7036b

All beneficiaries shall be entitled, among others, to the following:(1) Receive quality medical services when needed.(2) Easy access to medical services.(3) Select their health care services organization.(4) Select their primary physician.(5) Select a specialist physician, jointly with the primary physician.(6) Change their primary physician or their health care services organization.(7) Not to be denied services under their coverage.(8) Easy and immediate access to emergency services.(9) Receive the necessary instructions and information to know all the benefits offered by the health insurance.(10) Not to be discriminated against.(11) Initiate a formal claim procedure before the insurer, if there is a claim or concern regarding the health care services offered by the plan.(12) Appeal any final determination of the insurer before the Administration.(13) Select their pharmacy and laboratory. History —Sept. 7, 1993, No. 72, added as Art. VI, § 14 on June 1, 2003, No. 133, § 2.