Member Rights and Responsibilities

December 8, 2021

As a participating provider, it’s important that you are aware of our members’ rights and responsibilities. A summary is provided below. More information can be found in the members’ benefit booklet and on our member website.

Member rights include the right to:

  • Receive information about Blue Cross and Blue Shield of Illinois (BCBSIL), our services, participating providers and facilities, and member rights and responsibilities
  • Be treated with respect and dignity with recognition of their right to privacy
  • Participate with providers in making decisions about their health care
  • Have a candid discussion of appropriate or medically necessary treatment options for their condition, regardless of cost or benefit coverage
  • Voice complaints or appeals about BCBSIL or the services we provide
  • Make recommendations regarding our members’ rights and responsibilities policy

Member responsibilities include a responsibility to:

  • Provide, to the extent possible, information that BCBSIL and the provider and facility need to provide care
  • Follow the plans and instructions for care that the member has agreed to with their provider
  • Understand their health problems and participate in the development of mutually agreed upon treatment goals, to the degree possible

Federal Employee Program® (FEP®) members: In addition to the details provided above, visit fepblue.org  for more information about our FEP members.

 

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