Your Rights as a Member
As a CCA One Care member, you have the right to privacy, respect, and fair treatment. You also have the right to file a complaint or report fraud.
Learn More About Your Rights and Responsibilities
As a Commonwealth Care Alliance (CCA) member, you have certain rights concerning your healthcare. You also have certain responsibilities to the healthcare providers who are taking care of you. For more information, read the Rights and Responsibilities document (below) or call Member Services at 866-610-2273 (TTY 711).
Your Rights as a Member – CCA One Care (HMO D-SNP)
Release of Information Instructions
Release of Information (ROI) Form
Authorize Oral Disclosure Instructions
Authorization for Oral Disclosure Form
You can also file a grievance if your rights are not respected. Learn how on the Appeals and Grievances page.
Authorized Representation
These forms let you choose someone you trust to help you. They can help with benefit requests, appeals, grievances, and other issues with CCA. Unlike the Oral Disclosure Form, these forms allow someone to make decisions on your behalf.
The Appointment of Representative (AOR) form lasts one year, or until the request or appeal ends.
The Authorized Representative Designation (ARD) form stays in effect until you choose to change it.
Appointment of Representative Form
Authorized Representative Designation Form
Disenrolling from CCA Plans
You can leave the plan at any time.
To learn more, check your Member Handbook. You can also call Member Services.
