meridian illinois member handbook

%PDF-1.7 % Check out the Interoperability page to learn more. Other pharmacies/physicians/providers are available in our network. 1-855-580-1689 (TTY 711) The benefit information is a brief summary, not a complete description of benefits. The benefit information is a brief summary, not a complete description of benefits. %PDF-1.4 % Find a doctor, explore coverage, review documents and much more. 0000151745 00000 n Meridian is for people eligible for both Medicaid and Medicare. Member ID Cards 5. 1-855-580-1689 (TTY 711) If you have any questions, call Meridian Member Services toll-free at 866-606-3700. 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 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. Monday-Friday, 8 a.m. to 8 p.m. CST Want a paper copy? Out-of-network/non-contracted providers are under no obligation to treat Meridian members, except in emergency situations. Limitations, copays, and restrictions may apply. 0000002041 00000 n 167 0 obj <> endobj 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. If you wish to stay on this website, please click Cancel. Making healthcare decisions can be tough--who to see for care, what to ask, when to go. This is not a complete list. For more information contact the plan or read the MeridianComplete Member Handbook. When you go to file, youll want to write when and where the incident took place, and what happened. Llame al 1-855-580-1689 (los usuarios de TTY deben llamar al 711). ATTENTION: If you speak a language other than English, language assistance services, free of charge, are available to you. Download the Member Handbook(PDF). Monday-Friday, 8 a.m. to 5 p.m. CST It also explains how to find care and how to earn rewards. You've got questions and we've got answers. Report an address update to HFS online. Monday-Friday, 7:00 a.m. to 5:30 p.m. (TTY: 711) Ser vice area . %%EOF All Rights Reserved. 0000000956 00000 n // ]]>. Don't forget to call your local HFS oce and Meridian Member Services with your new address. Please turn on JavaScript and try again. The Member Handbook, along with your enrollment form, serves as Meridian Medicare-Medicaid Plan's (MMP) contract with you. Call 1-855-580-1689 (TTY: 711). Please contact the plan for more details. Out-of-network/non-contracted providers are under no obligation to treat MeridianComplete members, except in emergency situations. Llame al 1-855-580-1689 (los usuarios de TTY deben llamar al 711). 2022 Provider Manual (PDF) Meridian Provider Manual Errata Sheet (PDF) Documents and Forms Medical Referrals & Authorizations Pharmacy Billing Mandatory Training Attestation You can get this document for free in other formats, such as large print, braille, or audio. 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). Be sure to read your Meridian Member Handbook and keep it handy. The call is free. For example, we may not approve your providers request for a certain drug. It will also explain our responsibilities to you, as well as outline the following details: Usually a mail-order pharmacy order will get to you in no more than 5 days. Meridian covers all counties in Illinois. All Rights Reserved. Material ID:H6080_WEBSITE_2023_Accepted_09282022. 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. With HealthChoice Illinois, you have a health plan partner to turn to for help. You are now able to view your health information from a third-party app on a mobile device or PC! Material ID:H6080_WEBSITE_2023_Accepted_09282022. This site contains various Meridian Medicare-Medicaid Plan (MMP) links and resources. Each link will open a new window and is either a PDF or a website. The benefit information is a brief summary, not a complete description of benefits. We want you to be happy with the treatment and services you get from Meridian and our providers. The handbook will explain your rights, benefits, and responsibilities as a member of Meridian. Your call will be returned within the next business day. The handbook will explain your rights, benefits, and responsibilities as a member of MeridianComplete. 1-855-580-1689 (TTY 711) Prior Authorization, Step Therapy and Quantity Limits, Coverage Determinations and Redeterminations for Drugs, Notice of Nondiscrimination & Language Assistance. It will help you get the care you need. If you wish to stay on this website, please click Cancel. 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. This site contains various MeridianComplete (Medicare-Medicaid Plan) links and resources. Each link will open a new window and is either a PDF or a website. Each link will open a new window and is either a PDF or a website. You can also visit the Illinois Client Enrollment Services website. Visit your Member Portal or call Member Services. 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. This way, we can connect you with the right care. The Member Handbook, along with your enrollment form, serves asMeridian Medicare-Medicaid Plan's (MMP) contract with you. You also need to make sure that the Department of Healthcare & Family Services (HFS) has your new address. 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 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. If your pregnancy is at high risk, we may call you. It also explains how to find care and how to earn rewards. We can connect you with support, services, and even rewards. We will send you a notice before we make a change that affects you. 0000041209 00000 n You can get this document in Spanish, or speak with someone about this information in other languages for free. ATENCIN: Si habla espaol, tiene a su disposicin servicios gratuitos de asistencia lingstica. You can join our Start Smart for Your Baby program. More information is in your Member Handbook(PDF). 