Rights & Responsibilities

Rights & Responsibilities

US Family Health Plan Member Rights and Responsibilities

As a member of CHRISTUS Health Plan/US Family Health Plan, you have certain rights and responsibilities. It is important to know and understand them. Please take a moment to read through your rights and responsibilities below. If you have questions, please call us at 800-67-USFHP. We’re here to give you the answers you need to get the health care you’ve earned!

As a member of the US Family Health Plan, you have the right to:

  • Change your PCP once every 30 days.
  • Attend all member meetings.
  • Use all additional programs offered by the plan.
  • Submit a letter if a problem concerning your health care was not solved where it occurred.
  • Talk with a patient advocate or member services representative.
  • Call and speak with a nurse 24 hours a day by calling 1-800-455-WELL (1-800-455-9355).
  • Have one complete eye exam and one annual physical each year.
  • Get current information about the doctors and hospitals that participate in the plan.
  • Help your doctors make decisions about your health care.
  • Have the information you need to make appointments and get health care from your PCP during and after office hours
  • Have the information you need to contact your PCP or on-call support 24 hours a day, every day

As a member of the US Family Health Plan, you have a responsibility to:

  • Pay your enrollment fees on time
  • Pay copayments required by the Plan
  • Not use Medicare Part A or B and Medicaid for services covered by the Plan
  • Keep your military ID updated
  • Keep your Defense Enrollment Eligibility Reporting System (DEERS) record information and status correct and current
  • Notify member services at 800-67-USFHP (800-678-7347) if there is a change in address and/or phone number or in eligibility for you or a family member
  • Disenroll from the Plan if you move outside of the service area
  • Provide the Plan with information if you are a member of other health insurance plans
  • Bring your member card with you when visiting your doctor, pharmacy or you are seeking medical treatment
  • Give your correct spelling of your first and last name, date of birth and sponsor’s Social Security number to the provider any time a claim is filed
  • Provide a complete medical history to your physician, including a list of all your prescription and over-the-counter medicines
  • Use your Plan PCP, Plan network specialist (with referral), Plan network hospital/facility and the network pharmacy for routine care
  • Not use a military hospital or clinic, TRICARE or NMOP (National Mail-Order Pharmacy) for routine care
  • Notify your PCP if possible before seeking emergency medical treatment or seeking care outside of the service area (except when outside of the United States)
  • Notify the Plan at 800-67-USFHP (800-678-7347) as soon as possible within the first 24 hours of an emergency medical treatment or an accident requiring medical attention (motor vehicle accident, workers’ compensation, etc.)
  • Transfer your medical record(s) when necessary

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Last Updated:02/16/18