Member rights and responsibilities

As a Health Share member, you have rights when you get care. You also have responsibilities that help you and your providers work together to support your health.

You have the right to:

  • Be treated with dignity and respect, with consideration for your privacy.

  • Be treated the same as other people seeking health care.

  • Get care that respects your needs, culture, language and preferences.

  • Get information in a language and format you can understand.

  • Get information about your health, treatment options and covered and non-covered services so you can make informed decisions about your care.

  • Choose your providers and change your choices when allowed.

  • Get a second opinion.

  • Have a friend, family member or helper come to your appointments.

  • Take part in making your treatment plan and decisions about your care.

  • Agree to or refuse services and be told what could happen as a result of your decision, except for court-ordered services.

  • Get behavioral health and family planning services without a referral.

  • Get covered preventive services and medically necessary referrals to specialists.

  • Get urgent and emergency services 24 hours a day, 7 days a week, without prior approval.

  • Get free certified or qualified interpreters, including sign language interpreters.

  • Get help navigating the health care system, including care coordination and culturally appropriate support.

  • See and get copies of your health records and share them with your providers.

  • Receive notice about certain changes to your benefits or provider network.

  • Make an advance directive or name someone to make health care decisions for you if you cannot.

  • Make a complaint or appeal a decision and get a response from Health Share.

  • Ask the state for a hearing if you disagree with a Health Share decision.

  • Be free from restraint or isolation used for punishment, convenience, retaliation or to make you do something you do not want to do.

  • Exercise your rights without discrimination or being treated differently.

You have the responsibility to:

  • Treat Health Share staff, providers and others with respect.

  • Give your providers accurate and honest information so they can give you the best care.

  • Choose a primary care provider (PCP) and get recommended checkups and preventive care.

  • Keep your appointments or call ahead if you need to cancel or will be late.

  • Bring your Health Share and other insurance ID cards to appointments.

  • Work with your providers to create and follow your treatment plan.

  • Ask questions when you do not understand your condition, treatment or other care.

  • Follow your provider’s instructions or ask about other options.

  • Use your PCP for most care and follow Health Share requirements when seeing an out-of-network specialist, unless it is an emergency.

  • Use urgent and emergency services appropriately and tell your PCP after receiving this care.

  • Help your providers get the health records they need to care for you.

  • Tell Health Share if you have a concern, complaint or need help.

  • Report required changes about you or your household to OHP.

  • Complete an Agreement to Pay if you choose to receive services that OHP does not cover.

  • Help Health Share recover payment when another party is responsible for health care costs related to an injury.

Need help?

If you have questions about your rights or responsibilities, call Health Share Customer Service at 503-416-8090 or 888-519-3845 (TTY/TDD 711).

If you believe your rights have not been respected, you can make a complaint. You can also contact an Oregon Health Authority Ombudsperson at 877-642-0450 (TTY/TDD 711).