. Quality Matters
. Performance Summary
. Service and Access
. Doctors and Medical Care
. Staying Healthy
. Getting Better /
Living with Illness
. Getting Better /
Living with Illness (Part 2)
. Choosing Your Health Plan
. Contacting Your Health Plan
. Other Important Resources
. Appeals and Complaints
. Consumer Bill of Rights
. HMO and POS Plan Differences

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Plan Comparison Tool


2000 HMO Performance Report

Taking Responsibility for Your Health Care

Getting involved in your health care can help you get the most from your health plan.

Know the Rules

  • Understand what services your plan does not cover by reading the member handbook or talking to your employer.
  • Know how to choose or change your primary care physician.
  • Understand how to schedule appointments for check-ups and when you are sick.
  • Know when you need referrals and how to get them.
  • Know what you are required to do when using a hospital or emergency room.

Stay Informed

  • Keep current about any new policies affecting how the plan works by reading member newsletters and checking the plan's Web site.
  • Know the telephone numbers and hours of your physician's office and the plan's member services department.

Take Charge

  • Take good care of your health by making appointments for check-ups and preventive care.
  • Talk with your doctor about when you need regular health screenings.
  • Call member services if you don't understand information that the plan or provider sends you.
  • If you don't understand the answers to your questions, ask for clarification.

Choose a Doctor Carefully

  • Ask for recommendations from medical societies, health care providers, referral services, hospitals, family members and friends.
  • Get information about the doctor's training and experience from the plan or the doctor.
  • Ask if the doctor is board certified in his or her specialty area.
  • Check whether prospective doctors have any disciplinary actions issued against them.

Keep Records

  • Write down your health concerns to help you discuss them with your doctor.
  • Set up health files to keep track of the care and services received by you and members of your family.


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