Rights and Responsibilities

Member Rights

• To receive timely, appropriate, and accessible medical care
• To obtain a second opinion regarding a medical diagnosis
• To choose the provider of your choice from the providers available with your MCO
• To change your MCO as allowed by program policy
• To appeal a decision that you do not agree with
• To be treated with respect and dignity
• To be treated without discrimination with regard to race, color, national origin, sex, sexual orientation, gender identity, religion, age, disability, political belief or veteran status
• To participate in decisions regarding your health care, including the right to refuse treatment 

Member Responsibilities

• To be knowledgeable about your medical coverage
• To obtain routine and ongoing care from your provider in an office setting
• To contact your provider before emergency room visits with the exception of situations requiring emergency care. 
• To carry your MCO card at all times and present it when accessing medical care. 
• To call the number on the reverse side of your medical cards if you move or have incorrect information printed on your medical cards
• To be responsible for any medical bills if you do not present your MCO card at the time of your visit
• To be responsible for any medical bills for services provided by a practitioner who is not enrolled with your MCO

You Have the Right to Appeal

Hawki members have the right to file an appeal with their MCO, before filing an appeal with the Department of Human Services (DHS). For benefit or service-related issues, please contact your MCO to learn about your appeal rights with them. If a Hawki member is dissatisfied with the MCO’s decision, the member can access the State Fair Hearing appeal process through DHS.

Learn more about the appeal process here: Appeals