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You
Have The Right To:
Get the services you need 24 hours a day, 7
days a week. This includes emergencies.
Be informed about your health problems.
Get information about treatments, and how
they will help or harm you.
Refuse treatment. Receive information about
what may happen if you refuse treatment.
Know that the Circle of Health will keep
your records private.
File a complaint with the member service
representative.
File an appeal with the Circle of Health
Insurance Director.
A clear explanation of covered benefits.
Give written instructions about your
medical care. This is called a "health care
directive."
Choose where you will get family planning
services.
Get a second opinion for medical, mental
health, and chemical dependency services.
Your Responsibility:
In order to make the Circle of Health work you must
cooperate with us to maximize the available resources to
cover all of your health care needs.
You must complete an application form with
the Circle of Health.
You must inform us of your primary coverage
with other insurance companies and let us know
immediately of any changes in that coverage.
You must keep us informed on your current
address and if you change it.
You must be willing to apply and accept any
medical coverage that may be available through an
employer of from a governmental program. The Circle of
Health will assist you in applying for these programs.
You must have a doctor's order and prior
authorization for specialty or benefits not covered by
your insurance policy.
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Mille
Lacs Band of Ojibwe - Circle of Health
"Where
Care, Culture and Community Complete the Circle"
500 East Main Street,
Onamia, MN 56359
Toll Free: (800)-491-6106 Local: (320) 532-5358
Fax: (320) 532-5699
info@mlcircleofhealth.com
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