Monday-Friday, 8 a.m. to 5 p.m. CST Llame al 1-855-580-1689 (los usuarios de TTY deben llamar al 711). Limitations, copays, and restrictions may apply. Benefits, List of Covered Drugs, pharmacy and provider networks and/or copayments may change from time to time throughout the year and on January 1 of each year. HFS sends paperwork in the mail that you need to renew your Medicaid coverage. Meridian It explains the medical, dental, vision, and pharmacy services that are covered by your plan. It also explains how to find care and how to earn rewards. You can get this document for free in other formats, such as large print, braille, or audio. The benefit information is a brief summary, not a complete description of benefits. You will need Adobe Reader to open PDFs on this site. Your call will be returned within the next business day. We want you to be happy with the treatment and services you get from Meridian and our providers. hKq?wNe?t!ARk;v6[IqK,h!i2jLnn}>^| ! More information is in your Member Handbook(PDF). On weekends and on state or federal holidays, The handbook will explain your rights, benefits, and responsibilities as a member of Meridian. Be sure to read your Meridian Member Handbook and keep it handy. With HealthChoice Illinois, you have a health plan partner to turn to for help. The call is free. If theres a question you cant find the answer to on our website, call us at 1-855-323-4578(TTY 711), Monday - Friday from 8 a.m. - 8 p.m. EST. trailer This is not a complete list. ATTENTION: If you speak a language other than English, language assistance services, free of charge, are available to you. Provider Manual | Meridian Health Plan of Illinois On weekends and on state or federal holidays, you may be asked to leave a message. Your Member Handbook is a great resource if you have any questions or just want to learn more about your coverage. // PDF 2021 Member Handbook - Meridian Medicare Medicaid Plan Please contact the plan for more details. Want a paper copy? For certain kinds of drugs, you can use the plans network mail-order services. 0000014634 00000 n Usually a mail-order pharmacy order will get to you in no more than 5 days. This is not a complete list. providerhelp.IL@mhplan.com, The Interoperability and Patient Access Rule. This handbook will help you understand your coverage. ATENCIN: Si habla espaol, tiene a su disposicin servicios gratuitos de asistencia lingstica. Learn more about how being a Meridian provider benefits you. We will send you a notice before we make a change that affects you. La llamada es gratis. On weekends and on state or federal holidays, you may be asked to leave a message. With added benefits like support making smart health choices, personal care coordination, 24-hour nursing help line, and more. The benefit information is a brief summary, not a complete description of benefits. You are leaving this website to go to a website managed by a contracted company, which provides service on our behalf. 199 0 obj <>stream The COC lays out all the details so that you can stay on top of your coverage. It explains the medical, dental, vision, and pharmacy services that are covered by your plan. La llamada es gratis. The Member Handbook, along with your enrollment form, serves as Meridian Medicare-Medicaid Plan's (MMP) contract with you. Representatives are available Monday-Friday, 8 a.m. to 8 p.m. to assist you. Other pharmacies/physicians/providers are available in our network. 0000006553 00000 n This site contains various Meridian Medicare-Medicaid Plan (MMP) links and resources. Under our plan, you will have one card for your Medicare and Medicaid services, including long-term services and supports and prescriptions. It will also explain our responsibilities to you, as well as outline the following details: The Annual Notice of Changes (ANOC) is a brief summary of benefits and benefit changes that occurred from one year to the next. If we fall short, you can file a grievance or appeal. Member Handbook - Meridian Medicare Medicaid Plan We also have an optional automatic mail-order delivery program under which we will automatically fill all new prescriptions your health care provider sends to us, as well as refills for prescriptions that have already been filled but are running out. If you wish to stay on this