
Members are entitled to confidential treatment of personal and medical records, and may refuse their release to a person outside the provider facility except as required because of a transfer to another provider facility, as required by law or third-party payment contract, or as permitted or required under the Health Insurance Portability and Accountability Act of 1996, Public Law 104-191, or regulations promulgated under that act, 45 CFR parts 160 and 164.
Members are entitled to privacy, to the extent feasible, in treatment and in caring for personal needs with consideration, respect, and full recognition of their dignity and individuality.
Members are entitled to receive adequate and appropriate care, and to receive, from the appropriate individual within the provider facility, information about their condition, proposed course of treatment, and prospects for recovery, in terms that the member can understand, unless medically contraindicated as documented in the medical record by the provider.
Members are entitled to refuse treatment to the extent provided by law and to be informed of the consequences of that refusal. If a refusal of treatment prevents a provider facility or its staff from providing appropriate care according to ethical and professional standards, the relationship with the member may be terminated upon reasonable notice.
Members are entitled to exercise their rights as a patient and as a citizen, and to this end may present grievances or recommend changes in policies and services on behalf of themselves or others to the provider facility staff, to governmental officials, or to another person of their choice within or outside the provider facility, free from restraint, interference, coercion, discrimination, or reprisal. Members are entitled to information about the provider facility’s policies and procedures for initiation, review, and resolution of member complaints.
Members are entitled to receive and examine an explanation of their bill regardless of the source of payment and to receive, upon request, information relating to financial assistance available through the provider.
Members are entitled to know who is responsible for and who is providing their direct care, to receive information concerning their continuing needs and alternatives for meeting those needs.
Members are entitled to associate and have private communications and consultations with their provider, with their attorney, or with any other individual of their choice and to send and receive personal mail unopened on the same day it is received at the provider facility, unless medically contraindicated as documented in the medical record by the provider. A member’s civil and religious liberties, including the right to independent personal decisions and the right to knowledge of available choices, shall not be infringed and the provider facility shall encourage and assist in the fullest possible exercise of these rights. Member may meet with, and participate in, the activities of social, religious, and community groups at their discretion, unless medically contraindicated as documented in the medical record by their provider.
Members are entitled to information about the provider facility rules and regulations affecting member care and conduct.

Responsibilities:

Members are responsible for following the provider facility rules and regulations affecting patient care and conduct.
Members are responsible for providing a complete and accurate medical history.
Members are responsible for making it known whether they clearly comprehend a contemplated course of action and the things they are expected to do.
Members are responsible for following the recommendations and advice prescribed in a course of treatment by their provider.
Members are responsible for providing information about unexpected complications that arise in an expected course of treatment.
Members are responsible for being considerate of the rights of other patients and provider facility personnel and property.
Members are responsible for providing the provider facility with accurate and timely information concerning their sources of payment and ability to meet financial obligations.