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Members' Rights and Responsibilities

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When you enrolled with Blue Cross of Northeastern Pennsylvania, you made an important commitment. This commitment reflects a concern for making wise health care decisions for yourself and your family. We respect your commitment and consider ourselves a partner, along with your physician and other health care providers, in your health care experience.

As with most successful partnerships, all parties make clearly defined contributions toward achieving a common goal. At Blue Cross of Northeastern Pennsylvania, these are called "Rights and Responsibilities."

We encourage you to learn and exercise your rights and responsibilities. By working together, a common goal can be achieved - a healthier future for you and your loved ones.


  • A right to receive information about the organization, its services, its practitioners and providers and member rights and responsibilities.
  • A right to be treated with respect and recognition of your dignity and your right to privacy.
  • A right to participate with practitioners in making decisions about your health care.
  • A right to a candid discussion of appropriate or medically necessary treatment options for your conditions, regardless of cost or benefit coverage.
  • A right to voice complaints or appeals about the organization or the care it provides.
  • A right to make recommendations regarding the organization’s member rights and responsibilities policy.


  • A responsibility to supply information, to the extent possible, that the organization and its practitioners and providers need in order to care for you.
  • A responsibility to follow plans and instructions for care that you have agreed to with your practitioners.
  • A responsibility to understand your health problems and participate in developing mutually agreed-upon treatment goals, to the degree possible.

Your health plan may not cover all your health care expenses. Read your contract carefully to determine which health care services are covered. Call the Customer Service line number on the back of your card for additional information about your rights and responsibilities or covered services.