Magellan Health

Benefits & Services

Rights & Responsibilities

Your Rights and Responsibilties 

Getting mental health and substance abuse services is a private matter. We respect your right to privacy.  You have the rights and duties listed below:
 
You have rights if you get services through the Iowa Plan. You have the right to:
  • Be treated carefully, with respect and privacy.
  • Be treated fairly, whatever your:
    • Race.
    • Religion.
    • Gender.
    • Ethnic background.
    • Disability.
    • Source of payment.
  • Have your treatment and other information kept private. We share treatment records without your okay only when the law allows it.
  • Get care easily and when you need it.
  • Learn about treatment in a way that:
    • Respects your culture.
    • You can understand.
    • Fits your needs.
  • Take part in making your plan of care.
  • Get information in a language you can understand. And get things translated for free.
  • Get information in other ways if you ask for it.
  • Get information about Magellan and its:
    • Providers.
    • Programs.
    • Services.
    • Role in the treatment process.
  • Get information about clinical rules followed in your care.
  • Ask your providers about their work history and training.
  • Not be kept alone or forced to do something you do not want to do. This is based on a federal law.
  • Give your thoughts on the Rights and Responsibilities policy.
  • Ask for a certain type of provider.
  • Have your provider make care decisions based on the treatment you need.
  • Get health care services that obey state and federal laws about your rights.
  • Help make decisions about your health care. This includes the right:
    • To get a second medical opinion.
    • To say no to treatment. This is your right unless the court says otherwise.
  • File a complaint or grievance about:
    • Magellan.
    • A provider.
    • The care you receive.
  • File an appeal about a Magellan action or decision. You can ask for a State Fair Hearing if you are not happy with the result of the appeal. This applies for Medicaid only. It does not apply for Iowa DPH.
  • Sign a form saying that you know your health information may be shared in a public way during the State Fair Hearing process. This applies if your provider asks for a State Fair Hearing for you. Your provider will need you to sign this form. (effective April 2013)
  • Get a copy of your medical records. You can ask that they be changed or corrected.
  • Use your rights. This will not affect the way Magellan and its providers treat you.
  • Get written information on advance directives and your rights under state law. (An advance directive tells doctors the kind of care you would want if you become too sick to decide.)
  • Talk with your provider about the types of treatment that are right for you. The cost or benefit coverage do not affect this.
  • Be free from any form of control used in a hostile way.
  • Be free from any form of control or restraint used to hurt or punish you.

Your Responsibilities

There are things you need to do as an Iowa Plan member. Agreeing to them helps you get better. It can help you get the most out of your mental health or substance abuse services. It also helps us work with you better.

 You should:

  • Get treatment you need from an Iowa Plan provider.
  • Treat with respect anyone giving you care.
  • Give providers and Magellan the information they need. This helps providers give you quality care. It helps us give you the right service.
  • Ask questions about your care. This helps you and your providers understand your health problems. It helps create treatment goals. It helps create plans you agree on.
  • Follow your treatment plan. You and your provider should agree on this plan.
  • Follow the plan for taking your medicine. You and your provider should agree on the plan.
  • Tell your providers and primary care doctor about changes in your medicine. This includes medicines other doctors give you.
  • Come to all your provider visits. You should call your provider as soon as you know you need to cancel a visit.
  • Tell your provider when you think the treatment plan is not working.
  • Tell your provider if you have problems paying co-pays. This is for IDPH substance abuse services only.
  • Share your worries about the quality of your care.
  • Tell someone if you suspect abuse and fraud.  (This is someone not being honest.)
    • Call the Corporate Compliance Hotline. You can reach this 24 hours a day and seven days a week.
    • This hotline is run by an outside company.
    • You do not have to give your name when you call.
    • All calls will be looked into and will stay private.
    • You can report fraud, waste and abuse using one of the following.

                              Compliance Hotline: 800-915-2108.

                              Compliance email: Compliance@MagellanHealth.com.

 

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Contact Information

Important member information: Iowa Medicaid Enterprise is now managing behavioral health services for the state of Iowa. For questions regarding your services, please call 1-800-338-7909.

** To file a grievance or appeal for services provided on or before December 31, 2015, please call Magellan Healthcare at 1-800-638-8820.