Out-of-network/non-contracted providers are under no obligation to treat Meridian members, except in emergency situations. All Rights Reserved. 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. ATTENTION: If you speak a language other than English, language assistance services, free of charge, are available to you. Other pharmacies/physicians/providers are available in our network. 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. 0000072727 00000 n 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. For more information, or to find out how to get enrolled, please contact Meridian at 888-437-0606. Meridian Member Services . 0000041585 00000 n 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. Documents and Forms - Meridian Medicare Medicaid Plan You are leaving this website to go to a website managed by a contracted company, which provides service on our behalf. [CDATA[ This is not a complete list. La llamada es gratis. Your call will be returned within the next business day. Su llamada ser devuelta dentro del siguiente da hbil. Download the Member Handbook (PDF). You can get this document for free in other formats, such as large print, braille, or audio. 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. 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. PDF <DATE> Program called HealthChoice Illinois . We have been working hard v4P+r-k E`:8\TV%F1MeLT=LyMit+GYrUn*mH gp`x Y;EgPCSSphf>op!mOQtkC v^K#x" The handbook will explain your rights, benefits, and responsibilities as a member of Meridian. Your Member Handbook is a great resource if you have any questions or just want to learn more about your coverage. 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. Please turn on JavaScript and try again. window.location.replace("https://mmp.ilmeridian.com/member/benefits-coverage/whats-covered/member-handbook.html"); View your Provider Manual, important plan information and more. Call 1-855-580-1689 (TTY: 711). %%EOF If you have questions, please call MeridianComplete (Medicare-Medicaid Plan) Member Services at 1-855-580-1689 (TTY users should call 711). For certain kinds of drugs, you can use the plans network mail-order services. Important Phone Numbers & Contacts In an Emergency 911 Meridian Member Services 866-606-3700 2023 Report an address update to HFS online. 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)! 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. Download the Member Handbook (PDF). The benefit information is a brief summary, not a complete description of benefits. Meridian will help make your Medicare and Medicaid benefits work better together and work better for you. 0000010510 00000 n h|kPQevkmNRIDrDI-)Vw*DYS7cgcr!349g3. 0000000016 00000 n Its full of tips and resources for pregnant members and new parents. Want a paper copy? 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. MeridianComplete is a health plan that contracts with both Medicare and Illinois Medicaid to provide benefits of both programs to enrollees. <<0B5A082EC79D7049BD46C1656B63CA22>]/Prev 539953>> For Members | Meridian JB Pritzker, Governor Theresa Eagleson, Director. 3. With added benefits like support making smart health choices, personal care coordination, 24-hour nursing help line, and more. 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. La llamada es gratis. The Member Handbook, along with your enrollment form, serves as Meridian Medicare-Medicaid Plan's (MMP) contract with you. 0000068208 00000 n Representatives are available Monday-Friday, 8 a.m. to 8 p.m. to assist you. On weekends and on state or federal holidays, you may be asked to leave a message. Monday-Friday, 7:00 a.m. to 5:30 p.m. (TTY: 711) Ser vice area . You can join our Start Smart for Your Baby program. endstream endobj startxref 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. 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 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! Provider Network 6 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. 2021 Member Handbook Illinois Counties: Cook, DuPage, Kane, Kankakee, Lake, Will . The handbook will explain your rights, benefits, and responsibilities as a member of Meridian. You can also file a grievance or appeal on the phone by calling Member Services or in writing via mail or fax. You can also visit the Illinois Client Enrollment Services website. Each link will open a new window and is either a PDF or a website. HFS sends paperwork in the mail that you need to renew your Medicaid coverage. This site contains various MeridianComplete (Medicare-Medicaid Plan) links and resources. 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. The Member Handbook, along with your enrollment form, serves as Meridian Medicare-Medicaid Plan's (MMP) contract with you. Your Member Handbook is a great resource if you have any questions or just want to learn more about your coverage. There are a few ways to complete the form: We want you to have a safe, healthy, and happy pregnancy! Each link will open a new window and is either a PDF or a website. It will help you get the care you need. The Provider Manual has everything you need to know about member benefits, coverage, and provider guidelines. The Health Library is a free resource exclusively for MeridianComplete members and providers. It will also explain our responsibilities to you, as well as outline the following details: A certificate of coverage (COC) tells you what to expect from your healthcare plan. 0 ATENCIN: Si habla espaol, tiene a su disposicin servicios gratuitos de asistencia lingstica. Don't forget to call your local HFS oce and Meridian Member Services with your new address. Be sure to read your Meridian Member Handbook and keep it handy. With added benefitslike supportmakingsmart health choices, personal care coordination, 24-hour nursing help line, and more. 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. On weekends and on state or federal holidays, You can make an appeal if you disagree with our verdict. Member Handbook | Meridian Health Plan of Illinois Meridian You also need to make sure that the Department of Healthcare & Family Services (HFS) has your new address. Making healthcare decisions can be tough--who to see for care, what to ask, when to go. PDF here's your member handbook. 