June 10, 2026
As a participating provider, it’s important that you are aware that our members have certain rights and responsibilities. Members can review their rights and responsibilities in their benefit booklet and in their online account. Following is a summary of member rights and responsibilities:
Members have the right to:
- Receive information about the organization, its services, its practitioners and providers, and member’s rights and responsibilities
- Make recommendations regarding the organization’s member rights and responsibilities policy
Members have the responsibility to:
- Provide, to the extent possible, information that their health benefit plan and practitioner/provider need in order to provide care
Members have communication rights to:
- Participate with practitioners in making decisions about their health care
- Be treated with respect and recognition of their dignity and their right to privacy
- A candid discussion of appropriate or medically necessary treatment options for their condition, regardless of cost or benefit coverage
- Voice complaints or appeals about the organization or the care it provides
Members have communication responsibilities to:
- Follow the plans and instructions for care that the member has agreed to with their practitioner
- Understand their health problems and participate in the development of mutually agreed upon treatment goals, to the degree possible
Federal Employee Program® members: Visit fepblue.org for more information about our FEP® members and their rights and responsibilities.
If you have questions about member rights and responsibilities, call the number on the member’s ID card.