BadgerCare Plus and/or Medicaid SSI Members

Thank you for being a Quartz BadgerCare and/or Medicaid SSI Plus member.

We have a contract with the Wisconsin Department of Health Services (DHS) to offer these HMO plans.

As a member, you have access to all Quartz’s in-network BadgerCare Plus and Medicaid SSI providers. You should only use the doctors and hospitals in your plan’s network. To find a doctor or clinic, go to Find a Doctor – BadgerCare Plus or Find a Doctor – Medicaid SSI. Or, you can call Customer Success at (800​) 362​-3310 or TTY 711.

Member Rights

• You have the right to ask for an interpreter and have one provided to you during any BadgerCare Plus and/or Medicaid SSI covered service.
• You have the right to receive the information in another language or another format.
• You have the right to pick a personal doctor from primary care physicians who participate in your plan’s provider network.
• You have the right to get information about your rights and responsibilities as a Quartz member, and to give us ideas about these rights and responsibilities.
• You have a right to know about doctors you can see.
• You have the right to receive health care services as provided for in federal and state laws. All covered services must be available and accessible to you. When medically appropriate, services must be available 24 hours a day, seven days a week.
• You have the right to receive information about treatment options including the right to request a second opinion.
• You also have the right to get preventive care information.
• You have the right to make decisions about your health care. You can also refuse care.
• You have the right to be treated with dignity and respect.
• You have the right to be free from any form of restraint or seclusion used as means of force, control, ease, or reprisal.
• You have a right to know how to file a complaint, appeal, or grievance. You have the right to privacy and confidentiality in all communications and records about your health care.
• You have the right to be free to exercise your rights without adverse treatment by the HMO and its network providers.
• You may switch HMOs without cause during the first 90 days of Quartz enrollment.
• You have the right to switch HMOs, without cause, if the State imposes sanctions or temporary management on Quartz.
• You have the right to receive information from Quartz regarding any significant changes with Quartz at least 30 days before the effective date of the change.
• You have the right to disenroll from the HMO if:
  • You move out of the HMO’s service area.
  • Your HMO does not, for moral or religious objections, cover a service you want.
  • You need a related service performed at the same time, not all related services are available within the provider network, and your PCP or another provider determines that receiving the services separately could put you at unnecessary risk.
  • Other reasons, including poor quality of care, lack of access to services covered under the contract, or lack of access to providers experienced in dealing with your care needs.

Your Civil Rights

All medically necessary covered services are available and will be provided in the same manner to all members. All persons or organizations connected with Quartz that refer or recommend members for services shall do so in the same manner for all members.

Quartz provides covered services to all eligible members regardless of the following:

• Age
• Color
• Disability
• National origin
• Race
• Sex

All medically necessary covered services are available and will be provided in the same manner to all members. All persons or organizations connected with Quartz that refer or recommend members for services shall do so in the same manner for all members.

Member Responsibilities

As a Quartz BadgerCare Plus and/or Medicaid SSI member:

• It is your responsibility to pick a personal doctor from Quartz’s list of primary care physicians who participate in your plan’s network.
• It is also your responsibility to create a relationship with that doctor.
• It is your responsibility to read your member handbook and ask questions about information you don’t understand.
• It is your responsibility to carry your ForwardHealth ID card with you and show them when you go to your doctor and hospital.
• It is your responsibility to be honest with your doctors and give them information they need to take care of your health.
• It is your responsibility to ask questions about your health.
• It is your responsibility to follow the instructions your doctor gives you.
• It is your responsibility to make healthy choices.