website, please click Cancel. Meridian Medicare Medicaid Plan h|kPQevkmNRIDrDI-)Vw*DYS7cgcr!349g3. The handbook will explain your rights, benefits, and responsibilities as a member of MeridianComplete. On weekends and on state or federal holidays, you may be asked to leave a message. Each link will open a new window and is either a PDF or a website. It will also explain our responsibilities to you, as well as outline the following details: The Annual Notice of Changes (ANOC) is a brief summary of benefits and benefit changes that occurred from one year to the next. This site contains various MeridianComplete (Medicare-Medicaid Plan) links and resources. Download the Member Handbook (PDF). Out-of-network/non-contracted providers are under no obligation to treat Meridian members, except in emergency situations. This is not a complete list. Representatives are available Monday-Friday, 8 a.m. to 8 p.m. to assist you. The call is free. Provider Network 6 When you go to file, youll want to write when and where the incident took place, and what happened. The call is free. Your handbook is full of important information about your health care and Meridian. 0000002131 00000 n PDF ILLINOIS MEMBER HANDBOOK - Meridian Illinois Managed Care Plans The benefit information is a brief summary, not a complete description of benefits. Out-of-network/non-contracted providers are under no obligation to treat Meridian members, except in emergency situations. With added benefitslike supportmakingsmart health choices, personal care coordination, 24-hour nursing help line, and more. v4P+r-k E`:8\TV%F1MeLT=LyMit+GYrUn*mH gp`x Y;EgPCSSphf>op!mOQtkC v^K#x" You can also visit the Illinois Client Enrollment Services website. If you need help finding a network provider and/or pharmacy, please call 1-855-580-1689 (TTY: 711) or visit mmp.ILmeridian.com to access our online searchable directory. Its full of tips and resources for pregnant members and new parents. If your address changes, let us know. Starting January 1, 2018, the Illinois Medicaid Managed Care Program is expanding to include all 167 0 obj <> endobj Los representantes estn disponibles para ayudarle de lunes a viernes de 8 a.m. a 8 p.m. Los fines de semana y los das feriados estatales o federales, es posible que se le solicite que deje un mensaje. An appeal is a way for you to ask for a review of our actions. The call is free. (los usuarios de TTY deben llamar al 711), lunes a domingo, de 8 a.m. a 8 p.m. La llamada es gratuita. Member Handbook | Meridian Health Plan of Illinois Making healthcare decisions can be tough--who to see for care, what to ask, when to go. %PDF-1.7 % Call 1-855-580-1689 (TTY: 711). Understanding the ins and outs of your health plan can be difficult. We are excited to share that MeridianCare, a WellCare company, is changing its name to WellCare, effective January 1, 2020! If you need help finding a network provider and/or pharmacy, please call 1-855-580-1689 (TTY: 711) or visit mmp.ILmeridian.com to access our online searchable directory. Meridian is for people eligible for both Medicaid and Medicare. Call Member Services if youd like paper copies of any of these documents. If you have any questions, call Meridian Member Services toll-free at 866-606-3700. Looking for your plan home page or interested in becoming a member? Want a paper copy? You will need Adobe Reader to open PDFs on this site. Monday-Friday, 8 a.m. to 8 p.m. CST 0000000016 00000 n Please call our Member Services number or see your Member Handbook for more information, including the cost-sharing that applies to out-of-network services. Keep in mind that everything you choose to share is confidential. The Member Handbook, along with your enrollment form, serves as MeridianCompletes contract with you. member.ILmeridian.com. We want you to be happy with your healthcare services. Catching a Breath Complex Case Management Flu Outreach Opioids fm.formularynavigator.com,medicare.entrykeyid.com,member.membersecurelogin.com,mmp.ilmeridian.com,findaprovider.mmp.ilmeridian.com,provider.mmp.mimeridian.com, You are now able to view your health information from a third-party app on a mobile device or PC! Language Assistance & Notice of Nondiscrimination, What is covered, including health care services, behavioral health coverage, prescription drug