Rights and Responsibilities of a Health Care Consumer

When you check into a hospital or see a doctor for the first time, you should be given a copy of the “Consumer Bill of Rights and Responsibilities.” 

Most likely you glance at it and put it aside. Taking time to read, understand and act on your rights and responsibilities, however, can help you proactively engage in the health care you receive.

Here is a summary of the eight areas of consumer rights and responsibilities, according to the Advisory Commission on Consumer Protection and Quality in the Health Care Industry.

Information disclosure

“Consumers have the right to receive accurate, easily understood information.”

This includes information from your health insurance plan, doctor, service providers and hospitals.

Choice of providers

“Consumers have the right to a choice of health care providers that is sufficient to ensure access to appropriate high-quality health care.”

To ensure choice, insurance plans should provide access to specialists for women’s health and serious medical conditions.

Access to emergency services

“Consumers have the right to access emergency health care services when and where the need arises.”

To ensure this right, health plans should educate members about the availability, location and appropriate use of emergency services.

Participation in treatment decisions

“Consumers have the right and responsibility to fully participate in all decisions related to their health care. Consumers who are unable to fully participate in treatment decisions have the right to be represented by parents, guardians, family members or other conservators.”

To ensure the ability to participate in treatment decisions, health care professionals should discuss all treatment options, including the option of no treatment at all.

Respect and nondiscrimination

“Consumers have the right to considerate, respectful care from all members of the health care system at all times and under all circumstances.”

Consumers must not be discriminated against in the delivery of health care services based on race, ethnicity, national origin, religion, sex, age, mental or physical disability, sexual orientation or source of payment.

Confidentiality of health information

“Consumers have the right to communicate with health care providers in confidence and to have the confidentiality of their individually identifiable health care information protected. Consumers also have the right to review and copy their own medical records and request amendments to their records.”

To ensure this right, health care providers give consumers a HIPAA-approved form that spells out privacy considerations.

Complaints and appeals

“All consumers have the right to a fair and efficient process for resolving differences with their health plans, health care providers and the institutions that serve them, including a rigorous system of internal review and an independent system of external review.”

Consumer responsibilities

“In a health care system that protects consumers’ rights, it is reasonable to expect and encourage consumers to assume reasonable responsibilities.”

These are example of consumer responsibilities:

• Adopting healthy habits, such as exercising and not smoking.

• Becoming involved in health care decisions.

• Working with health care providers in developing and carrying out treatment plans.

• Becoming knowledgeable about his or her health plan coverage.