Member Eligibility & Benefits
Member’s Rights & Responsibilities
Please refer to the Empire member handbook for more information about:
- A member’s right to fair treatment
- Empire Privacy Practices
- Your responsibility to report waste, fraud and abuse
- Your right to appeal health care problems
- Your right to a fair hearing
The member, their parents and any representatives they choose have the right to:
- Be treated with respect, dignity, privacy, and fairness
- Be involved in their medical or behavioral health decisions and care plan
- Be told in an understandable way about the necessary treatment options for their conditions, no matter what they cost or if the benefit is covered
- Choose and/or change health care providers
- Make a complaint about Empire or appeal any decisions regarding the care or services we provide
- Get information about Empire, its services, doctors and other providers
- Get information about their member rights and responsibilities
- Make suggestions to us regarding Empire rights and responsibilities policy
They have the responsibility to:
- Listen to health care advice and follow the care plan they agreed to with their doctors
- Be sure they know what might happen if they accept or reject health care advice
- Be sure they understand their health problems and help plan their treatment goals
- Provide Empire and their doctors with information needed to carry out their care and services
- Tell Empire and their doctors if they want to leave the program
Empire is a culturally diverse company. We welcome all eligible individuals into our health care programs, regardless of health status. If you have questions or concerns, please call 1-800-300-8181 (TTY 711) and ask for extension 34925. Or visit www.empireblue.com/nymedicaid.