coverage, How to get the care you need, including the rules you must follow, Your rights and responsibilities as a member of our plan. Please call our Member Services number or see your Member Handbook for more information, including the cost-sharing that applies to out-of-network services. Call 1-855-580-1689 (TTY: 711). For other questions about Meridian, please contact Member Services at 1-855-580-1689 (TTY 711), Mondaythrough Friday from 8 a.m. to 8 p.m.On weekends and on state or federal holidays, you may be asked to leave a message. Please note that once you have left our website, you may be able to access portions of the contracted company's website that are not related to your plan. 0000040481 00000 n Los representantes estn disponibles para ayudarle de lunes a viernes de 8 a.m. a 8 p.m. Los fines de semana y los das feriados estatales o federales, es posible que se le solicite que deje un mensaje. You are now able to view your health information from a third-party app on a mobile device or PC! Llame al. Material ID:H6080_WEBSITE_2023_Accepted_09282022. You will be able to work with one health plan for all of your health insurance needs. Your call will be returned within the next business day. Other pharmacies/physicians/providers are available in our network. Meridian Medicare-Medicaid Plan (MMP) is a health plan that contracts with both Medicare and Illinois Medicaid to provide benefits of both programs to enrollees. 167 33 Want a paper copy? Please call our Member Services number or see your Member Handbook for more information, including the cost-sharing that applies to out-of-network services. 2390 0 obj <>/Filter/FlateDecode/ID[]/Index[2369 132]/Info 2368 0 R/Length 109/Prev 879097/Root 2370 0 R/Size 2501/Type/XRef/W[1 2 1]>>stream Copays for prescription drugs may vary based on the level of Extra Help you receive. Please note that once you have left our website, you may be able to access portions of the contracted company's website that are not related to your plan. You will need Adobe Reader to open PDFs on this site. ATENCIN: Si habla espaol, tiene a su disposicin servicios gratuitos de asistencia lingstica. 0000067553 00000 n Each link will open a new window and is either a PDF or a website. The Member Handbook, along with your enrollment form, serves as Meridian Medicare-Medicaid Plan's (MMP) contract with you. Your call will be returned within the next business day. You can enroll in Meridian by contacting Client Enrollment Services for the Illinois Department of Healthcare and Family Services at 1-877-912-8880 (TTY 1-866-565-8576), Monday through Friday from 8 a.m. to 7 p.m. The right care for you. Please visit our new website to see up to date information about your plan. Monday-Friday, 7:00 a.m. to 5:30 p.m. (TTY: 711) Ser vice area . Visit your Member Portal or call Member Services. PDF Welcome to MeridianHealth Intro to Plan 0000021917 00000 n 0000002177 00000 n The handbook will explain your rights, benefits, and responsibilities as a member of Meridian. 2022 Provider Manual (PDF) Meridian Provider Manual Errata Sheet (PDF) Documents and Forms Medical Referrals & Authorizations Pharmacy Billing Mandatory Training Attestation 0000151745 00000 n Other pharmacies/physicians/providers are available in our network. You can also file a grievance or appeal on the phone by calling Member Services or in writing via mail or fax. This site contains various Meridian Medicare-Medicaid Plan (MMP) links and resources. Making healthcare decisions can be tough--who to see for care, what to ask, when to go. Monday-Friday, 8 a.m. to 8 p.m. CST A certificate of coverage (COC) tells you what to expect from your healthcare plan. Each link will open a new window and is either a PDF or a website. Llame al 1-855-580-1689 (los usuarios de TTY deben llamar al 711). La llamada es gratis. Download the Member Handbook(PDF). Llame al 1-855-580-1689 (los usuarios de TTY deben llamar al 711). 0000041585 00000 n If you wish to stay on this website, please click Cancel. Don't forget to call your local HFS oce and Meridian Member Services with your new address. The List of Covered Drugs and/or pharmacy and provider networks may change throughout the year. Meridian will work with you to make sure you get all of the care you need, when you need it. +t x1Rdt!v8,1{1"sAS*.