CalOptima Direct Members
Rights and Responsibilities

• Be treated with respect and dignity by all CalOptima and provider staff
  
  
• Privacy and to have your medical information kept confidential
  
  
• Get information about CalOptima, our providers, the services they provide and your member rights and responsibilities
  
  
• Choose a doctor within CalOptima's network
  
  
• Talk openly with your health care providers about medically necessary treatment options, regardless of cost or benefit
  
  
• Help make decisions about your health care, including the right to say “no” to medical treatment
  
  
• Voice complaints or appeals, either verbally or in writing, about CalOptima or the care we provide
  
  
• Get oral interpretation services in the language that you understand
  
  
• Make an advance directive
  
  
• Access family planning services, Federally Qualified Health Centers, Indian Health Service Facilities, sexually transmitted disease services and emergency services outside CalOptima's network
  
  
• Ask for a State Hearing, including information on the conditions under which your State Hearing can be expedited
  
  
• Have access to your medical record, and where legally appropriate, get copies of, update or correct your medical record
  
  
• Access minor consent services
  
  
• Get written member information in large-size print and other formats upon request and in a timely manner appropriate for the format being requested
  
  
• Be free from any form of control or limitation used as a means of pressure, punishment, convenience or revenge
  
  
• Get information about your medical condition and treatment plan options in a way that is easy to understand
  
  
• Make suggestions to CalOptima about your member rights and responsibilities
  
  
• Freely use these rights without negatively affecting how you are treated by CalOptima, providers or the state
  
  

• Knowing, understanding and following your member handbook
  
  
• Understanding your medical needs and working with your health care providers to create your treatment plan
  
  
• Following the treatment plan you agreed to with your health care providers
  
  
• Telling CalOptima and your health care providers what we need to know about your medical condition so we can provide care
  
  
• Making and keeping medical appointments and telling the office when you must cancel your appointment
  
  
• Learning about your medical condition and what keeps you healthy
  
  
• Taking part in health care programs that keep you healthy
  
  
• Working with and being polite to the people who are partners in your health care