Meridian covers all counties in Illinois. 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), Mondaythrough Friday from 8 a.m. to 7 p.m. All Rights Reserved. %PDF-1.4 % If your pregnancy is at high risk, we may call you. It explains the medical, dental, vision, and pharmacy services that are covered by your plan. <<0B5A082EC79D7049BD46C1656B63CA22>]/Prev 539953>> Call MeridianComplete at 1-855-323-4578 (TTY users should call 711), 8 a.m to 8 p.m., seven days a week. Want a paper copy? The call is free. You will need Adobe Reader to open PDFs on this site. 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. Providers - MeridianComplete 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. Important Phone Numbers & Contacts In an Emergency 911 Meridian Member Services 866-606-3700 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. Find a doctor, explore coverage, review documents and much more. Usually a mail-order pharmacy order will get to you in no more than 5 days. Representatives are available Monday-Friday, 8 a.m. to 8 p.m. to assist you. Monday-Friday, 8 a.m. to 8 p.m. CST You will need Adobe Reader to open PDFs on this site. Please contact the plan for more details. 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. The benefit information is a brief summary, not a complete description of benefits. Call 1-855-580-1689 (TTY: 711). With HealthChoice Illinois, you have a health plan partner to turn to for help. Please visit our new website to see up to date information about your plan. With our Medicare-Medicaid Plan (MMP) youre getting: An assigned care manager to help answer questions and coordinate your care. You can get this document for free in other formats, such as large print, braille, or audio. 0 1-855-580-1689 (TTY 711) The call is free. Your call will be returned within the next business day. (los usuarios de TTY deben llamar al 711), lunes a domingo, de 8 a.m. a 8 p.m. La llamada es gratuita. Call 1-855-580-1689 (TTY: 711). 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. Representatives are available Monday-Friday, 8 a.m. to 8 p.m. to assist you. Member ID Cards 5. Keep in mind that everything you choose to share is confidential. It explains the medical, dental, vision, and pharmacy services that are covered by your plan. 2500 0 obj <>stream 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. 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. 0 You can get this document for free in other formats, such as large print, braille, or audio. On weekends and on state or federal holidays, you may be asked to leave a message. The call is free. 0000041668 00000 n The Personal Wellness Assessment is a short form about you and your health journey. Meridian This way, we can connect you with the right care. The handbook will explain your rights, benefits, and responsibilities as a member of MeridianComplete. 0000047422 00000 n 0000017969 00000 n You will need Adobe Reader to open PDFs on this site. Your call will be returned within the next business day. Llame al 1-855-580-1689 (los usuarios de TTY deben llamar al 711). This handbook will help you understand your coverage. If you wish to stay on this website, please click Cancel. The COC lays out all the details so that you can stay on top of your coverage. For more information contact the plan or read the Meridian Member Handbook. This is not a complete list. [CDATA[ You are leaving this website to go to a website managed by a contracted company, which provides service on our behalf. Your Member Handbook is a great resource if you have any questions or just want to learn more about your coverage. 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. 0000040481 00000 n An appeal is a way for you to ask for a review of our actions. 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. It also explains how to find care and how to earn rewards. 0000002041 00000 n With HealthChoice Illinois, you have a health plan partner to turn to for help. The right care for you. You will need Adobe Reader to open PDFs on this site. Download the free version of Adobe Reader. Call, Usted puede obtener gratuitamente este documento en espaol o hablar con alguien sobre esta informacin en otros idiomas. 167 33 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)! If you are using a Meridian provider, you will not have to pay a plan premium, deductible, or copay. Member Handbooks and Forms Other pharmacies/physicians/providers are available in our network. Out-of-network/non-contracted providers are under no obligation to treat Meridian members, except in emergency situations. On weekends and on state or federal holidays, you may be asked to leave a message. 0000067354 00000 n It will also explain our responsibilities to you, as well as outline the following details: You also need to make sure that the Department of Healthcare & Family Services (HFS) has your new address. Documents and Forms - Meridian Medicare Medicaid Plan 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. 