Verda Healthcare members have the Right:
-
Members have the right to be treated with respect and recognition of their dignity by everyone who works with Verda Health Plan. -
Members have the right to get information about Verda Health Plan, our providers, our doctors, our services and member’s rights and responsibilities.
-
Members have the right to choose their “main” doctor from Verda Health Plan’s network. (This doctor is called a primary care doctor or personal doctor.)
-
Members have the right to be informed about their health. If members are ill, members have the right to be told about all treatment options regardless of cost or benefit coverage. Members have the right to have all their questions about their health answered.
-
Members have the right to help make decisions about their health care. Members have the right to refuse medical treatment.
-
Members have the right to privacy. Verda Health Plan keeps their medical records private.
-
Members have the right to see their medical record, including the results of their Initial Health Risk Assessment (IHRA). Members also have the right to get a copy of and correct their medical record where permitted.
-
Members have the right to complain about Verda Health Plan or their care. Members can call, fax, email or write to Verda Health Plan.
-
Members have the right to appeal Verda Health Plan’s decisions. Members have the right to have someone speak for them during their grievance.
To view the complete Verda Rights & Responsibilities you can download it here.
Verda Healthcare members have the Responsibility
-
Members have the responsibility to learn and ask questions about their health benefits. If Members have a question about their benefits, they may call toll-free at 1-888-256-5123 TTY 711. -
Members have the responsibility to give information to their doctor, provider, or Verda Health Plan that is needed to care for them.
-
Members have the responsibility to be active in decisions about their health care.
-
Members have the responsibility to follow the care plans and instructions for care that they have agreed on with their doctor(s).
-
Members have the responsibility to build and keep a strong patient-doctor relationship, cooperate with your doctor and staff, keep appointments and be on time. If Members are going to be late or cannot keep their appointment, they should call their doctor’s office.
-
Members have the responsibility to give their Verda Health Plan and State card when getting medical care. Members have the responsibility to not give their card to others and let Verda Health Plan or the State know about any fraud or wrongdoing.
-
Members have a responsibility to understand their health problems and participate in developing mutually agreed-upon treatment goals as they are able.
Disenrollment from Verda Healthcare:
Ending your membership in Verda Health Plan of Texas may be voluntary (your own choice) or involuntary (not your own choice):
-
You might leave our plan because you have decided that you want to leave. There are only certain times during the year, or certain situations, when you may voluntarily end your membership in the plan. Please review Chapter 10 of your Evidence of Coverage (Member Handbook) to view disenrollment periods and situations.
-
The process for voluntarily ending your membership varies depending on what type of new coverage you are choosing.
-
There are also limited situations where you do not choose to leave, but we are required to end your membership.