Member and patient rights and responsibilities
At Kaiser Permanente, we believe maintaining good health is a very important part of your well-being. Providing the quality health care necessary to maintain your good health requires a partnership between you and your health care professionals. You need information to make appropriate decisions about your care and lifestyle choices. Your health care professionals need your involvement to ensure you receive appropriate and effective health care. Mutual respect and cooperation are essential to this partnership.
It's important to know what you can expect and what we need from you when you receive care from us.
You have the right to:
- Be notified of your rights and responsibilities as a patient and member and be able to suggest changes to them and/or related policies.
- Be treated fairly, with respect and dignity without regard to your race, color, national origin, age, disability, sex, sexual orientation, gender identity or financial status.
- Be supported in choosing and changing providers and seeking a second opinion within your plan.
- Expect your personal physician to provide, arrange, and/or coordinate your care.
- Be involved in your health care decisions including refusing or agreeing to care and treatment; be provided information about your care, including unanticipated outcomes; the benefits and risks of, and alternatives to recommended treatments or procedures regardless of cost or coverage; and realistic alternatives when hospital care is no longer appropriate.
- Participate in decisions to receive, or not receive, life-sustaining treatment including care at the end of life.
- Get information about our policies, services, facilities, and your benefits and care, in a way you can understand. Be provided an interpreter if you need one. Receive written information in an alternative format or language (in prevalent non-English languages as defined by the state).
- Confidentiality, privacy, security, complaint resolution, spiritual care, and communication. If communication restrictions are necessary for your care and safety, we will document and explain the restrictions to you and your family.
- Receive timely access to quality care and services in a safe setting.
- Be able to access information about Kaiser Permanente, our practitioners and providers, and how to use our services, including information about the qualifications of the professionals caring for you.
- Create and update your advance directives such as a living will or durable power of attorney for healthcare and have your wishes honored to the extent permitted by state and federal laws.
- Donate organs and other tissues according to state law.
- Have your family provide input to care decisions consistent with your advance directives or with court orders.
- Appeal a decision and receive a response within a reasonable amount of time.
- Be free from any form of restraint or seclusion unless medically necessary for your well-being.
- Be protected from all forms of abuse, neglect, harassment, or discrimination and have access to protective services, if needed.
- Receive visitors (in a hospital setting) that you or your support person designates, including, but not limited to: a spouse, domestic partner, significant other, family member or friend. Visitors are restricted from most treatment and procedure areas and may be limited based on your medical condition. You have the right to withdraw or deny your consent at any time.
- Be free from discrimination, reprisal, or any other negative action when exercising your rights.
- Request and receive a copy of your medical records, and request amendment or correction to such documents, in accordance with applicable state and federal laws.
- Voice opinions, concerns, positive comments, complaints or grievances about your care, treatment or other services without fear of retribution or denial of care and receive timely resolution of your complaint, generally within seven business days.
Member Services can provide you with information about complaint and appeal procedures and the resources to assist you. You can reach Member Services toll-free at 1-888-901-4636.
You may also contact the following agencies:
Washington State Department of Health
Health Systems Quality Assurance Complaint Intake
P.O. Box 47857
Olympia, WA 98504-7857
Idaho Department of Health and Welfare
405 W State St.
Boise, ID 83702
Center for Medicare and Medicaid Services (CMS)
Office of the Medicare Beneficiary Ombudsman
Phone: 1-800-MEDICARE (Medicare Help and Support)
You have the responsibility to:
- Participate in the development of your treatment plan, follow it, and let your health care provider know if changes need to be made.
- Improve the quality and safety of your care by fully informing health professionals serving you about your medical history, medications, and any changes in your condition.
- Use practitioners and providers affiliated with your health plan for health care benefits and services, except where services are authorized or allowed by your health plan, or in the event of emergencies.
- Be active, informed, and involved in your care, and ask questions when you do not understand your care, what you are expected to do, or the payment for the care.
- Be considerate of other members, patients, and your health care team. This includes arriving on time for appointments, and notifying staff if you cannot make it on time or if you need to cancel.
- If you are having surgery, ensure a responsible adult is with you throughout the surgical procedure and for the first 24 hours after your surgical procedure.
- Be familiar with your health care benefits.
- Pay your bills on time and pay your office visit charges when you come in for care.
Board approved on September 12, 2017
You may have additional rights under federal and state laws.