Member rights and responsibilities

As a Health Tradition member, you’re a very important person

Health Tradition has a company-wide commitment to providing a high level of service, giving you straight answers and treating you with integrity. You have placed your trust in us; we want to earn it.

The State of Wisconsin agrees that there should be expectations on the part of your health plan, your provider and you. It has established a set of rights and responsibilities:

Members have the following rights under Wisconsin law

Along with your rights under the Certificate of Coverage, you also have these rights under law:

  • To choose Members have the right to choose a personal health care provider from the plan’s network of health care providers. Health Tradition encourages you to establish a relationship with that network health care provider.
  • To information Members have the right to information about the benefit plan relating to covered services and excluded health care benefits; available health care providers; preventive care; their illness and its care; the process to make known a complaint or request; and policies/procedures relevant to their care.
  • To privacy and confidentiality Members have the right to privacy and confidentiality of all communications and records on covered services received.
  • To participate in their care Members have the right to be active in decisions about their treatment. Members have the right to a candid discussion of appropriate or medically necessary treatment options for their condition, regardless of cost of benefit coverage. Members have the right to be informed about the risks and benefits of treatment and to refuse care.
  • To present a complaint/grievance  Members have the right to voice concerns about their care and to receive a prompt and fair review of any complaints.
  • To be treated with respect and dignity Members have the right to be treated with respect and dignity regardless of race, age, gender or creed.

Members have the following responsibilities under Wisconsin law

  • To know their benefits and responsibilities Members have a responsibility to understand their health plan benefits, follow the required procedures, know how to use the plan’s provider network, and ask questions about things they don’t understand.
  • To provide accurate information Members have a responsibility to provide accurate and complete information about their health history and eligibility/enrollment. Members have a responsibility to show their membership card each time they receive services and to fulfill any financial obligations they  may incur.
  • To participate in their care  Members have a responsibility to participate in their care by asking questions to understand their illness, following the recommended/agreed upon treatment plan, and making healthy lifestyle choices to try to maintain their health and prevent illness.
  • To keep their appointments Members have a responsibility to keep their appointments or to give early notice if they must cancel.
  • To show consideration and respect Members have a responsibility to show consideration and respect to health care providers and staff.