167 0 obj <> endobj It also explains how to find care and how to earn rewards. It also explains how to find care and how to earn rewards. Visit your Member Portal or call Member Services. 0000047422 00000 n You've got questions and we've got answers. Please visit our new website to see up to date information about your plan. 0000017969 00000 n Out-of-network/non-contracted providers are under no obligation to treat Meridian members, except in emergency situations. You can get this document for free in other formats, such as large print, braille, or audio. Download the Member Handbook(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. Want a paper copy? If you wish to stay on this website, please click Cancel. Copyright 2023 Meridian All Rights Reserved. Material ID:H6080_WEBSITE_2023_Accepted_09282022. Meridian will work with you to make sure you get all of the care you need, when you need it. On weekends and on state or federal holidays, you may be asked to leave a message. MeridianComplete (Medicare-Medicaid Plan) is a health plan that contracts with both Medicare and Michigan Medicaid to provide benefits of both programs to enrollees. PDF Welcome to MeridianHealth Intro to Plan 0000040481 00000 n PDF ILLINOIS MEMBER HANDBOOK - Meridian Illinois Managed Care Plans You will need Adobe Reader to open PDFs on this site. Meridian is for people eligible for both Medicaid and Medicare. Moving? The COC lays out all the details so that you can stay on top of your coverage. Out-of-network/non-contracted providers are under no obligation to treat MeridianComplete members, except in emergency situations. Material ID:H6080_WEBSITE_2023_Accepted_09282022. On weekends and on state or federal holidays, you may be asked to leave a message. Meridian covers all counties in Illinois. Meridian Medicare-Medicaid Plan (MMP) is a health plan that contracts with both Medicare and Illinois Medicaid to provide benefits of both programs to enrollees. The benefit information is a brief summary, not a complete description of benefits. Monday-Friday, 8 a.m. to 5 p.m. CST Call, Usted puede obtener gratuitamente este documento en espaol o hablar con alguien sobre esta informacin en otros idiomas. Click the link below to view or save a copy. If you wish to stay on this website, please click Cancel. We need to be able to send you important information in the mail. Llame al 1-855-580-1689 (los usuarios de TTY deben llamar al 711). Find a doctor, explore coverage, review documents and much more. 0000151745 00000 n 0000046386 00000 n %PDF-1.7 % You can also visit the Illinois Client Enrollment Services website. 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. 0000001708 00000 n You will need Adobe Reader to open PDFs on this site. 0000006553 00000 n Looking for your plan home page or interested in becoming a member? We are excited to share that MeridianCare, a WellCare company, is changing its name to WellCare, effective January 1, 2020! The handbook will explain your rights, benefits, and responsibilities as a member of Meridian. When you go to file, youll want to write when and where the incident took place, and what happened. 0000067553 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. If your pregnancy is at high risk, we may call you. 0000040678 00000 n Each link will open a new window and is either a PDF or a website. %%EOF Other pharmacies/physicians/providers are available in our network. For a more comprehensive description of the plan benefits, please refer to your Member Handbook. 2023 We can connect you with support, services, and even rewards. member.ILmeridian.com. It explains the medical, dental, vision, and pharmacy services that are covered by your plan. 0000080946 00000 n If you wish to stay on this website, please click Cancel. The call is free. Member Handbook - Meridian Medicare Medicaid Plan 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. 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. 0000002177 00000 n Under our plan, you will have one card for your Medicare and Medicaid services, including long-term services and supports and prescriptions. This way, we can connect you with the right care. All Rights Reserved. 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. Language Assistance & Notice of Nondiscrimination. It will also explain our responsibilities to you, as well as outline the following details: HealthChoice Illinois | HFS 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 Member Handbook, along with your enrollment form, serves as MeridianCompletes contract with you. Please review the various programs below. For more information contact the plan or read the Meridian Member Handbook. If you need help finding a network provider and/or pharmacy, please call 1-855-580-1689 (TTY: 711) or visit mmp.ILmeridian.com to access our online searchable directory. // 2369 0 obj <> endobj On weekends and on state or federal holidays, you may be asked to leave a message. 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. We want you to be happy with your healthcare services. Representatives are available Monday-Friday, 8 a.m. to 8 p.m. to assist you. The Personal Wellness Assessment is a short form about you and your health journey. Check out the Interoperability page to learn more. 0000067354 00000 n Llame al. With HealthChoice Illinois, you have a health plan partner to turn to for help. 0000068680 00000 n Member Handbooks and Forms You are leaving this website to go to a website managed by a contracted company, which provides service on our behalf. Download the free version of Adobe Reader. La llamada es gratis. providerhelp.IL@mhplan.com. HealthChoice Illinois is the smart way most Medicaid members get quality care. Each link will open a new window and is either a PDF or a website. Usually a mail-order pharmacy order will get to you in no more than 5 days. It also explains how to find care and how to earn rewards. More information is in your Member Handbook(PDF). The call is free. Making healthcare decisions can be tough--who to see for care, what to ask, when to go. If you wish to stay on this website, please click Cancel. 1-855-580-1689 (TTY 711) hKq?wNe?t!ARk;v6[IqK,h!i2jLnn}>^| ! 