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. You are now able to view your health information from a third-party app on a mobile device or PC! 0000067553 00000 n We are excited to share that MeridianCare, a WellCare company, is changing its name to WellCare, effective January 1, 2020! 3. Prior Authorization, Step Therapy and Quantity Limits, Coverage Determinations and Redeterminations for Drugs, Notice of Nondiscrimination & Language Assistance. window.location.replace("https://mmp.ilmeridian.com/member/benefits-coverage/whats-covered/member-handbook.html"); Member Handbook | Meridian Complete of Illinois Copyright 2023 Meridian All Rights Reserved. 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. 0000002177 00000 n 0000072727 00000 n providerhelp.IL@mhplan.com, The Interoperability and Patient Access Rule. The handbook will explain your rights, benefits, and responsibilities as a member of Meridian. ATENCIN: Si habla espaol, tiene a su disposicin servicios gratuitos de asistencia lingstica. Limitations, copays, and restrictions may apply. This site contains various Meridian Medicare-Medicaid Plan (MMP) links and resources. %%EOF 866-606-3700 . The benefit information is a brief summary, not a complete description of benefits. 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. If you wish to stay on this website, please click Cancel. Material ID:H6080_WEBSITE_2023_Accepted_09282022. It looks like your browser does not have JavaScript enabled. Su llamada ser devuelta dentro del siguiente da hbil. 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 information regarding our Pharmacy Benefit Manager (PBM), MeridianRx, visit the MeridianRx website. It also explains how to find care and how to earn rewards. If you wish to stay on this website, please click Cancel. 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 If you have questions, please call MeridianComplete (Medicare-Medicaid Plan) Member Services at 1-855-580-1689 (TTY users should call 711). The benefit information is a brief summary, not a complete description of benefits. 0000002074 00000 n 1-855-580-1689 (TTY 711) Language Assistance & Notice of Nondiscrimination. It will also explain our responsibilities to you, as well as outline the following details: This site contains various Meridian Medicare-Medicaid Plan (MMP) links and resources. xref ATTENTION: If you speak a language other than English, language assistance services, free of charge, are available to you. It will also explain our responsibilities to you, as well as outline the following details: The handbook will explain your rights, benefits, and responsibilities as a member of Meridian. Want a paper copy? 0000040678 00000 n Copays for prescription drugs may vary based on the level of Extra Help you receive. Provider Manual | Meridian Health Plan of Illinois 0000000016 00000 n 0000001708 00000 n You are leaving this website to go to a website managed by a contracted company, which provides service on our behalf. 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. You will need Adobe Reader to open PDFs on this site. Llame al 1-855-580-1689 (los usuarios de TTY deben llamar al 711). Out-of-network/non-contracted providers are under no obligation to treat Meridian members, except in emergency situations. With added benefits like support making smart health choices, personal care coordination, 24-hour nursing help line, and more. Catching a Breath Complex Case Management Flu Outreach Opioids PDF here's your member handbook. The benefit information is a brief summary, not a complete description of benefits. 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. If your address changes, let us know. Out-of-network/non-contracted providers are under no obligation to treat Meridian members, except in emergency situations. Our Population Health Management Programs are offered to Meridian members and designed to improve your overall health and quality of care. // ]]>. On weekends and on state or federal holidays, you may be asked to leave a message. Download the Member Handbook (PDF). Monday-Friday, 8 a.m. to 8 p.m. CST We want you to be happy with the treatment and services you get from Meridian and our providers. You can get this document for free in other formats, such as large print, braille, or audio. 0000006553 00000 n La llamada es gratis. Monday-Friday, 7:00 a.m. to 5:30 p.m. (TTY: 711) Ser vice area . Moving? We are excited to share that MeridianCare, a WellCare company, is changing its name to WellCare, effective January 1, 2020! +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 PDF <DATE> Program called HealthChoice Illinois . We have been working hard Representatives are available Monday-Friday, 8 a.m. to 8 p.m. to assist you. We will send you a notice before we make a change that affects you. Other pharmacies/physicians/providers are available in our network. If you wish to stay on this website, please click Cancel. 