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Medicaid and CHIP Rights and Responsibilities

Find out your rights and responsibilities.

  • Dignity and privacy. Be treated with respect and due consideration for your dignity and privacy.
  • Fully Participate in Community. Everyone can work, live and learn as much as possible.
  • Fair Treatment: Your health plan will not treat you, or someone helping you, differently just because you exercise your rights. You can exercise your rights without being scared. Your health plan, your dentist, and the state of Iowa will not treat you differently for using your rights.
  • Get information. Get information you can understand about your dental benefits, treatment choices and other options available to you, no matter the cost.
  • No discrimination. Be treated fairly no matter your race, color, where you are from, disability, or sex.
  • Language help. Get a free interpreter or materials in large print, audio, or other formats.
  • Take part in your care. Learn about your choices, and say yes or no to care.
  • No restraint or seclusion. You cannot be restrained or isolated as punishment.
  • See your records. Ask for your records and request corrections.
  • Emergency care. Get emergency dental care without approval.
  • Second opinion. See another dentist for a second opinion at no cost if needed. For help contact customer service at 866-629-6074 (TTY: 711 or 1‑800‑466‑7566).
  • Grievances and appeals. File a grievance or ask us to review a decision. You may also request a State Fair Hearing (see page 27 for details).
  • If your dentist leaves the network. Get a notice if your regular dentist leaves the plan.
  • Follows Rules. You have the right to receive dental care that follows the rules and regulations.
  • Right to get care on time. You have the right to get dental care when you need it without long waits.
  • Right to enough providers. You have the right to see a dentist close to you without having to travel too far.
  • Right to out-of-network care. If we cannot give you the care you need, we will find another dentist for you at no extra cost to you.
  • Right to coordinated care. You have the right to care that is planned well and shared between your providers.
  • Right to fair approval decisions. You have the right to quick and fair decisions about your care based on what you need, and to be told if your care is approved or denied.
  • Limit Sharing of information. Ask us to limit how we use or share your information
  • Contact Choice. Ask us to contact you in a different way
  • Know Who your information is shared with. Get a list of who we share your information with, in specific cases.
  • Receive a Notice of Privacy Practices. That explains how we use/share information and your rights. We have it posted online and send it to you if you ask. If there is a privacy breach
  • Be told if information was not kept safe (Breach)
     

  • Give correct information. Tell us and your dentist about your health and any other insurance.
  • Use your benefits the right way. Bring your ID card. Do not share it. Report a lost or stolen card.
  • Keep appointments. Be on time or call early to cancel. Follow the care plan you agreed to.
  • Share updates. Tell your dentist if you went to the ER, saw another dentist, or your health changes.
  • Ask for help when you need it, including language or format support.
  • Keep contact information updated. Report address or phone number changes so you do not miss notices.
  • Respect staff. Treat providers and office staff with respect.
  • Ask about approvals. If your dentist suggests a service, ask if it needs pre-approval.
  • Learn basic plan rules. Know the main rules so you can use your benefits the right way.
  • Follow your dentist’s advice. If you cannot, tell your dentist so you can make a new plan together.
  • Speak up. Use the complaint or appeal process if something is wrong.