2500 0 obj <>stream 0000002220 00000 n 0000046576 00000 n This handbook will help you understand your coverage. 0000001774 00000 n Call 1-855-580-1689 (TTY: 711). Other pharmacies/physicians/providers are available in our network. 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 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 call our Member Services number or see your Member Handbook for more information, including the cost-sharing that applies to out-of-network services. Your call will be returned within the next business day. You are leaving this website to go to a website managed by a contracted company, which provides service on our behalf. 0000000956 00000 n You can get this document in Spanish, or speak with someone about this information in other languages for free. Our Population Health Management Programs are offered to Meridian members and designed to improve your overall health and quality of care. 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. The List of Covered Drugs and/or pharmacy and provider networks may change throughout the year. 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 If we fall short, you can file a grievance or appeal. You will need Adobe Reader to open PDFs on this site. hbbd``b`R@AH&="> $ $= @+D C[} "Fod(AE+ 0000002131 00000 n Just call Member Services with your new address. Youll tell us about any health conditions, recent hospital visits, medications, and more. PDF 2021 Member Handbook - Meridian Medicare Medicaid Plan // ]]>. 0000021917 00000 n Fill out the Member Notification of Pregnancy form(PDF)to let us know if you are pregnant. We are excited to share that MeridianCare, a WellCare company, is changing its name to WellCare, effective January 1, 2020! 0000014634 00000 n If your address changes, let us know. Su llamada ser devuelta dentro del siguiente da hbil. The call is free. The benefit information is a brief summary, not a complete description of benefits. For more information contact the plan or read the Meridian Member Handbook. The Member Handbook, along with your enrollment form, serves asMeridian Medicare-Medicaid Plan's (MMP) contract with you. This is not a complete list. 1-855-580-1689 (TTY 711) Representatives are available Monday-Friday, 8 a.m. to 8 p.m. to assist you. The handbook will explain your rights, benefits, and responsibilities as a member of Meridian. 866-606-3700 . For more information contact the plan or read the Meridian Member Handbook. 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. Prior Authorization, Step Therapy and Quantity Limits, Coverage Determinations and Redeterminations for Drugs, Notice of Nondiscrimination & Language Assistance. You will need Adobe Reader to open PDFs on this site. providerhelp.IL@mhplan.com, The Interoperability and Patient Access Rule. 0000002041 00000 n For example, we may not approve your providers request for a certain drug. Member Handbook | Meridian Complete of Illinois With HealthChoice Illinois, you have a health plan partner to turn to for help. It looks like your browser does not have JavaScript enabled. 0000046966 00000 n The right care for you. On weekends and on state or federal holidays, you may be asked to leave a message. 0000025639 00000 n 0000025980 00000 n The benefit information is a brief summary, not a complete description of benefits. 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. If you experience any problems receiving your mail order prescription, call Member Services at. Catching a Breath Complex Case Management Flu Outreach Opioids 0000041668 00000 n You are now able to view your health information from a third-party app on a mobile device or PC! Please contact the plan for more details. Your call will be returned within the next business day. Learn more about how being a Meridian provider benefits you. https://www.illinois.gov/hfs/healthchoice/Pages/HealthPlans.aspx, https://www.illinois.gov/hfs/healthchoice/reportcard. Your Member Handbook is a great resource if you have any questions or just want to learn more about your coverage. Limitations, copays, and restrictions may apply. Llame al 1-855-580-1689 (los usuarios de TTY deben llamar al 711). (los usuarios de TTY deben llamar al 711), lunes a domingo, de 8 a.m. a 8 p.m. La llamada es gratuita. Monday-Friday, 8 a.m. to 8 p.m. CST The call is free. Representatives are available Monday-Friday, 8 a.m. to 8 p.m. to assist you. 0000002074 00000 n An appeal is a way for you to ask for a review of our actions. If you are using a Meridian provider, you will not have to pay a plan premium, deductible, or copay. %PDF-1.4 % You can get this document for free in other formats, such as large print, braille, or audio. We will send you a notice before we make a change that affects you. You will be able to work with one health plan for all of your health insurance needs. Call Member Services if youd like paper copies of any of these documents. Your call will be returned within the next business day. 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. 0 Your handbook is full of important information about your health care and Meridian. Providers - MeridianComplete 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. 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. 0000046799 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. The call is free. This site contains various Meridian Medicare-Medicaid Plan (MMP) links and resources. 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 are leaving this website to go to a website managed by a contracted company, which provides service on our behalf. Su llamada ser devuelta dentro del siguiente da hbil. This site contains various Meridian Medicare-Medicaid Plan (MMP) links and resources. ATENCIN: Si habla espaol, tiene a su disposicin servicios gratuitos de asistencia lingstica. 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) Out-of-network/non-contracted providers are under no obligation to treat Meridian members, except in emergency situations. 167 33 If you have any questions, call Meridian Member Services toll-free at 866-606-3700. Provider Manual | Meridian Health Plan of Illinois Call 1-855-580-1689 (TTY: 711). 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.

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