Your Rights and Responsibilities

As a member of Alliance Health, you have a right to:

• Be cared for with respect, dignity and privacy without regard for health status, sex, race, color, religion, national origin, age, marital status, sexual orientation or gender identity
• Be told what services are available to you
• Be told where, when and how to get the services you need from Alliance Health
• Be told of your options when getting services so you or your guardian can make an informed choice
• Be told by your primary care provider (PCP) what health issues you may have, what can be done for you and what will likely be the result, in a way you understand. This includes additional languages.
• Get a second opinion about your care
• Give your approval of any treatment
• Give your approval of any plan for your care after that plan has been fully explained to you
• Refuse care and be told what you may risk if you do
• Get information about your health care
• Get a copy of your medical record and talk about it with your PCP
• Ask, if needed, that your medical record be amended or corrected
• Be sure that your medical record is private and will not be shared with anyone except as required by law, contract or with your approval
• Use the Alliance Health complaint process to settle complaints. You can also contact the NC Medicaid Ombudsman any time you feel you were not fairly treated
• Use the State Fair Hearing system
• Appoint someone you trust (relative, friend or lawyer) to speak for you if you are unable to speak for yourself about your care and treatment
• Receive considerate and respectful care in a clean and safe environment, free from any form of restraint or seclusion used as a means of coercion, discipline, convenience or retaliation

Minors have the right to agree to some treatments and services without the consent of a parent or guardian:

• Treatment for sexually transmitted diseases
• Services related to pregnancy
• Services to help with alcohol and/or other substance use disorders
• Services to help with emotional conditions

As a member of Alliance Health, you agree to:

• Work with your PCP to protect and improve your health
• Find out how your health plan coverage works
• Listen to your PCP’s advice and ask questions
• Call or go back to your PCP if you do not get better or ask for a second opinion
• Treat health care staff with respect
• Tell us if you have problems with any health care staff by calling Member and Recipient Services at 800-510-9132
• Keep your appointments or if you must cancel, call as soon as you can
• Use the emergency department only for emergencies
• Call your PCP when you need medical care, even if it is after hours
• Supply all information (to the extent possible), including information about health problems, that Alliance and providers need to provide care
• Understand health problems and participate in developing mutually agreed-upon treatment goals, to the degree possible, telling the doctor or nurse about any health changes
• Invite people who will be helpful and supportive in treatment planning
• Work on the goals of your treatment plan
• Meet financial obligations according to established agreements
• Inform staff of any medical condition that is contagious
• Take medications as they are prescribed
• Tell your doctor about unpleasant side effects from medications, or if medications do not seem to be working
• Tell your doctor or therapist when there is a disagreement with their recommendations
• Tell the doctor or therapist if there is a desire to end treatment
• Have your Medicaid or other insurance card at all times
• Not allow others access to your Medicaid card
• Follow the rules posted in day, evening or 24-hour service programs
• Be considerate of other individuals and family members
• Seek out additional support services in your community
• Read, or have someone read to you, written notices from Alliance about changes in benefits, services or providers
• When you leave a program, request a discharge plan, be sure you understand it and be committed to following it