Take Note of Member Rights and Responsibilities
Aug. 13, 2026
As a participating provider, it’s important that you’re aware our members have certain rights and responsibilities. Following is a summary:
Member rights are:
The right to be treated with dignity and respect
The right to the privacy of medical records and personal health information
The right to see participating providers, get covered services and get prescriptions filled within a reasonable period of time
The right to participate with providers in making decisions about their health care
The right to candid discussion of appropriate or medically necessary treatment options for their conditions, regardless of cost or benefit coverage
The right to use advance directives (such as a living will or a power of attorney)
The right to voice complaints or appeals about the organization or the care it provides
The right to get information about their health care coverage and cost
The right to get information about HealthSpring coverage, its services, plan providers, drug coverage and costs
The right to take action if they think they have been treated unfairly or their rights are not being respected
The right to make recommendations regarding the organization’s rights and responsibilities policy
Members responsibilities are:
A responsibility to supply information (to the extent possible) that HealthSpring, its practitioners and providers need in order to provide care
A responsibility to follow plans and instructions for care that they have agreed to with their practitioners
A responsibility to understand their health problems and participate in developing mutually agreed on treatment goals, to the degree possible
Resources
Refer to the provider manual for more details. It has information about provider rights and responsibilities, and how you can obtain clinical criteria available electronically at the point of care.
Members can refer to their Evidence of Coverage for more details.