Receive information about your coverage and your rights and responsibilities.
Receive, upon request, facts about your Plan, including a list of the health
care services covered and providers available to meet your healthcare needs.
Receive courteous service and respect with an appreciation of your dignity
and protection of your privacy from St. Luke’s Health Plan.
Receive courteous service and respect from St. Luke’s Health Plan’s network providers.
Receive the reasons why St. Luke’s Health Plan denied a request for treatment
or health care service, and the rules used to reach those results.
Receive, upon request, details on the rules used by St. Luke’s Health Plan to
decide whether a procedure, treatment, site, equipment, drug, or device needs prior approval.
Receive, upon request, a copy of St. Luke’s Health Plan list of covered prescription drugs. You can also request updates about when a drug may become covered.
Receive clear and correct facts to help you make your own health care choices.
Play an active part in your health care and discuss treatment options with your doctor without regard to cost or benefit coverage.
Be informed by your provider about your health so you may make thoughtful decisions before you receive treatment.
Participate with practitioners in making decisions about your health care.
Have reasonable access to appropriate medical services regardless of your race, religion, nationality, disability, sex, or sexual orientation, and
24- hour access to urgent and emergency care.
Have all claims paid accurately and in a timely manner.
Expect that St. Luke’s Health Plan will take measures to keep your health information private and protect your health care records.
Voice complaints and expect a fair and quick appeals process for addressing any concerns you may have with St. Luke’s Health Plan.
Make recommendations regarding St. Luke’s Health Plan’s member rights and responsibilities policies.