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Getting the most from my coverage. It's all part of my plan.

Get the Most from Your Coverage

Your Child Deserves Quality Healthcare. And you also deserve to have the information you need to get the most from your child’s coverage. Goals for quality are set and reviewed by CMS Health Plan to make sure your child gets the proper care.

This information is part of a Quality Program designed to improve the services and care your child gets. It provides details about the coverage and services available. 

Contact Member Services to learn more about the Quality Program.

Know Your Rights

Being a member means there are things you should expect from CMS Health Plan. These are some of your rights:

  • Your child should be treated with courtesy and respect
  • You should be able to get a copy of your child’s medical record
  • You should know your child’s medical data will be kept private. There are policies in place to guard health records and protected health information.

It’s also important to know what you can do to get the most from your coverage:

  • Ask questions if you don’t understand your rights
  • Be sure to keep your child’s scheduled appointments
  • Keep your child’s Member ID Card with you so you have it at appointments
  • Tell your child’s doctor if your child has gotten care in an emergency room.

The full list of rights and responsibilities is in your Member Handbook.

Getting the Care Your Child Needs

Get More Information

The Member Handbook is a great source for information about coverage and benefits. It also lists important phone numbers.

Contact Member Services for additional help at 1-866-799-5321 (TTY 1-800-955-8770). Translation services are available if you need them.

Contact Member Services to get:

  • A paper copy of your Member Handbook, Privacy Notice or anything on the CMS Health Plan website
  • Help finding a doctor and making an appointment
  • Help speaking with your child’s care manager
  • Help with an appeal for a service that’s been denied
  • Help with a ride to your child’s appointment

The CMS Health Plan website also has a lot of helpful information. Visit it to find the Member Handbook, Find-a-Provider tool, and the Preferred Drug List

Creating an online member account is free and easy. With it, you can:

  • Find or change your child’s PCP
  •  Request a new Member ID Card or print a temporary ID Card
  • View and update your child’s personal information

You can also send a message directly to CMS Health Plan from a member account.