Member Rights and Responsibilities


Member Rights and Responsibilities

As a participating provider, it’s important that you are aware of our members’ rights and responsibilities. A summary is provided below. Additional information can be found in the members’ benefit booklet and on our member website.

Member rights include the right to:

  • Receive information about Blue Cross and Blue Shield of Texas, our services, participating providers and facilities, and member rights and responsibilities
  • Be treated with respect and dignity with recognition of their right to privacy
  • Participate with providers in making decisions about their health care
  • Have a candid discussion of appropriate or medically necessary treatment options for their condition, regardless of cost or benefit coverage
  • Voice complaints or appeals about BCBSTX or the services we provide
  • Make recommendations regarding our member rights and responsibilities policy

Member responsibilities include a responsibility to:

  • Provide, to the extent possible, information that BCBSTX and the provider and facility need to provide care
  • Follow the plans and instructions for care that the member has agreed to with their provider
  • Understand their health problems and participate in the development of mutually agreed upon treatment goals, to the degree possible

Blue Cross and Blue Shield Federal Employee Program® members: In addition to the details provided above, visit for more information about our FEP® members, including on rights and responsibilities.

To learn more about member/subscriber rights and responsibilities, see: 

Texas Medicaid members: In addition to the details provided above, our Medicaid members have an expanded list of rights and responsibilities that can be found under Education and Reference on our website for Medicaid providers and also in our Medicaid STAR, CHIP and STAR Kids Provider Manual in Section 18.