2024 Evidence of Coverage for WA PEBB Kaiser Permanente Senior Advantage 65 Chapter 6: Your rights and responsibilities Section 1.4 – We must give you information about our plan, our network of providers, and your covered services As a member of our plan, you have the right to get several kinds of information from us. If you want any of the following kinds of information, please call Member Services: • Information about our plan. This includes, for example, information about our plan's financial condition. • Information about our network providers. ♦ You have the right to get information about the qualifications of the providers in our network and how we pay the providers in our network. • Information about your coverage and the rules you must follow when using your coverage. ♦ Chapter 3 and Chapter 4 provide information regarding medical services. • Information about why something is not covered and what you can do about it. ♦ Chapter 7 provides information on asking for a written explanation on why a medical service is not covered or if your coverage is restricted. ♦ Chapter 7 also provides information on asking us to change a decision, also called an appeal. Section 1.5 – We must support your right to make decisions about your care You have the right to know your treatment options and participate in decisions about your health care You have the right to get full information from your doctors and other health care providers when you go for medical care. Your providers must explain your medical condition and your treatment choices in a way that you can understand. You also have the right to participate fully in decisions about your health care. To help you make decisions with your doctors about what treatment is best for you, your rights include the following: • To know about all of your choices. You have the right to be told about all of the treatment options that are recommended for your condition, no matter what they cost or whether they are covered by our plan. • To know about the risks. You have the right to be told about any risks involved in your care. You must be told in advance if any proposed medical care or treatment is part of a research experiment. You always have the choice to refuse any experimental treatments. • The right to say "no." You have the right to refuse any recommended treatment. This includes the right to leave a hospital or other medical facility, even if your doctor advises you not to leave. Of course, if you refuse treatment, you accept full responsibility for what happens to your body as a result. 1-877-221-8221 (TTY 711), 7 days a week, 8 a.m. to 8 p.m.