Health Plan of San Joaquin | Focus Your Health | Fall 2021

2 Focus Your Health We’ve got you covered! How to make the most of your membership Here at HPSJ, we want you to know that we are on your side. As an HPSJ member, you have rights and responsibilities that help keep you safe. HPSJ mem- ber rights and responsibilities are as follows: 1 A right to receive informa- tion about HPSJ, services, providers, and these rights and responsibilities 2 A right to be treated with respect and dignity, and a right to privacy 3 A right to participate with providers in making health care decisions 4 A right to discuss treatment options for your condition, regardless of cost or benefit coverage 5 A right to voice complaints or appeals about HPSJ or the care provided 6 A right to make recommen- dations regarding the HPSJ member rights and responsi- bilities policy 7 A responsibility to give information that HPSJ and HPSJ providers need in order to provide care 8 A responsibility to follow plans and instructions for care that are agreed upon with your provider 9 A responsibility to under- stand your health problems and participate in developing treatment goals when possible You can also find out what is covered in your Evidence of Coverage (EOC) booklet. This is online at hpsj.com/ medi-cal-evidence-coverage . There you can find: ● What is and is not covered ● Your benefits and limits in and out of service area ● Howwe decide to involve new technology as a covered benefit Learn more about your pharmacy benefit at hpsj.com/ formulary . There you can find: ● When we use generic medicine ● How to ask for a brand-name medicine ● How to ask for a medicine that is not covered ● How to find out if your medicine is covered but needs extra approval ● About meds that can work in a similar way or step therapy for other meds Looking for a provider? You can choose your primary care provider (PCP) at hpsj.com/find-a-provider . Our list shows language, specialty, medical school attended, residency and board status.