Receive information about Blue Cross and Blue Shield of Illinois benefit programs and covered services, as well as which network providers are available for you to receive the maximum level of benefits.

Read all Blue Cross and Blue Shield of Illinkis benefit materials, become familiar with your plan and ask questions when necessary.

Select a medical group and/or a primary care physician (PCP) from the appropriate network. You also have the right to change your PCP and/or medical group at any time.*

*Not applicable to PPO

Develop a relationship with your health care providers based on trust and cooperation.

Receive a Blue Cross and Blue Shield of Illinois identification (ID) card.

Carry your Blue Cross and Blue Shield of Illinois ID card in the event you need to receive health care services.

Obtain a copy of your rights and responsibilities as a member and to make recommendations regarding its content.

Follow the member guidelines for your healthcare benefits plan.

Choose an OB/GYN as your Woman's Prinicpal Health Care Provider (WPHCP) or additional OB/GYN PCP as outlined in your health plan guidelines.*

*Not applicable to PPO

Notify Blue Cross and Blue Shield of Illinois or your Medical Group/Independent Practice Association (MG/IPA) if you wish to change your WPHCP or OB/GYN PCP.*

*Not applicable to PPO

Have your PCP provide or authorize the covered services of your benefit plan that are necessary for your health care.*

*Not applicable to PPO

Obtain services from or through your PCP, or within your medical group or product network.*

*Not applicable to PPO

Reasonable access to appropriate medical services based on level of need. You also have the right to speak promptly with a physician or other provider when illness occurs.

Notify your PCP of any care or treatment received outside of your medical group, without your PCP's authorization or outside of your product network.*

*Not applicable to PPO

Care from a specialist when medically necessary.

If care or treatment occurs without PCP authorization or outside of your product network, be familiar with the requirements of your plan and know your financial obligations.*

*Not applicable to PPO

When this care is authorized by your PCP, you will receive the maximum level of benefits available.*

*Not applicable to PPO

Keep scheduled appointments or give adequate notice of delay or cancellation.

If your PCP determines specialist services are not required, you have the right to be informed of the reason and an alternative treatment plan, as well as the right to appeal if you do not agree.*

*Not applicable to PPO

Discuss your questions and concerns about specialty care with your PCP or health care provider.

Emergency care in any hospital emergency room 24 hours a day.

Contact your PCP, medical group or health care provider as soon as possible after treatment for an emergency, and coordinate follow-up care with your PCP or health care provider.

Mental health and chemical dependency treatment.

Obtain necessary mental health or chemical dependency services by following the requirements of your plan and calling the number indicated on the back of your member ID card.

Communicate openly and fully with network providers, knowing that all information will be treated confidentially.

Be honest with your health care providers and communicate any information that may affect diagnostic and treatment decisions.

Receive considerate and courteous care, with respect for personal privacy and dignity.

Treat all network provider personnel and Blue Cross and Blue Shield of Illinois personnel respectfully and courteously.

Confidential health records, except when disclosure is required by law or authorized by you in writing, and to review your medical records with your PCP or health care provider, given adequate notice.

Help your health care provider maintain accurate and current medical records.

Receive information and to have a full discussion about all appropriate or medically necessary treatment options for your condition in order to make an informed decision regardless of cost or benefit coverage.

Ask questions and make certain that you understand all options, financial obligations and plan requirements related to the agreed-upon treatment.

These requirements may include pre-authorization from or notification to Blue Cross and Blue Shield of Illinois*

*Not applicable to PPO

Be completely informed of your diagnosis, treatment and outlook and to participate in decisions involving your medical care.

Follow the agreed-upon treatment plans and instructions for care and to consider the potential consequences if you refuse to comply with treatment plans or recommendations.

An advance directive (such as a durable power of attorney for health care) concerning treatment, with the expectation that your PCP or health care provider will honor the intent of the directive to the extent permitted by law.

Notify your PCP or health care provider as well as family members of any advance directive.

Express a complaint about clinical or administrative issues related to your health plan, appeal plan decisions and receive timely response.

Express your opinions, concerns and complaints in a constructive manner to your PCP, medical group, health care provider or Blue Cross and Blue Shield of Illinois.