Member Bill of Rights and Responsibilities

Member Rights

• You have the Right to receive medically necessary care.
• You have the Right to timely access to care and services.
• You have the Right to privacy about your medical record and when you get treatment.
• You have the Right to get information on available treatment options and alternatives presented in a manner and language you understand.
• You have the Right to get information in a language you understand; you can get oral translation services free of charge.
• You have the Right to get information necessary to give informed consent before the start of treatment.
• You have the Right to be treated with respect and dignity.
• You have the Right to get a copy of your medical records and ask that the records be amended or corrected.
• You have the Right to take part in decisions about your health care, including the right to refuse treatment.
• You have the Right to be free from any form of restraint or seclusion used as a means of coercion, discipline, convenience or retaliation.
• You have the Right to get care without regard to sex, race, health status, color, age, national origin, sexual orientation, marital status or religion.
• You have the Right to be told where, when and how to get the services you need from your managed long term care plan, including how you can get covered benefits from out-of-network providers if they are not available in the plan network.
• You have the Right to complain to the New York State Department of Health or your Local Department of Social Services.
• You have the Right to use the New York State Fair Hearing System and/or a New York State External Appeal, where appropriate.
• You have the Right to appoint someone to speak for you about your care and treatment.
• You have the Right to seek assistance from the Participant Ombudsman program.

Member Responsibilities

• Receiving covered services through Nascentia Health Options.
• Using Nascentia Health Options network providers for covered services to the extent network providers are available.
• Obtaining prior authorization for covered services, except for pre-approved covered services or in emergencies; Being seen by your physician, if a change in your health status occurs.
• Sharing complete and accurate health information with your health care providers.
• Informing Nascentia Health Options staff of any changes in your health, and making it known if you do not understand or are unable to follow instructions.
• Following the plan of care recommended by the Nascentia Health Options staff (with your input).
• Cooperating with and being respectful with the Nascentia Health Options staff and not discriminating against Nascentia Health Options staff because of race, color, national origin, religion, sex, age, mental or physical ability, sexual orientation or marital status.
• Notifying Nascentia Health Options within two business days of receiving non-covered or non-pre-approved services.
• Notifying your Nascentia Health Options health care team in advance whenever you will not be home to receive services or care that has been arranged for you.
• Informing Nascentia Health Options  before permanently moving out of the service area, or of any lengthy absence from the service area.
• Your actions if you refuse treatment or do not follow the instructions of your caregiver.
• Meeting your financial obligations.

If you have any questions, please contact Nascentia Health Options at (315) 477-4663.

Download a copy of our Member Bill of Rights and Responsibilities (pdf)

Last Updated on August 21, 2025