~Y|U:d\e6qXaI1,JSh\0y7x'zz|:nY\bnLM H\Bd ;,|Xt$Au*5Ndt:|_bLR[QcO?#VJ2VH n6 (_`/}^v}~/ OZ1?.9H Pl;-wrZi}wSzpibGlU}~/r B5[AuJL~2P1W^ j}Y@5( ?d 0000025639 00000 n Member Handbooks and Forms Please note that once you have left our website, you may be able to access portions of the contracted company's website that are not related to your plan. 3. You've got questions and we've got answers. providerhelp.IL@mhplan.com. If you wish to stay on this website, please click Cancel. 0000040678 00000 n If you are using a Meridian provider, you will not have to pay a plan premium, deductible, or copay. Important Phone Numbers & Contacts In an Emergency 911 Meridian Member Services 866-606-3700 View your Provider Manual, important plan information and more. If you wish to stay on this website, please click Cancel. Meridian Member Services . You can get this document in Spanish, or speak with someone about this information in other languages for free. You are leaving this website to go to a website managed by a contracted company, which provides service on our behalf. 0000041668 00000 n 2021 Member Handbook Illinois Counties: Cook, DuPage, Kane, Kankakee, Lake, Will . It outlines services and benefits that areand are notcovered. 0 If you need help finding a network provider and/or pharmacy, please call 1-855-580-1689 (TTY: 711) or visit mmp.ILmeridian.com to access our online searchable directory. 0000080946 00000 n fm.formularynavigator.com,medicare.entrykeyid.com,member.membersecurelogin.com,mmp.ilmeridian.com,findaprovider.mmp.ilmeridian.com,provider.mmp.mimeridian.com, Prior Authorization, Step Therapy and Quantity Limits, Coverage Determinations and Redeterminations for Drugs, 2022 IL Prior Authorization Fax Submission Forms - Inpatient (PDF), 2022 IL Prior Authorization Fax Submission Forms - Outpatient (PDF), 2020 MeridianComplete Authorization Lookup (PDF), Behavioral Health Discharge Transition of Care Form (PDF), HealthHelp and eviCore Provider Notification (PDF), Primary Care Provider Reassignment Form (PDF), Annual Care for Older Adults (COA) Form (PDF), Breast Cancer Screening Exclusion Form (PDF), Colorectal Cancer Screening Exclusion Form (PDF), Timely Submission of Encounter Data by Medicare-Medicaid Plans (MMPs) to CMS (PDF), Prohibition Billing Dually Eligible Individuals Enrolled in the Qualified Medicare Beneficiary (QMB) Program (PDF), Part D Coverage Determination Request Form (PDF), Part D Redetermination Request Form (PDF), Hospice Information for Medicare Part D plans (PDF), 2021 IL Prior Authorization Fax Submission Forms - Inpatient (PDF), 2021 IL Prior Authorization Fax Submission Forms - Outpatient (PDF), Partnership for Quality (P4Q Program) (PDF), Language Assistance & Notice of Nondiscrimination. If you would like a Provider/Pharmacy Directory mailed to you, you may call the number above, request one at the website link provided above, or email memberservices.mi@mhplan.com. 0000002041 00000 n All Rights Reserved. ATENCIN: Si habla espaol, tiene a su disposicin servicios gratuitos de asistencia lingstica. For more information contact the plan or read the MeridianComplete Member Handbook. window.location.replace("https://mmp.ilmeridian.com/member/benefits-coverage/whats-covered/member-handbook.html"); We are excited to share that MeridianCare, a WellCare company, is changing its name to WellCare, effective January 1, 2020! xref On weekends and on state or federal holidays, you may be asked to leave a message. See if you qualify, and explore the HealthChoice Illinois advantage. If your pregnancy is at high risk, we may call you. 0000001774 00000 n Out-of-network/non-contracted providers are under no obligation to treat Meridian members, except in emergency situations. endstream endobj startxref Call, Usted puede obtener gratuitamente este documento en espaol o hablar con alguien sobre esta informacin en otros idiomas. If you would like a Provider/Pharmacy Directory mailed to you, you may call the number above, request one at the website link provided above, or email memberservices.il@mhplan.com. If you have questions, please call MeridianComplete (Medicare-Medicaid Plan) Member Services at 1-855-580-1689 (TTY users should call 711). Call 1-855-580-1689 (TTY: 711). You can also visit the Illinois Client Enrollment Services website. https://www.illinois.gov/hfs/healthchoice/Pages/HealthPlans.aspx, https://www.illinois.gov/hfs/healthchoice/reportcard. Documents and Forms - Meridian Medicare Medicaid Plan JB Pritzker, Governor Theresa Eagleson, Director. 