If your pregnancy is at high risk, we may call you. hKq?wNe?t!ARk;v6[IqK,h!i2jLnn}>^| ! Under our plan, you will have one card for your Medicare and Medicaid services, including long-term services and supports and prescriptions. Understanding the ins and outs of your health plan can be difficult. Just call Member Services with your new address. With added benefitslike supportmakingsmart health choices, personal care coordination, 24-hour nursing help line, and more. Your Member Handbook is a great resource if you have any questions or just want to learn more about your coverage. 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. With our Medicare-Medicaid Plan (MMP) youre getting: An assigned care manager to help answer questions and coordinate your care. 0000014634 00000 n Meridian will help make your Medicare and Medicaid benefits work better together and work better for you. The benefit information is a brief summary, not a complete description of benefits. ATENCIN: Si habla espaol, tiene a su disposicin servicios gratuitos de asistencia lingstica. Click the link below to view or save a copy. Out-of-network/non-contracted providers are under no obligation to treat MeridianComplete members, except in emergency situations. For more information, call MeridianComplete Member Services or read the MeridianComplete Member Handbook. https://www.illinois.gov/hfs/healthchoice/Pages/HealthPlans.aspx, https://www.illinois.gov/hfs/healthchoice/reportcard. 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. Meridian will work with you to make sure you get all of the care you need, when you need it. Su llamada ser devuelta dentro del siguiente da hbil. Your call will be returned within the next business day. Representatives are available Monday-Friday, 8 a.m. to 8 p.m. to assist you. For more information, or to find out how to get enrolled, please contact Meridian at 888-437-0606. On weekends and on state or federal holidays, you may be asked to leave a message. It also explains how to find care and how to earn rewards. Material ID:H6080_WEBSITE_2023_Accepted_09282022. Out-of-network/non-contracted providers are under no obligation to treat Meridian members, except in emergency situations. We need to be able to send you important information in the mail. 0000002041 00000 n You also need to make sure that the Department of Healthcare & Family Services (HFS) has your new address. Llame al 1-855-580-1689 (los usuarios de TTY deben llamar al 711). This site contains various MeridianComplete (Medicare-Medicaid Plan) links and resources. +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 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) // 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. 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. xref providerhelp.IL@mhplan.com. The Member Handbook, along with your enrollment form, serves as Meridian Medicare-Medicaid Plan's (MMP) contract with you. 0000068680 00000 n Your handbook is full of important information about your health care and Meridian. You are now able to view your health information from a third-party app on a mobile device or PC! 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 1-855-580-1689 (TTY: 711) or visit mmp.ILmeridian.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. You will need Adobe Reader to open PDFs on this site. 0000002131 00000 n On weekends and on state or federal holidays, you may be asked to leave a message. The right care for you. On weekends and on state or federal holidays, you may be asked to leave a message. This is not a complete list. You can get this document for free in other formats, such as large print, braille, or audio. If you have any questions, call Meridian Member Services toll-free at 866-606-3700. 3. It will also explain our responsibilities to you, as well as outline the following details: Please visit our new website to see up to date information about your plan. %PDF-1.4 % 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. It looks like your browser does not have JavaScript enabled. We want you to be happy with your healthcare services. 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. You can also file a grievance or appeal on the phone by calling Member Services or in writing via mail or fax. You are leaving this website to go to a website managed by a contracted company, which provides service on our behalf. For information regarding our Pharmacy Benefit Manager (PBM), MeridianRx, visit the MeridianRx website. 0000151745 00000 n Want a paper copy? 0000000016 00000 n 0000002074 00000 n Download the Member Handbook(PDF). For more information contact the plan or read the Meridian Member Handbook. Be sure to read your Meridian Member Handbook and keep it handy. Other pharmacies/physicians/providers are available in our network. HealthChoice Illinois is the smart way most Medicaid members get quality care. 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. Call MeridianComplete at 1-855-323-4578 (TTY users should call 711), 8 a.m to 8 p.m., seven days a week. Youll tell us about any health conditions, recent hospital visits, medications, and more. The benefit information is a brief summary, not a complete description of benefits. La llamada es gratis. Limitations, copays, and restrictions may apply. Meridian Medicare Medicaid Plan Copyright 2023 Meridian All Rights Reserved. Looking for your plan home page or interested in becoming a member? 