Member rights

Member rights & responsibilities

As a member, you have a certain rights and responsibilities, such as filing appeals, subrogation, privacy, nondiscrimination and more.

View your rights

Report fraud and abuse

Find out how to spot and report fraud such as false claims, misrepresentation of services, medically unnecessary services and more.

Report fraud

File an appeal if a claim is denied

Members have a right to file an appeal to request the review of a denial of a claim in whole or in part.

Avoid phone scams

If you receive a call from Health Advantage, we want you to be certain it really is from us. Here's a few ways to be 100 percent certain.

What is subrogation?

Subrogation refers to the legal right of an insurance company — after payment of a loss — to recover monies from the responsible party's insurance carrier.

Personally Identifiable Information (PII) disclosure

Review our privacy notice statement regarding your Personally Identifiable Information.

Claims payment policies & other information

This section provides general information concerning our health insurance plans to aid in the understanding of common policies and procedures.