View your Provider Manual, important plan information and more. 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. All Rights Reserved. MeridianHealth is now Meridian! Limitations, copays, and restrictions may apply. The handbook will explain your rights, benefits, and responsibilities as a member of Meridian. 167 0 obj <> endobj 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. 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. We are excited to share that MeridianCare, a WellCare company, is changing its name to WellCare, effective January 1, 2020! For more information contact the plan or read the MeridianComplete Member Handbook. HealthChoice Illinois is the smart way most Medicaid members get quality care. 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. All Rights Reserved. 866-606-3700 . %PDF-1.7 % The COC lays out all the details so that you can stay on top of your coverage. 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. Monday-Friday, 8 a.m. to 8 p.m. CST The call is free. For information regarding our Pharmacy Benefit Manager (PBM), MeridianRx, visit the MeridianRx website. 0000002074 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. When you go to file, youll want to write when and where the incident took place, and what happened. 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. The handbook will explain your rights, benefits, and responsibilities as a member of MeridianComplete. 3. 0000040481 00000 n Click the link below to view or save a copy. For more information contact the plan or read the Meridian Member Handbook. A grievance is a complaint about a provider or about the quality of care or services you received. 0000002041 00000 n Looking for your plan home page or interested in becoming a member? 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. Want a paper copy? Monday-Friday, 7:00 a.m. to 5:30 p.m. (TTY: 711) Ser vice area . Moving? 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. You will need Adobe Reader to open PDFs on this site. 0000000016 00000 n You can also visit the Illinois Client Enrollment Services website. Monday-Friday, 8 a.m. to 8 p.m. CST With HealthChoice Illinois, you have a health plan partner to turn to for help. Each link will open a new window and is either a PDF or a website. This site contains various Meridian Medicare-Medicaid Plan (MMP) links and resources. Starting January 1, 2018, the Illinois Medicaid Managed Care Program is expanding to include all You can make an appeal if you disagree with our verdict. With HealthChoice Illinois, you have a health plan partner to turn to for help. 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. 0000072727 00000 n 0000067354 00000 n h|kPQevkmNRIDrDI-)Vw*DYS7cgcr!349g3. If you wish to stay on this website, please click Cancel. 0000047422 00000 n Out-of-network/non-contracted providers are under no obligation to treat Meridian members, except in emergency situations. Download the Member Handbook(PDF). We want you to be happy with your healthcare services. Our Population Health Management Programs are offered to Meridian members and designed to improve your overall health and quality of care. We are excited to share that MeridianCare, a WellCare company, is changing its name to WellCare, effective January 1, 2020! v4P+r-k E`:8\TV%F1MeLT=LyMit+GYrUn*mH gp`x Y;EgPCSSphf>op!mOQtkC v^K#x" ATENCIN: Si habla espaol, tiene a su disposicin servicios gratuitos de asistencia lingstica. 2023 It will also explain our responsibilities to you, as well as outline the following details: 0000068208 00000 n More information is in your Member Handbook(PDF). Monday-Friday, 8 a.m. to 5 p.m. CST 0000041668 00000 n Youll tell us about any health conditions, recent hospital visits, medications, and more. 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. trailer %PDF-1.4 % Meridian will work with you to make sure you get all of the care you need, when you need it. Call MeridianComplete at 1-855-323-4578 (TTY users should call 711), 8 a.m to 8 p.m., seven days a week. On weekends and on state or federal holidays, you may be asked to leave a message. On weekends and on state or federal holidays, you may be asked to leave a message. It will also explain our responsibilities to you, as well as outline the following details: Meridian will help make your Medicare and Medicaid benefits work better together and work better for you. 0000151745 00000 n It will help you get the care you need. Your call will be returned within the next business day. This site contains various MeridianComplete (Medicare-Medicaid Plan) links and resources. endstream endobj startxref We want you to be happy with the treatment and services you get from Meridian and our providers. This is not a complete list. Report an address update to HFS online. You can get this document for free in other formats, such as large print, braille, or audio. xref The handbook will explain your rights, benefits, and responsibilities as a member of Meridian. 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. 0000000956 00000 n Your Member Handbook is a great resource if you have any questions or just want to learn more about your coverage. 0000068680 00000 n MeridianComplete is a health plan that contracts with both Medicare and Illinois Medicaid to provide benefits of both programs to enrollees. Representatives are available Monday-Friday, 8 a.m. to 8 p.m. to assist you. 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. 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. Important Phone Numbers & Contacts In an Emergency 911 Meridian Member Services 866-606-3700 The List of Covered Drugs and/or pharmacy and provider networks may change throughout the year. With added benefitslike supportmakingsmart health choices, personal care coordination, 24-hour nursing help line, and more. 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! The handbook will explain your rights, benefits, and responsibilities as a member of Meridian. 0000041585 00000 n You are now able to view your health information from a third-party app on a mobile device or PC! %%EOF You are leaving this website to go to a website managed by a contracted company, which provides service on our behalf. 