2500 0 obj <>stream Each link will open a new window and is either a PDF or a website. Find a doctor, explore coverage, review documents and much more. The Personal Wellness Assessment is a short form about you and your health journey. 0000002220 00000 n Prior Authorization, Step Therapy and Quantity Limits, Coverage Determinations and Redeterminations for Drugs, Notice of Nondiscrimination & Language Assistance. Download the Member Handbook (PDF). hbbd``b`R@AH&="> $ $= @+D C[} "Fod(AE+ PDF here's your member handbook. 0000041209 00000 n 0000010510 00000 n Check out the, Prior Authorization, Step Therapy and Quantity Limits, Coverage Determinations and Redeterminations for Drugs, Illinois Client Enrollment Services website, Language Assistance & Notice of Nondiscrimination. The Health Library is a free resource exclusively for MeridianComplete members and providers. 0000001708 00000 n Member Request for Reimbursement (PDF) Mandatory Training Attestation (PDF) Mandatory Training Attestation (PDF) Preventive Care (HEDIS) (PDF) Annual Care for Older Adults (COA) Form (PDF) Breast Cancer Screening Exclusion Form (PDF) Colorectal Cancer Screening Exclusion Form (PDF) Diabetes Exclusion Form (PDF) For more information contact the plan or read the Meridian Member Handbook. Please call our Member Services number or see your Member Handbook for more information, including the cost-sharing that applies to out-of-network services. MeridianComplete (Medicare-Medicaid Plan) is a health plan that contracts with both Medicare and Michigan Medicaid to provide benefits of both programs to enrollees. Report an address update to HFS online. You can join our Start Smart for Your Baby program. For more information, or to find out how to get enrolled, please contact Meridian at 888-437-0606. You also need to make sure that the Department of Healthcare & Family Services (HFS) has your new address. 1-855-580-1689 (TTY 711) %PDF-1.4 % For more information contact the plan or read the Meridian Member Handbook. If you need help finding a network provider and/or pharmacy, please call 1-855-323-4578 (TTY 711) or visit mmp.mimeridian.com to access our online searchable directory. Our Population Health Management Programs are offered to Meridian members and designed to improve your overall health and quality of care. For more information, call MeridianComplete Member Services or read the MeridianComplete Member Handbook. If you experience any problems receiving your mail order prescription, call Member Services at. For a more comprehensive description of the plan benefits, please refer to your Member Handbook which can also be found on this page. Representatives are available Monday-Friday, 8 a.m. to 8 p.m. to assist you. Please note that once you have left our website, you may be able to access portions of the contracted company's website that are not related to your plan. For a more comprehensive description of the plan benefits, please refer to your Member Handbook. Add a New Provider or Term an Existing Provider, Make a Change to an IRS Number or NPI Number, IMPORTANT NOTICE TO PROVIDERS REGARDING THE PURCHASE, BILLING AND ADMINISTRATION OF J CODE DRUGS IN THE OFFICE AND OUTPATIENT FACILITY SETTING, MeridianHealth Provider Information Regarding System Updates Effective July 1, 2021, Meridian Clinical Policy Readmission Review, Meridian of Illinois Announces Provider Relations Team Reorganization, Meridian of Illinois Partners with Jeremiah Development for LOVE Rockford Event, UPDATE PRACTICE INFORMATION USING THE MERIDIAN PROVIDER UPDATES TOOL, SUPPORT & RESOURCES FOR THOSE IMPACTED BY THE HIGHLAND PARK TRAGEDY ON JULY 4, Personal Wellness Assessment: English (PDF), Personal Wellness Assessment: Spanish (PDF), Member Notification of Pregnancy form(PDF), Meridian Managed Long Term Services & Supports Plan, Or if you receive the form by mail, complete it and send it back to us in the perpaid envelope. %%EOF MeridianHealth is now Meridian! On this page, youll learn more about your Member Handbook and some important forms that can help you understand your plan and get the care you need. For more information contact the plan or read the Meridian Member Handbook. Just call Member Services with your new address. 