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If Members decide that they want to have an advance directive, there are several ways to get this type
of legal form. Members can get a form from their lawyer, from a social worker, from Bravo Health, or
from some office supply stores. Members can sometimes get advance directive forms from
organizations that give people information about Medicare. Regardless of where they get this form,
keep in mind that it is a legal document. Members should consider having a lawyer help them prepare
it. It is important to sign this form and keep a copy at home. Members should give a copy of the form
to their doctor and to the person they name on the form as the one to make decisions for them if they
can’t. Members may want to give copies to close friends or family Members as well.
If Members know ahead of time that they are going to be hospitalized, and they have signed an
advance directive, take should a copy with them to the hospital. If Members are admitted to the
hospital, the hospital will ask them whether they have signed an advance directive form and whether
they have it with them. If Members have not signed an advance directive form, the hospital has forms
available and will ask if the Member wants to sign one.
Remember, it is a Member’s choice whether he/she wants to fill out an advance directive (including
whether they want to sign one if they are in the hospital). According to law, no one can deny them care
or discriminate against them based on whether or not they have signed an advance directive. If
Members have signed an advance directive, and they believe that a doctor or hospital has not followed
the instructions in it, Members may file a complaint with their State’s Board of Medicine.
The right to make complaints
Members have the right to make a complaint if they have concerns or problems related to their
coverage or care. “Appeals” and “grievances” are the two different types of complaints Members can
make. If Members make a complaint, Bravo Health must treat them fairly, i.e., not discriminate against
Members, because they made a complaint. Members have the right to get a summary of information
about the appeals and grievances that have been filed with Bravo Health in the past. To get this
information, Members should be directed to call Member Services.
The right to get information about their health care coverage and cost
The Evidence of Coverage tells Members what medical services are covered and what they have to
pay. If they need more information, they should be directed to call Member Services. Members have
the right to an explanation from Bravo Health about any bills they may get for services not covered by
Bravo Health. Bravo Health must tell Members in writing why Bravo Health will not pay for or allow
them to get a service, and how they can file an appeal to ask Bravo Health to change this decision.
Staff should inform Members on how to file an appeal, if asked and should direct Members to review
their Evidence of Coverage for more information about filing an appeal.
The right to get information about Bravo Health, plan Providers, drug coverage, and costs
Members have the right to get information from us about our plan and operations. This includes
information about our financial condition, the services we provide, about our health care Providers and
their qualifications, and about how Bravo Health compares to other health plans. Members have the
right to find out from us how we pay our doctors. To get any of this information, Members should be
directed to call Member Services. Members have the right to get information from us about their Part
D prescription coverage. This includes information about our financial condition and about our
network pharmacies. To get any of this information, staff should direct Members to call Member
Services.