0000067553 00000 n You can get this document in Spanish, or speak with someone about this information in other languages for free. Just call Member Services with your new address. 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. 0000001708 00000 n Llame al 1-855-580-1689 (los usuarios de TTY deben llamar al 711). It looks like your browser does not have JavaScript enabled. It explains the medical, dental, vision, and pharmacy services that are covered by your plan. 0 A certificate of coverage (COC) tells you what to expect from your healthcare plan. 0000017969 00000 n At the right time and place. Member ID Cards 5. providerhelp.IL@mhplan.com, The Interoperability and Patient Access Rule. 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.il@mhplan.com. Su llamada ser devuelta dentro del siguiente da hbil. The benefit information is a brief summary, not a complete description of benefits. We will send you a notice before we make a change that affects you. Call, Usted puede obtener gratuitamente este documento en espaol o hablar con alguien sobre esta informacin en otros idiomas. Your call will be returned within the next business day. MeridianComplete (Medicare-Medicaid Plan) is a health plan that contracts with both Medicare and Michigan Medicaid to provide benefits of both programs to enrollees. 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) You are leaving this website to go to a website managed by a contracted company, which provides service on our behalf. Making healthcare decisions can be tough--who to see for care, what to ask, when to go. This is not a complete list. The Member Handbook, along with your enrollment form, serves as Meridian Medicare-Medicaid Plan's (MMP) contract with you. 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. 0000046799 00000 n Catching a Breath Complex Case Management Flu Outreach Opioids Call 1-855-580-1689 (TTY: 711). There are a few ways to complete the form: We want you to have a safe, healthy, and happy pregnancy! startxref 0000014634 00000 n 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. Out-of-network/non-contracted providers are under no obligation to treat Meridian members, except in emergency situations. (los usuarios de TTY deben llamar al 711), lunes a domingo, de 8 a.m. a 8 p.m. La llamada es gratuita. 2021 Member Handbook Illinois Counties: Cook, DuPage, Kane, Kankakee, Lake, Will . Fill out the Member Notification of Pregnancy form(PDF)to let us know if you are pregnant. On weekends and on state or federal holidays, you may be asked to leave a message. Meridian covers all counties in Illinois. 0000046576 00000 n La llamada es gratis. You will need Adobe Reader to open PDFs on this site. 167 33 It also explains how to find care and how to earn rewards. Visit your Member Portal or call Member Services. You can also visit the Illinois Client Enrollment Services website. Meridian Member Services . Please turn on JavaScript and try again. We need to be able to send you important information in the mail. For a more comprehensive description of the plan benefits, please refer to your Member Handbook which can also be found on this page. 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 call is free. The Member Handbook, along with your enrollment form, serves as Meridian Medicare-Medicaid Plan's (MMP) contract with you. [CDATA[ Su llamada ser devuelta dentro del siguiente da hbil. The Health Library is a free resource exclusively for MeridianComplete members and providers. // endobj 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. Each link will open a new window and is either a PDF or a website. This site contains various Meridian Medicare-Medicaid Plan (MMP) links and resources. For more information contact the plan or read the Meridian Member Handbook. Meridian 1-855-580-1689 (TTY 711) 199 0 obj <>stream Open Enrollment 6. You can get this document for free in other formats, such as large print, braille, or audio. 2022 Provider Manual (PDF) Meridian Provider Manual Errata Sheet (PDF) Documents and Forms Medical Referrals & Authorizations Pharmacy Billing Mandatory Training Attestation 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. Want a paper copy? See if you qualify, and explore the HealthChoice Illinois advantage. Meridian is for people eligible for both Medicaid and Medicare. With our Medicare-Medicaid Plan (MMP) youre getting: An assigned care manager to help answer questions and coordinate your care. providerhelp.IL@mhplan.com. ATTENTION: If you speak a language other than English, language assistance services, free of charge, are available to you. 0000080946 00000 n The right care for you. Its full of tips and resources for pregnant members and new parents. Llame al 1-855-580-1689 (los usuarios de TTY deben llamar al 711). Llame al. Your call will be returned within the next business day. The call is free. If your pregnancy is at high risk, we may call you. Please contact the plan for more details. Language Assistance & Notice of Nondiscrimination. If we fall short, you can file a grievance or appeal. You've got questions and we've got answers. Out-of-network/non-contracted providers are under no obligation to treat Meridian members, except in emergency situations. La llamada es gratis. 0000010510 00000 n This handbook will help you understand your coverage. The Member Handbook, along with your enrollment form, serves asMeridian Medicare-Medicaid Plan's (MMP) contract with you. It explains the medical, dental, vision, and pharmacy services that are covered by your plan. Other pharmacies/physicians/providers are available in our network. 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. %%EOF 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. <<0B5A082EC79D7049BD46C1656B63CA22>]/Prev 539953>> 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. 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. Su llamada ser devuelta dentro del siguiente da hbil. 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. 