Rights and Responsibilities
As a Superior HealthPlan STAR+PLUS Medicare-Medicaid Plan (MMP) member you have the right to:
- Get information in a way you will know it. We can give you information in other languages. We can give you information in large print, or other formats.
- Be treated with respect and recognition of your dignity and your right to privacy.
- Get covered services and drugs in a timely manner.
- Have a candid discussion of appropriate or medically necessary treatment options for your conditions, regardless of cost or benefit coverage.
- Have Superior STAR+PLUS MMP protect your health, race, ethnicity and language information by not telling people not involved in your healthcare or not authorized by you about your health or other information.
- See your medical record.
- Get information about the plan, its services, its network providers and member rights and responsibilities.
- Not get charged directly by network providers.
- Not get charged for covered services.
- Make decisions about your healthcare on your own and participate with providers in making decisions about your health care.
- Voice complaints or appeals about the plan or the care it provides.
- Ask us again to approve a request that was originally denied.
- Make recommendations about Superior STAR+PLUS MMP’s member rights and responsibilities policy.
- Leave the plan at any time during the year.
As a member, you need to:
- Know your covered services.
- Know the rules you must follow to get these covered services.
- Tell us if you have other health insurance.
- Tell us if you have other drug coverage.
- Tell your doctor and other providers that you are enrolled in our plan. Show your Member ID Card whenever you get services or drugs.
- Help your doctors and other providers help you by giving them the information they need.
- Be considerate and respect the rights of other patients. Act with respect in your doctor’s office, hospitals and other providers’ offices.
- Pay the amounts you are responsible for.
- Ask your doctors any questions you have about your care or medications.
- Understand your health problems and participate in developing treatment goals with your provider.
- Follow instructions about your care that you have agreed to with your providers.
- Tell us if you move.
- Be sure you have approval from your Primary Care Provider (PCP) before going to a specialist.
Additional member responsibilities while using Superior’s Medical Ride Program:
- When requesting nonemergency medical transportation (NEMT) services through Superior’s Medical Ride Program, you must provide the information requested by the person arranging or verifying your transportation.
- You must follow all rules and regulations affecting your NEMT services.
- You must return unused advanced funds. You must provide proof that you kept your medical appointment prior to receiving future advanced funds.
- You must not verbally, sexually, or physically abuse or harass anyone while requesting or receiving NEMT services.
- You must not lose bus tickets or tokens and must return any bus tickets or tokens you do not use. You must use the bus tickets or tokens only to go to your medical appointment.
- You must only use NEMT services to travel to and from your medical appointments.
- If you have arranged for an NEMT service but something changes, and you no longer need the service, you must contact the person who helped you arrange your transportation as soon as possible.
Call Superior STAR+PLUS MMP's Member Services for help if you have questions or concerns. You can request a complete list of Member Rights and Responsibilities or refer to Chapter 8 of your Member Handbook. To request a printed copy of your Member Handbook, or a paper copy of anything on our website, call Member Services.
Call Member Services at 1-866-896-1844. Hours are from 8 a.m. to 8 p.m., Monday through Friday. After hours, on weekends and on holidays, you may be asked to leave a message. Your call will be returned the next business day. TTY users call 711.