Medicaid Member Rights and Responsibilities

As a member of the Upper Peninsula Health Plan (UPHP), you are entitled to specific rights regarding your health care and related services. UPHP also expects you to be responsible for certain aspects of your health care and related services.

The following rights and responsibilities are given to UPHP Medicaid members after they enroll:

Member Rights

  • To get high-quality health care services that complies with out contract with the State and all State and Federal laws.
  • To be treated with dignity and respect.
  • Ask for and be sent information about:
    • Upper Peninsula Health Plan
    • Out structure and operations
    • Our services
    • Our providers
    • Our provider incentive programs
    • Member rights and responsibilities
  • To have full discussions with your doctors about your treatment options and decisions, whether covered or costly.
  • To work with your doctors to make health care decisions including the right to refuse treatment.
  • To be free from any form of restraint or seclusion used as a means of coercion, discipline, convenience or retaliation.
  • To choose or change your primary care provider (PCP).
  • To know the names and backgrounds of your health care providers.
  • To have your medical and personal information kept private.
  • To request and receive a copy of your medical records, and request those be amended or corrected.
  • To look at your records or those of your minor dependents at the office of your doctor during the doctor’s normal work hours.
  • To have your problems taken care of quickly by filing a complaint or appeal.
  • To have a fair hearing with the State of Michigan.
  • To get your questions answered about your bills.
  • To have medical benefits even if you have or had a long-term illness or problems before you enrolled with UPHP.
  • To get help with any special disability needs you may have.
  • To get help with any special language or cultural needs you may have.
  • To be free from other discrimination prohibited by State and Federal regulations
  • To get information about how your PCP is paid.
  • To have the UPHP staff and its providers comply with all of your rights and responsibilities.
  • To make suggestions about member rights, member responsibilities and UPHP policies.

Member Responsibilities

  • Be respectful to your doctors, all health care staff, and the UPHP staff.
  • Tell your doctors your full health and social history.
  • Follow the advice of your doctors.
  • Get care if you are pregnant.
  • Call Customer Service as soon as you know that you are pregnant.
  • Ask questions about your care.
  • Make and keep appointments.
  • Cancel your appointments 24 hours ahead of time if you cannot go.
  • Follow UPHP rules.
  • Tell UPHP and your local Department of Human Services office about name, address, and telephone number changes if you have Medicaid.
  • Always carry your current mihealth and UPHP ID cards.
  • Call UPHP if your card is lost or stolen.
  • Tell UPHP, Michigan Medicaid, and your doctors if you have other insurance. Also tell your local Department of Health and Human Services office.
  • Work with your PCP to manage your health.
  • Understand your health problems so that you and your doctors can set treatment goals.
  • Work with your UPHP Clinical Services nurse to help manage an ongoing health problem.
  • Provide information needed by UPHP or your doctors.
  • If you have more than one doctor, ask them to communicate about your care.

Page Last Updated: 07/14/2017