Member Rights and Responsibilities

We want you to understand your rights and responsibilities as a member of Jai Medical Systems.

Please review your member rights and responsibilities, which are detailed below.

Member Rights

As a HealthChoice member, you have the right to:

• Be treated with respect and dignity and have the right to privacy.
• Get candid and easy-to-understand information about your treatment options – even if they cost more or your plan does not cover them.
• Take part in decisions about your healthcare, including the right to refuse treatment.
• Be free from any form of physical or mental control or left alone to make you agree to something, punish you, or because it is easier for someone else.
• Ask for and get a copy of your medical records. You can also ask for corrections to your record.
• Exercise your rights and to know that the exercise of those rights will not adversely affect the way that the Maryland Department of Health, Jai Medical Systems, or our providers treat you.
• File a complaint, grievance or appeal with Jai Medical Systems.
• Request to continue ongoing benefits while your appeal or State fair hearing is pending. NOTE: You may have to pay for any care you receive during this time if the original decision stands.
• Get a second opinion from another provider in the Jai Medical Systems network if you disagree with your provider’s opinion about a service that you need. Call our Customer Service Department at 1-888-JAI-1999 for help with finding another provider.
• Make, or refuse to make, an advance directive for healthcare decisions. For more information, see the Maryland Attorney General’s advanced directives web page.
• Ask for and get information about how Jai Medical Systems manages the organization. For more information, call our Customer Service Department at 1-888-JAI-1999.
• Ask for and get information about the health plan’s services, practitioners, providers and member rights and responsibilities.
• Make recommendations about the member rights and responsibilities policy.

Member Responsibilities

As a HealthChoice member, you have the responsibility to:

• Treat all those who work with you with respect and dignity.
• Be on time for your appointment.
• Cancel your appointment right away if you cannot keep it.
• Always Carry your Medicaid and Jai Medical Systems member card with you.
• Never allow anyone else to use your Medicaid or Jai Medical Systems member card.
• Report a lost or stolen member ID card to Jai Medical Systems and get a new card.
• Report other health insurance coverage to your provider and to Jai Medical Systems.
• Work with your primary care provider to create a care plan together.
• Work with your providers and follow plans and instructions for care that you have agreed to with them.
• Ask questions about your care and let your provider know if you do not understand something.
• Give honest, current health information to your providers.
• Use the emergency room only for a medical emergency. Let your primary care provider know as soon as possible after you receive emergency care.
• Tell your caregivers about any change to your advance directive.
• Call our Customer Service Department at 1-888-JAI-1999if you have a problem or a complaint.
• Report required changes to your status within 10 days to the Maryland Health Connection.