2369 0 obj <> endobj The call is free. The handbook will explain your rights, benefits, and responsibilities as a member of Meridian. Su llamada ser devuelta dentro del siguiente da hbil. All Rights Reserved. For information regarding our Pharmacy Benefit Manager (PBM), MeridianRx, visit the MeridianRx website. Click the link below to view or save a copy. Complete the Member Notification of Pregnancy(PDF) form in the Member Portal. <<0B5A082EC79D7049BD46C1656B63CA22>]/Prev 539953>> At the right time and place. Meridian covers all counties in Illinois. Meridian Medicare-Medicaid Plan (MMP) is a health plan that contracts with both Medicare and Illinois Medicaid to provide benefits of both programs to enrollees. Your Member Handbook is a great resource if you have any questions or just want to learn more about your coverage. MeridianComplete is a health plan that contracts with both Medicare and Illinois Medicaid to provide benefits of both programs to enrollees. 0000047422 00000 n Other pharmacies/physicians/providers are available in our network. Open Enrollment 6. You are leaving this website to go to a website managed by a contracted company, which provides service on our behalf. This way, we can connect you with the right care. With our Medicare-Medicaid Plan (MMP) youre getting: An assigned care manager to help answer questions and coordinate your care. We can connect you with support, services, and even rewards. fm.formularynavigator.com,medicare.entrykeyid.com,member.membersecurelogin.com,mmp.ilmeridian.com,findaprovider.mmp.ilmeridian.com,provider.mmp.mimeridian.com, Prior Authorization, Step Therapy and Quantity Limits, Coverage Determinations and Redeterminations for Drugs, 2022 Annual Notice of Changes - English (PDF), 2022 Notificacion Anual de Cambios - Spanish (PDF), 2023 Annual Notice of Changes - English (PDF), 2023 Notificacion Anual de Cambios - Spanish (PDF), Language Assistance & Notice of Nondiscrimination, What is covered, including health care services, behavioral health coverage, prescription drug coverage, How to get the care you need, including the rules you must follow, Your rights and responsibilities as a member of our plan. You can get this document for free in other formats, such as large print, braille, or audio. You are leaving this website to go to a website managed by a contracted company, which provides service on our behalf. 0000046799 00000 n Your call will be returned within the next business day. // ]]>. You will need Adobe Reader to open PDFs on this site. It will also explain our responsibilities to you, as well as outline the following details: The benefit information is a brief summary, not a complete description of benefits. For Members | Meridian We need to be able to send you important information in the mail. Member Handbook | Meridian Complete of Illinois ILLINOIS MEMBER HANDBOOK ILLINOIS MEMBER HANDBOOK EFFECTIVE DATE: July 1, 2021 MEMBER SERVICES: 866-821-2308 TTY/TDD: 711 ilmeridian.com ILLINOIS MLTSS 1 Welcome to MeridianHealth Managed Long Term Services and Supports (MLTSS) Welcome to MeridianHealth (Meridian)! 0000068680 00000 n Please turn on JavaScript and try again. 0 Member ID Cards 5. With HealthChoice Illinois, you have a health plan partner to turn to for help. 0000025980 00000 n For example, we may not approve your providers request for a certain drug. Fill out the Member Notification of Pregnancy form(PDF)to let us know if you are pregnant. Please call our Member Services number or see your Member Handbook for more information, including the cost-sharing that applies to out-of-network services. It also explains how to find care and how to earn rewards. View our Frequently Asked Questions page. Los representantes estn disponibles para ayudarle de lunes a viernes de 8 a.m. a 8 p.m. Los fines de semana y los das feriados estatales o federales, es posible que se le solicite que deje un mensaje. 1-855-580-1689 (TTY 711) 0000046966 00000 n It explains the medical, dental, vision, and pharmacy services that are covered by your plan. It also explains how to find care and how to earn rewards.

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