Your Rights and Responsibilities
AmeriHealth Caritas Delaware works to make sure all of our members get the care, respect, and dignity they deserve. Here’s how.
Your rights
- Grievances
If you have a problem with your care that we can't fix, you can file a grievance. - Appeals
If you do not agree with a decision to deny or limit your medical care, you can file an appeal. - State fair hearings
If you're not happy about an appeal, you can request a state fair hearing. - Your rights as an AmeriHealth Caritas Delaware member
You have rights as one of our members. Read this list carefully. - Our dedication to quality
We take steps to make sure your health care is always excellent.
Your responsibilities
- Your responsibilities as an AmeriHealth Caritas Delaware member and how you can help us
Stay informed and to keep us updated about your health. - Notice of Privacy Practices (PDF)
We must follow the duties and privacy practices described in this notice. - Advance directives
Learn how to make important choices about your care ahead of time in case you can't later. - Report fraud, waste, and abuse
Report Medicaid fraud. It is the law. - Leaving the plan (disenrollment)
Learn how to leave (disenroll) from AmeriHealth Caritas Delaware.
If you have any questions, call AmeriHealth Caritas Delaware Member Services, 24 hours a day, seven days a week, at:
- Diamond State Health Plan: 1-844-211-0966 (TTY 1-855-349-6281).
- Diamond State Health Plan-Plus: 1-855-777-6617 (TTY 1-855-362-5769).
Explore thousands of health information articles in the member portal.
How to report critical incidents
All critical incidents must be reported immediately. Please let us know if one of these critical incidents happens to a member, such as you or a covered family member:
- Death
- Suspected physical, mental, or sexual mistreatment, abuse, and/or neglect
- Exploitation
- Injury, fall, or unexpected medical issue
- Medicine misuse or error
- Elopement
- Unsafe behavior
- Environmental
Critical incidents will be reported to the appropriate agency, including the Delaware Division of Medicaid and Medical Assistance (DMMA). You can report it directly to the State here or file a critical incident by calling Member Services, your Care coordinator, or Case Manager.
For more information, see the Member Handbook here.