0000017969 00000 n The COC lays out all the details so that you can stay on top of your coverage. ATENCIN: Si habla espaol, tiene a su disposicin servicios gratuitos de asistencia lingstica. 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. 0000046966 00000 n It explains the medical, dental, vision, and pharmacy services that are covered by your 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. Su llamada ser devuelta dentro del siguiente da hbil. Copyright 2023 Meridian All Rights Reserved. xref This site contains various Meridian Medicare-Medicaid Plan (MMP) links and resources. 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 explains the medical, dental, vision, and pharmacy services that are covered by your plan. Understanding the ins and outs of your health plan can be difficult. The call is free. 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. 0000047422 00000 n The benefit information is a brief summary, not a complete description of benefits. If you wish to stay on this website, please click Cancel. 866-606-3700 . JB Pritzker, Governor Theresa Eagleson, Director. 0000002220 00000 n Monday-Friday, 8 a.m. to 8 p.m. CST 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. 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. hKq?wNe?t!ARk;v6[IqK,h!i2jLnn}>^| ! Making healthcare decisions can be tough--who to see for care, what to ask, when to go. 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. Important Phone Numbers & Contacts In an Emergency 911 Meridian Member Services 866-606-3700 0000068680 00000 n 0000025980 00000 n providerhelp.IL@mhplan.com, The Interoperability and Patient Access Rule. View your Provider Manual, important plan information and more. Meridian 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 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. Our Population Health Management Programs are offered to Meridian members and designed to improve your overall health and quality of care. Llame al. HFS sends paperwork in the mail that you need to renew your Medicaid coverage. Please visit our new website to see up to date information about your plan. 199 0 obj <>stream 0000046386 00000 n Click the link below to view or save a copy. You will need Adobe Reader to open PDFs on this site. 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. For a more comprehensive description of the plan benefits, please refer to your Member Handbook which can also be found on this page. 0000006553 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. 0000010510 00000 n You can get this document for free in other formats, such as large print, braille, or audio. Catching a Breath Complex Case Management Flu Outreach Opioids See if you qualify, and explore the HealthChoice Illinois advantage. La llamada es gratis. You will need Adobe Reader to open PDFs on this site. HealthChoice Illinois is the smart way most Medicaid members get quality care. member.ILmeridian.com. 2500 0 obj <>stream 0000068208 00000 n The Member Handbook, along with your enrollment form, serves as Meridian Medicare-Medicaid Plan's (MMP) contract with you. You can make an appeal if you disagree with our verdict. Your Member Handbook is a great resource if you have any questions or just want to learn more about your coverage. Just call Member Services with your new address. [CDATA[ 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. On weekends and on state or federal holidays, you may be asked to leave a message. 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! If your address changes, let us know. Please review the various programs below. Complete the Member Notification of Pregnancy(PDF) form in the Member Portal. Your call will be returned within the next business day. Learn more about how being a Meridian provider benefits you. (los usuarios de TTY deben llamar al 711), lunes a domingo, de 8 a.m. a 8 p.m. La llamada es gratuita. The right care for you. Call Member Services if youd like paper copies of any of these documents. 0000040481 00000 n Provider Network 6 Copays for prescription drugs may vary based on the level of Extra Help you receive. 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. The handbook will explain your rights, benefits, and responsibilities as a member of Meridian. 0000046576 00000 n You are leaving this website to go to a website managed by a contracted company, which provides service on our behalf. You will need Adobe Reader to open PDFs on this site. 0000080946 00000 n On weekends and on state or federal holidays, you may be asked to leave a message. 0000041668 00000 n Representatives are available Monday-Friday, 8 a.m. to 8 p.m. to assist you. Looking for your plan home page or interested in becoming a member? For information regarding our Pharmacy Benefit Manager (PBM), MeridianRx, visit the MeridianRx website. Your call will be returned within the next business day. On weekends and on state or federal holidays, Under our plan, you will have one card for your Medicare and Medicaid services, including long-term services and supports and prescriptions. 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. 0000025639 00000 n trailer A certificate of coverage (COC) tells you what to expect from your healthcare plan. It also explains how to find care and how to earn rewards. La llamada es gratis. 0000002131 00000 n You can also file a grievance or appeal on the phone by calling Member Services or in writing via mail or fax. Representatives are available Monday-Friday, 8 a.m. to 8 p.m. to assist you. This is not a complete list. 