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. Monday-Friday, 8 a.m. to 5 p.m. CST For example, we may not approve your providers request for a certain drug. The Health Library is a free resource exclusively for MeridianComplete members and providers. 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 Handbook | Meridian Complete of Illinois For a more comprehensive description of the plan benefits, please refer to your 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. 2369 0 obj <> endobj 2023 Learn more about how being a Meridian provider benefits 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. Su llamada ser devuelta dentro del siguiente da hbil. This is not a complete list. Call 1-855-580-1689 (TTY: 711). PDF <DATE> Program called HealthChoice Illinois . We have been working hard Catching a Breath Complex Case Management Flu Outreach Opioids 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. We want you to be happy with the treatment and services you get from Meridian and our providers. You will need Adobe Reader to open PDFs on this site. 0000006553 00000 n Member Handbook | Meridian Health Plan of Illinois Download the free version of Adobe Reader. Usually a mail-order pharmacy order will get to you in no more than 5 days. Want a paper copy? We will send you a notice before we make a change that affects you. Download the Member Handbook (PDF). You've got questions and we've got answers. 2021 Member Handbook Illinois Counties: Cook, DuPage, Kane, Kankakee, Lake, Will . Your call will be returned within the next business day. 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! Other pharmacies/physicians/providers are available in our network. You can get this document in Spanish, or speak with someone about this information in other languages for free. <<0B5A082EC79D7049BD46C1656B63CA22>]/Prev 539953>> 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. The List of Covered Drugs and/or pharmacy and provider networks may change throughout the year. The COC lays out all the details so that you can stay on top of your coverage. %PDF-1.7 % This site contains various Meridian Medicare-Medicaid Plan (MMP) links and resources. Find a doctor, explore coverage, review documents and much more. Member ID Cards 5. 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 wish to stay on this website, please click Cancel. Representatives are available Monday-Friday, 8 a.m. to 8 p.m. to assist you. 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. 0000046386 00000 n Su llamada ser devuelta dentro del siguiente da hbil. If you experience any problems receiving your mail order prescription, call Member Services at. 0000080946 00000 n For more information contact the plan or read the Meridian Member Handbook. The call is free. It also explains how to find care and how to earn rewards. 0000047422 00000 n The call is free. The Member Handbook, along with your enrollment form, serves as MeridianCompletes contract with you. 0000041209 00000 n This way, we can connect you with the right care. 2023 For certain kinds of drugs, you can use the plans network mail-order services. You are leaving this website to go to a website managed by a contracted company, which provides service on our behalf. You are leaving this website to go to a website managed by a contracted company, which provides service on our behalf. 0000017969 00000 n Making healthcare decisions can be tough--who to see for care, what to ask, when to go. Visit your Member Portal or call Member Services. Our Population Health Management Programs are offered to Meridian members and designed to improve your overall health and quality of care. If you wish to stay on this website, please click Cancel. MeridianHealth is now Meridian! A grievance is a complaint about a provider or about the quality of care or services you received. When you go to file, youll want to write when and where the incident took place, and what happened. Your Member Handbook is a great resource if you have any questions or just want to learn more about your coverage. 0000000956 00000 n v4P+r-k E`:8\TV%F1MeLT=LyMit+GYrUn*mH gp`x Y;EgPCSSphf>op!mOQtkC v^K#x" You will be able to work with one health plan for all of your health insurance needs. Material ID:H6080_WEBSITE_2023_Accepted_09282022. Llame al 1-855-580-1689 (los usuarios de TTY deben llamar al 711). The Member Handbook, along with your enrollment form, serves as Meridian Medicare-Medicaid Plan's (MMP) contract with you. 0000021917 00000 n We are excited to share that MeridianCare, a WellCare company, is changing its name to WellCare, effective January 1, 2020! Each link will open a new window and is either a PDF or a website. h|kPQevkmNRIDrDI-)Vw*DYS7cgcr!349g3. 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. An appeal is a way for you to ask for a review of our actions. PDF ILLINOIS MEMBER HANDBOOK - Meridian Illinois Managed Care Plans With HealthChoice Illinois, you have a health plan partner to turn to for help. For more information contact the plan or read the Meridian Member Handbook. Member Handbook - Meridian Medicare Medicaid Plan With added benefits like support making smart health choices, personal care coordination, 24-hour nursing help line, and more. Complete the Member Notification of Pregnancy(PDF) form in the Member Portal. If we fall short, you can file a grievance or appeal. member.ILmeridian.com. PDF Welcome to MeridianHealth Intro to 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. Meridian The Provider Manual has everything you need to know about member benefits, coverage, and provider guidelines. PDF here's your member handbook. 