St. Lukes Health


Member Rights & Responsibilities.


As a St. Luke’s Health Plan member, you have the following rights and responsibilities.

Everything you need to know.

Member rights.
As a member of the Plan, you have the right to:

  • Receive information about your coverage and your rights and responsibilities.

  • Receive, upon request, facts about your Plan, including a list of the health 
care services covered and providers available to meet your healthcare needs.

  • Receive courteous service and respect with an appreciation of your dignity 
and protection of your privacy from St. Luke’s Health Plan.

  • Receive courteous service and respect from St. Luke’s Health Plan’s network providers.

  • Receive the reasons why St. Luke’s Health Plan denied a request for treatment 
or health care service, and the rules used to reach those results.

  • Receive, upon request, details on the rules used by St. Luke’s Health Plan to 
decide whether a procedure, treatment, site, equipment, drug, or device needs prior approval.

  • Receive, upon request, a copy of St. Luke’s Health Plan list of covered prescription drugs. You can also request updates about when a drug may become covered.

  • Receive clear and correct facts to help you make your own health care choices.

  • Play an active part in your health care and discuss treatment options with your doctor without regard to cost or benefit coverage.

  • Be informed by your provider about your health so you may make thoughtful decisions before you receive treatment.

  • Participate with practitioners in making decisions about your health care.

  • Have reasonable access to appropriate medical services regardless of your race, religion, nationality, disability, sex, or sexual orientation, and 24- hour access to urgent and emergency care.

  • Have all claims paid accurately and in a timely manner.

  • Expect that St. Luke’s Health Plan will take measures to keep your health information private and protect your health care records.

  • Voice complaints and expect a fair and quick appeals process for addressing any concerns you may have with St. Luke’s Health Plan.

  • Make recommendations regarding St. Luke’s Health Plan’s member rights and responsibilities policies.

Your responsibilities.
As a Plan member, you have the responsibility to:

  • Read all plan materials carefully as soon as you enroll and ask questions when necessary.

  • Contact St. Luke’s Health Plan whenever you have a question or if St. Luke’s Health Plan material or correspondence is unclear.

  • Use St. Luke’s Health Plan providers when available, carry your ID Card, and pay copay/coinsurance amounts at the time of service.

  • Follow the course of treatment prescribed by your provider. If you choose not to comply, advise your provider.

  • Provide St. Luke’s Health Plan and your doctors with complete information about your illness, accident, or health care issues, which may be needed to provide care.

  • Ask questions and make sure you understand the explanation and instructions you are given.

  • Understand your health problems and participate in developing mutually agreed upon treatment goals to the degree possible.

  • Make appointments for non-emergency medical care. Keep scheduled appointments or give adequate notice of cancellation.

  • Play an active part in your health care.

  • Be polite to network providers, their staff, and St. Luke’s Health Plan employees.

  • Comply with the rules outlined in your member material.

Alt text of Light Positive Texture
Alt text of Pebble Positive Texture

Glad you’re covered.

Get in touch

Questions about our plans or need help signing up? Reach out.

Call us at:



[email protected]

Quality Coverage

St. Luke's has an exceptional network of quality doctors and specialists serving Idaho. We're so glad you're a part of our family.