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. The call is free. +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 Su llamada ser devuelta dentro del siguiente da hbil. 0000002074 00000 n Open Enrollment 6. We want you to be happy with your healthcare services. 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. We are excited to share that MeridianCare, a WellCare company, is changing its name to WellCare, effective January 1, 2020! // /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 <. It looks like your browser does not have JavaScript enabled. Your handbook is full of important information about your health care and Meridian. It outlines services and benefits that areand are notcovered. The List of Covered Drugs and/or pharmacy and provider networks may change throughout the year. The call is free. 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. Other pharmacies/physicians/providers are available in our network. Its full of tips and resources for pregnant members and new parents. <<0B5A082EC79D7049BD46C1656B63CA22>]/Prev 539953>> This is not a complete list. Your Member Handbook is a great resource if you have any questions or just want to learn more about your coverage. Download the Member Handbook (PDF). At the right time and place. 3. This is not a complete list. 0000001708 00000 n The Personal Wellness Assessment is a short form about you and your health journey. For more information, call MeridianComplete Member Services or read the MeridianComplete Member Handbook. 2369 0 obj <> endobj 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. Want a paper copy? 0000014634 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. hbbd``b`R@AH&="> $ $= @+D C[} "Fod(AE+ A grievance is a complaint about a provider or about the quality of care or services you received. 2023 There are a few ways to complete the form: We want you to have a safe, healthy, and happy pregnancy! The handbook will explain your rights, benefits, and responsibilities as a member of Meridian. Your call will be returned within the next business day. 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 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 you are using a Meridian provider, you will not have to pay a plan premium, deductible, or copay. 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. Out-of-network/non-contracted providers are under no obligation to treat Meridian members, except in emergency situations. Your call will be returned within the next business day. 0000046799 00000 n 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)! 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. 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 Meridian You are leaving this website to go to a website managed by a contracted company, which provides service on our behalf. Moving? 0000067553 00000 n 0000041585 00000 n Download the Member Handbook (PDF). 0000000016 00000 n Call MeridianComplete at 1-855-323-4578 (TTY users should call 711), 8 a.m to 8 p.m., seven days a week. 2023 The Member Handbook, along with your enrollment form, serves as Meridian Medicare-Medicaid Plan's (MMP) contract with you. You can also visit the Illinois Client Enrollment Services website. 2021 Member Handbook Illinois Counties: Cook, DuPage, Kane, Kankakee, Lake, Will . %%EOF 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. Out-of-network/non-contracted providers are under no obligation to treat Meridian members, except in emergency situations. The Member Handbook, along with your enrollment form, serves as MeridianCompletes contract with you. Want a paper copy? You will be able to work with one health plan for all of your health insurance needs. MeridianComplete (Medicare-Medicaid Plan) is a health plan that contracts with both Medicare and Michigan Medicaid to provide benefits of both programs to enrollees. Fill out the Member Notification of Pregnancy form(PDF)to let us know if you are pregnant. 0000067354 00000 n 0000072727 00000 n For a more comprehensive description of the plan benefits, please refer to your Member Handbook. Keep in mind that everything you choose to share is confidential. If you have questions, please call MeridianComplete (Medicare-Medicaid Plan) Member Services at 1-855-580-1689 (TTY users should call 711). 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. 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. ATENCIN: Si habla espaol, tiene a su disposicin servicios gratuitos de asistencia lingstica. View our Frequently Asked Questions page. v4P+r-k E`:8\TV%F1MeLT=LyMit+GYrUn*mH gp`x Y;EgPCSSphf>op!mOQtkC v^K#x" h|kPQevkmNRIDrDI-)Vw*DYS7cgcr!349g3. 0000001774 00000 n La llamada es gratis. 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. Download the free version of Adobe Reader. For more information contact the plan or read the Meridian Member Handbook. The handbook will explain your rights, benefits, and responsibilities as a member of Meridian. With added benefitslike supportmakingsmart health choices, personal care coordination, 24-hour nursing help line, and more. startxref 0 It explains the medical, dental, vision, and pharmacy services that are covered by your plan. The Provider Manual has everything you need to know about member benefits, coverage, and provider guidelines. Other pharmacies/physicians/providers are available in our network. 167 33 This handbook will help you understand your coverage. With HealthChoice Illinois, you have a health plan partner to turn to for help. 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. endstream endobj startxref Meridian Member Services . You can get this document for free in other formats, such as large print, braille, or audio.

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