0000041585 00000 n 0000072727 00000 n Each link will open a new window and is either a PDF or a website. hbbd``b`R@AH&="> $ $= @+D C[} "Fod(AE+ This is not a complete list. Meridian Meridian Member Services . Meridian covers all counties in Illinois. The benefit information is a brief summary, not a complete description of benefits. 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. Your call will be returned within the next business day. It outlines services and benefits that areand are notcovered. Please review the various programs below. Keep in mind that everything you choose to share is confidential. HealthChoice Illinois | HFS Please turn on JavaScript and try again. 0000002177 00000 n We are excited to share that MeridianCare, a WellCare company, is changing its name to WellCare, effective January 1, 2020! 0000025980 00000 n If you are using a Meridian provider, you will not have to pay a plan premium, deductible, or copay. Representatives are available Monday-Friday, 8 a.m. to 8 p.m. to assist you. Moving? You will need Adobe Reader to open PDFs on this site. Open Enrollment 6. Making healthcare decisions can be tough--who to see for care, what to ask, when to go. Other pharmacies/physicians/providers are available in our network. All Rights Reserved. The Member Handbook, along with your enrollment form, serves asMeridian Medicare-Medicaid Plan's (MMP) contract with you. 0 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. Call 1-855-580-1689 (TTY: 711). 0000068208 00000 n Other pharmacies/physicians/providers are available in our network. %%EOF 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. The benefit information is a brief summary, not a complete description of benefits. providerhelp.IL@mhplan.com, The Interoperability and Patient Access Rule. There are a few ways to complete the form: We want you to have a safe, healthy, and happy pregnancy! 0000067553 00000 n It explains the medical, dental, vision, and pharmacy services that are covered by your plan. 866-606-3700 . View your Provider Manual, important plan information and more. It explains the medical, dental, vision, and pharmacy services that are covered by your plan. Copays for prescription drugs may vary based on the level of Extra Help you receive. Meridian is for people eligible for both Medicaid and Medicare. 2022 Provider Manual (PDF) Meridian Provider Manual Errata Sheet (PDF) Documents and Forms Medical Referrals & Authorizations Pharmacy Billing Mandatory Training Attestation Llame al 1-855-580-1689 (los usuarios de TTY deben llamar al 711). Call, Usted puede obtener gratuitamente este documento en espaol o hablar con alguien sobre esta informacin en otros idiomas. You can also visit the Illinois Client Enrollment Services website. If your address changes, let us know. You can get this document for free in other formats, such as large print, braille, or audio. You can also visit the Illinois Client Enrollment Services website. View our Frequently Asked Questions page. 2500 0 obj <>stream Monday-Friday, 8 a.m. to 8 p.m. CST It also explains how to find care and how to earn rewards. For Members | Meridian Call Member Services if youd like paper copies of any of these documents. JB Pritzker, Governor Theresa Eagleson, Director. 167 0 obj <> endobj You can get this document for free in other formats, such as large print, braille, or audio. 0000025639 00000 n The handbook will explain your rights, benefits, and responsibilities as a member of Meridian. 167 33 It explains the medical, dental, vision, and pharmacy services that are covered by your plan. 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. 0000046576 00000 n 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. At the right time and place. 0000046966 00000 n Your call will be returned within the next business day. This site contains various Meridian Medicare-Medicaid Plan (MMP) links and resources. On weekends and on state or federal holidays, you may be asked to leave a message. You can join our Start Smart for Your Baby program. It will also explain our responsibilities to you, as well as outline the following details: Call 1-855-580-1689 (TTY: 711). For a more comprehensive description of the plan benefits, please refer to your Member Handbook which can also be found on this page. Documents and Forms - Meridian Medicare Medicaid Plan 0000040678 00000 n 1-855-580-1689 (TTY 711) 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. You will need Adobe Reader to open PDFs on this site. You can make an appeal if you disagree with our verdict. 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. On weekends and on state or federal holidays, Each link will open a new window and is either a PDF or a website. 0000001774 00000 n The handbook will explain your rights, benefits, and responsibilities as a member of Meridian. The call is free. ATENCIN: Si habla espaol, tiene a su disposicin servicios gratuitos de asistencia lingstica. If you wish to stay on this website, please click Cancel. On weekends and on state or federal holidays, you may be asked to leave a message. Out-of-network/non-contracted providers are under no obligation to treat Meridian members, except in emergency situations. The call is free. 0000010510 00000 n Provider Manual | Meridian Health Plan of Illinois Check out the Interoperability page to learn more. 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.