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. It outlines services and benefits that areand are notcovered. Your call will be returned within the next business day. The Member Handbook, along with your enrollment form, serves as MeridianCompletes contract with you. The call is free. If you wish to stay on this website, please click Cancel. 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. Material ID:H6080_WEBSITE_2023_Accepted_09282022. ATENCIN: Si habla espaol, tiene a su disposicin servicios gratuitos de asistencia lingstica. 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. 0000046966 00000 n 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. On weekends and on state or federal holidays, you may be asked to leave a message. 0000006553 00000 n 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. If you wish to stay on this website, please click Cancel. For example, we may not approve your providers request for a certain drug. For more information, or to find out how to get enrolled, please contact Meridian at 888-437-0606. We can connect you with support, services, and even rewards. For more information contact the plan or read the Meridian Member Handbook. Call 1-855-580-1689 (TTY: 711). Download the Member Handbook (PDF). La llamada es gratis. Want a paper copy? Download the Member Handbook (PDF). member.ILmeridian.com. 0 An appeal is a way for you to ask for a review of our actions. hKq?wNe?t!ARk;v6[IqK,h!i2jLnn}>^| ! 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 call is free. Understanding the ins and outs of your health plan can be difficult. The call is free. It explains the medical, dental, vision, and pharmacy services that are covered by your plan. For certain kinds of drugs, you can use the plans network mail-order services. 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. 0000002131 00000 n The benefit information is a brief summary, not a complete description of benefits. This is not a complete list. You can also file a grievance or appeal on the phone by calling Member Services or in writing via mail or fax. HFS sends paperwork in the mail that you need to renew your Medicaid coverage. 0000025639 00000 n 0000041209 00000 n Your call will be returned within the next business day. This way, we can connect you with the right care. Find a doctor, explore coverage, review documents and much more. Call 1-855-580-1689 (TTY: 711). Out-of-network/non-contracted providers are under no obligation to treat MeridianComplete members, except in emergency situations. 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 Llame al 1-855-580-1689 (los usuarios de TTY deben llamar al 711). The Personal Wellness Assessment is a short form about you and your health journey. You can get this document for free in other formats, such as large print, braille, or audio. If you experience any problems receiving your mail order prescription, call Member Services at. If your address changes, let us know. 1-855-580-1689 (TTY 711) Please review the various programs below. 0000040678 00000 n View our Frequently Asked Questions page. If you have questions, please call MeridianComplete (Medicare-Medicaid Plan) Member Services at 1-855-580-1689 (TTY users should call 711). The handbook will explain your rights, benefits, and responsibilities as a member of Meridian. The Member Handbook, along with your enrollment form, serves as Meridian Medicare-Medicaid Plan's (MMP) contract with you. Copays for prescription drugs may vary based on the level of Extra Help you receive. Material ID:H6080_WEBSITE_2023_Accepted_09282022. Representatives are available Monday-Friday, 8 a.m. to 8 p.m. to assist you. Don't forget to call your local HFS oce and Meridian Member Services with your new address. JB Pritzker, Governor Theresa Eagleson, Director. Provider Network 6 Call Member Services if youd like paper copies of any of these documents. window.location.replace("https://mmp.ilmeridian.com/member/benefits-coverage/whats-covered/member-handbook.html"); You will need Adobe Reader to open PDFs on this site. 0000001774 00000 n Complete the Member Notification of Pregnancy(PDF) form in the Member Portal. 0000046386 00000 n 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 <. Other pharmacies/physicians/providers are available in our network. ATENCIN: Si habla espaol, tiene a su disposicin servicios gratuitos de asistencia lingstica. // ]]>. You are leaving this website to go to a website managed by a contracted company, which provides service on our behalf. The Provider Manual has everything you need to know about member benefits, coverage, and provider guidelines. For a more comprehensive description of the plan benefits, please refer to your Member Handbook. 2023 Other pharmacies/physicians/providers are available in our network. 1-855-580-1689 (TTY 711) 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)! Keep in mind that everything you choose to share is confidential. Each link will open a new window and is either a PDF or a website. Under our plan, you will have one card for your Medicare and Medicaid services, including long-term services and supports and prescriptions. Your call will be returned within the next business day. It also explains how to find care and how to earn rewards. Learn more about how being a Meridian provider benefits you. You can join our Start Smart for Your Baby program. Usually a mail-order pharmacy order will get to you in no more than 5 days. Be sure to read your Meridian Member Handbook and keep it handy. Check out the Interoperability page to learn more. Representatives are available Monday-Friday, 8 a.m. to 8 p.m. to assist you. You are leaving this website to go to a website managed by a contracted company, which provides service on our behalf. If you wish to stay on this website, please click Cancel. The benefit information is a brief summary, not a complete description of benefits. 0000002220 00000 n Other pharmacies/physicians/providers are available in our network. +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
meridian illinois member handbook
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