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MEDICARE ADVANTAGE PLAN MEMBER RIGHTS

Your Rights as a Member of a Generations Medicare Advantage Plan. Your rights as a member:

  1. We must provide information in a way that works for you (in languages other than English, in Braille, in large print, or other alternate formats, etc.).
  2. We must treat you with fairness and respect at all times.
  3. We must ensure that you get timely access to your covered services and drugs.
  4. We must protect the privacy of your personal health information.
  5. We must give you information about the plan, its network of providers, and your covered services.
  6. We must support your right to make decisions about your care.
  7. You have the right to make complaints and to ask us to reconsider decisions we have made.
  8. If you believe you are being treated unfairly or your rights are not being respected:
    1. If it is about discrimination, call the Office for Civil Rights at (800) 368-1019 or TTY (800) 537-7697 or call your local Civil Rights Office.
    2. If it is about something else:
      1. Call Customer Care at (844) 280-5555, 8:00 AM to 8:00 PM, 7 days/week. TTY/TDD users call 711.
      2. Call the State Health Insurance Program (SHIP) at (800) 763-2828.
      3. Contact Medicare at 1-800-MEDICARE (1-800-633-4227), 24 hours/day, 7 days/week. TTY users call (877) 486-2048.
  9. To get more information about your rights, you can: Call Customer Care at (844) 280-5555, 8:00 AM to 8:00 PM, 7 days/week. TTY users call 711.
    1. Call the State Health Insurance Program (SHIP) at (800) 763-2828.
    2. Contact Medicare at 1-800-MEDICARE (1-800-633-4227), 24 hours a day, 7 days per week. TTY users should call (877) 486-2048.
  10. If you are disenrolled involuntarily (against your wishes) from our plan, you have the right to ask us to reconsider your disenrollment through the Grievance procedure written in your Evidence of Coverage or on our website.

Your Responsibilities as a Member of a Generations Medicare Advantage Plan

  1. Be familiar with covered services and the rules you must follow to get the covered services.
  2. Let us know if you have any other health insurance or prescription drug coverage.
  3. Tell your doctors and other providers that you are enrolled in our plan.
  4. Help your doctors and other providers by giving them information, asking questions and following through on your care.
  5. Be considerate.
  6. Pay what you owe.
  7. Tell us if you move.
  8. Call our Customer Care department for help if you have questions or concerns.

Thank you for being a Member of our Medicare Advantage plan. We appreciate you and welcome the opportunity to provide you with high quality service.