As a valued member of the Florida Health Solution Corp. Prepaid Health Clinic; the following are your rights and responsibilities.

Access to Care

You have the right to impartial access to medically indicated treatment or accommodations, regardless of race, national origin, religion, disability or source of payment.

When the Prepaid Health Clinic Plan or HMO Plan cannot meet your request or need for care, you will be transferred when medically permissible to an available and appropriate facility.

You have the right to express your wishes with regard to your medical care. The Prepaid Health Clinic Plan and HMO Plan is willing to honor lawful requests to withhold or withdraw treatment should you or your legal representative decide to do so.

Respect, Dignity and Consideration

You have the right to considerate, respectful care at all times and under all circumstances, with recognition of your personal dignity, psychosocial needs, cultural, spiritual, personal values and belief systems.

You have the right to exercise your cultural and spiritual beliefs that do not interfere with the well-being of others or your planned course of medical therapy.

You have the right to know what patient support services are available, including whether an interpreter is available if you do not speak English.

Privacy and Confidentiality

You have the right, within the limits of the law, to personal privacy and confidentiality of information.

You do not have to speak with people who are not directly involved in your care.

Your discussions with your doctor should not be shared without your permission.

When you are examined, you are entitled to have the curtains drawn and to know what role any observer may have in your care.

You or your legal representative has the right to access the information contained in your medical record as allowed by the law. Your medical record should only be read by individuals monitoring your care or by individuals authorized by the law or regulation. Your medical record will be restricted as above unless you or your legal representative has given written authorization to someone else.

Clear Information About Your Condition and Care

You or your legal representative has the right to necessary information, with a clear and concise explanation, to enable you to make treatment decisions that reflect your wishes. You should not be subjected to any medical procedure posing risks without your understanding and consent (or that of your legal representative).

You have the right to know of experimental, research, or educational activities involved in your treatment. You also have the right to refuse to participate in any such activity.

Involvement in Decision Making

You or your legal representative has the right, in collaboration with your physician, to make decisions involving your care:

* the identity of the physician who has primary responsibility for your care; * the identity and professional status of the individuals who are authorizing and performing the procedure; * the existence of any multidisciplinary professional relationships among the individuals treating you; * the nature and purpose of the treatment or procedure; * the potential benefit(s) of the treatment or procedure; * the potential drawbacks(s) of the treatment or procedure; * the likelihood of success of the treatment or procedure; * problems related to recuperation; and, * Any significant alternatives to the treatment or procedure.

Documentation in the medical record will reflect that this information has been provided to you.

You have the right to formulate advance directives, living wills, or other legal documents.

You or your legal representative has the right to participate in the consideration of ethical issues that arise in your care.

Names of Your Caregivers

You have a right to know the identity and professional status of all the people involved in your care, including the identity of the physician who is primarily responsible for your treatment.

Refusal of Treatment

You have the right to accept medical care or to refuse treatment to the extent permitted by law and to be informed of the medical consequences of such refusal. You have the right to refuse treatment against medical advice, but you will be asked to sign a form to that effect.


You have the right to contact people outside the Plan by means of written or verbal communication. You also have the right to an interpreter, if necessary.

Plan Rules and Regulations

You have the right to know which Plan rules and regulations apply to you as a patient. If you have any complaints, you have a right to access the Plan’s system of answering member complaints.

Your complaint will in no way affect the quality of care or compromise your future access to care.

Provider Information

You have the right to general office practice for your provider such as hours of operation, posting of licenses, absence of malpractice insurance coverage in accordance to Florida law.


As a member of the Plan, you also have certain responsibilities which are for your own best interests.

Provide Information

You are responsible for providing, to the best of your knowledge, accurate and complete information about your present complaints, past illnesses, hospitalizations, medications, over-the-counter medications and dietary supplements, any allergies or sensitivities, or other matters relating to your health care.

You are responsible to inform your provider about any advance directives, living will, medial power of attorney and/or other directives that could affect your care.

You are responsible for reporting whether you clearly understand a planned course of action and what is expected of you.

Follow Instructions

You are responsible for following the treatment plan recommended by your caregivers. If you do not understand any instructions or if you have concerns, you need to let your caregiver know immediately about your misgivings.

Keep Appointments

You should keep any and all appointments or telephone the provider if you cannot keep the appointment. Your plan should include providing a responsible adult to assist transporting you to appointments or other options provided by the plan, if applicable.

Refusal of Treatment

If you refuse treatment or do not follow medical instructions, you are responsible for your own actions.

Respect for Others

You are responsible for being considerate of other patients, and Plan personnel and property, and health care professionals and staff.

Plan Rules and Regulations

You are responsible for following the Plan’s rules and regulations that affect patient care and conduct.

Payments and Charges

You are responsible to accept personal financial responsibility for any charges not covered by the plan.