0000010510 00000 n The List of Covered Drugs and/or pharmacy and provider networks may change throughout the year. Report an address update to HFS online. You can also file a grievance or appeal on the phone by calling Member Services or in writing via mail or fax. Provider Network 6 The handbook will explain your rights, benefits, and responsibilities as a member of Meridian. MeridianHealth is now Meridian! This is not a complete list. 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. Monday-Friday, 8 a.m. to 5 p.m. CST Learn more about how being a Meridian provider benefits you. 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. The Member Handbook, along with your enrollment form, serves as Meridian Medicare-Medicaid Plan's (MMP) contract with you. View your Provider Manual, important plan information and more. The call is free. // HealthChoice Illinois | HFS Your call will be returned within the next business day. This site contains various MeridianComplete (Medicare-Medicaid Plan) links and resources. Be sure to read your Meridian Member Handbook and keep it handy. Starting January 1, 2018, the Illinois Medicaid Managed Care Program is expanding to include all The handbook will explain your rights, benefits, and responsibilities as a member of Meridian. Meridian Member Services . 0000046576 00000 n Download the Member Handbook (PDF). 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. Youll tell us about any health conditions, recent hospital visits, medications, and more. All Rights Reserved. 0000041209 00000 n Want a paper copy? 0000001774 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. More information is in your Member Handbook(PDF). h|kPQevkmNRIDrDI-)Vw*DYS7cgcr!349g3. Each link will open a new window and is either a PDF or a website. v4P+r-k E`:8\TV%F1MeLT=LyMit+GYrUn*mH gp`x Y;EgPCSSphf>op!mOQtkC v^K#x" We want you to be happy with your healthcare services. There are a few ways to complete the form: We want you to have a safe, healthy, and happy pregnancy! For a more comprehensive description of the plan benefits, please refer to your Member Handbook. endstream endobj 2370 0 obj <>/Metadata 260 0 R/Names 2392 0 R/OpenAction 2371 0 R/Outlines 2412 0 R/PageLayout/SinglePage/PageMode/UseOutlines/Pages 2360 0 R/StructTreeRoot 410 0 R/Type/Catalog/ViewerPreferences<>>> endobj 2371 0 obj <> endobj 2372 0 obj <. For example, we may not approve your providers request for a certain drug. View our Frequently Asked Questions page. Check out the Interoperability page to learn more. The Member Handbook, along with your enrollment form, serves as Meridian Medicare-Medicaid Plan's (MMP) contract with you. You are leaving this website to go to a website managed by a contracted company, which provides service on our behalf. 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. ATENCIN: Si habla espaol, tiene a su disposicin servicios gratuitos de asistencia lingstica. Making healthcare decisions can be tough--who to see for care, what to ask, when to go. Your Member Handbook is a great resource if you have any questions or just want to learn more about your coverage. Call Member Services if youd like paper copies of any of these documents. Complete the Member Notification of Pregnancy(PDF) form in the Member Portal. Understanding the ins and outs of your health plan can be difficult. When you go to file, youll want to write when and where the incident took place, and what happened. For more information contact the plan or read the MeridianComplete Member Handbook. 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. 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. La llamada es gratis. For more information, or to find out how to get enrolled, please contact Meridian at 888-437-0606. 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. 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. Other pharmacies/physicians/providers are available in our network. HealthChoice Illinois is the smart way most Medicaid members get quality care. A certificate of coverage (COC) tells you what to expect from your healthcare plan. hKq?wNe?t!ARk;v6[IqK,h!i2jLnn}>^| ! 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. 2022 Provider Manual (PDF) Meridian Provider Manual Errata Sheet (PDF) Documents and Forms Medical Referrals & Authorizations Pharmacy Billing Mandatory Training Attestation You can also visit the Illinois Client Enrollment Services website. JB Pritzker, Governor Theresa Eagleson, Director. MeridianComplete (Medicare-Medicaid Plan) is a health plan that contracts with both Medicare and Michigan Medicaid to provide benefits of both programs to enrollees. On weekends and on state or federal holidays, Llame al. At the right time and place. 0000068680 00000 n On weekends and on state or federal holidays, you may be asked to leave a message.
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