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Understanding the ins and outs of your health plan can be difficult. 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. 3. Its full of tips and resources for pregnant members and new parents. Want a paper copy? If you wish to stay on this website, please click Cancel. The Member Handbook, along with your enrollment form, serves as Meridian Medicare-Medicaid Plan's (MMP) contract with you. 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 visit the Illinois Client Enrollment Services website. For more information, or to find out how to get enrolled, please contact Meridian at 888-437-0606. Please turn on JavaScript and try again. With HealthChoice Illinois, you have a health plan partner to turn to for help. Llame al 1-855-580-1689 (los usuarios de TTY deben llamar al 711). 167 33 Monday-Friday, 8 a.m. to 5 p.m. CST For information regarding our Pharmacy Benefit Manager (PBM), MeridianRx, visit the MeridianRx website. 0 Su llamada ser devuelta dentro del siguiente da hbil. 0000010510 00000 n Important Phone Numbers & Contacts In an Emergency 911 Meridian Member Services 866-606-3700 On weekends and on state or federal holidays, you may be asked to leave a message. For more information, call MeridianComplete Member Services or read the MeridianComplete Member Handbook. 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. 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. (los usuarios de TTY deben llamar al 711), lunes a domingo, de 8 a.m. a 8 p.m. La llamada es gratuita. https://www.illinois.gov/hfs/healthchoice/Pages/HealthPlans.aspx, https://www.illinois.gov/hfs/healthchoice/reportcard. You can make an appeal if you disagree with our verdict. hbbd``b`R@AH&="> $ $= @+D C[} "Fod(AE+ Want a paper copy? For a more comprehensive description of the plan benefits, please refer to your Member Handbook. 0000046386 00000 n This site contains various MeridianComplete (Medicare-Medicaid Plan) links and resources. 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. For more information contact the plan or read the Meridian Member Handbook. The Member Handbook, along with your enrollment form, serves as MeridianCompletes 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. For example, we may not approve your providers request for a certain drug. hKq?wNe?t!ARk;v6[IqK,h!i2jLnn}>^| ! 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. An appeal is a way for you to ask for a review of our actions. 0000041668 00000 n The Member Handbook, along with your enrollment form, serves as Meridian Medicare-Medicaid Plan's (MMP) contract with you. ATTENTION: If you speak a language other than English, language assistance services, free of charge, are available to you. Each link will open a new window and is either a PDF or a website. 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. Our Population Health Management Programs are offered to Meridian members and designed to improve your overall health and quality of care. 0000000956 00000 n 199 0 obj <>stream 0000002074 00000 n 2369 0 obj <> endobj View our Frequently Asked Questions page. The Member Handbook, along with your enrollment form, serves as Meridian Medicare-Medicaid Plan's (MMP) contract with you. The handbook will explain your rights, benefits, and responsibilities as a member of Meridian. 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-1.4 % The call is free. With HealthChoice Illinois, you have a health plan partner to turn to for help. For more information contact the plan or read the MeridianComplete Member Handbook. It will help you get the care you need. You can get this document for free in other formats, such as large print, braille, or audio. For more information contact the plan or read the Meridian Member Handbook. The Personal Wellness Assessment is a short form about you and your health journey. Your call will be returned within the next business day. You can join our Start Smart for Your Baby program. View your Provider Manual, important plan information and more. The handbook will explain your rights, benefits, and responsibilities as a member of Meridian. h|kPQevkmNRIDrDI-)Vw*DYS7cgcr!349g3. %PDF-1.7 % Meridian Member Services . Su llamada ser devuelta dentro del siguiente da hbil. Member Handbooks and Forms Out-of-network/non-contracted providers are under no obligation to treat MeridianComplete members, except in emergency situations. Representatives are available Monday-Friday, 8 a.m. to 8 p.m. to assist you. Out-of-network/non-contracted providers are under no obligation to treat Meridian members, except in emergency situations. Report an address update to HFS online. 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. Call 1-855-580-1689 (TTY: 711). Find a doctor, explore coverage, review documents and much 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! It will also explain our responsibilities to you, as well as outline the following details: Making healthcare decisions can be tough--who to see for care, what to ask, when to go. Copyright 2023 Meridian All Rights Reserved. 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 Representatives are available Monday-Friday, 8 a.m. to 8 p.m. to assist you. It outlines services and benefits that areand are notcovered. Your Member Handbook is a great resource if you have any questions or just want to learn more about your coverage. Meridian Medicare Medicaid 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. 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. Your call will be returned within the next business day. 0000040481 00000 n PDF here's your member handbook. Llame al. 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 can get this document for free in other formats, such as large print, braille, or audio. It explains the medical, dental, vision, and pharmacy services that are covered by your plan. Download the Member Handbook (PDF). You also need to make sure that the Department of Healthcare & Family Services (HFS) has your new address. All Rights Reserved. Making healthcare decisions can be tough--who to see for care, what to ask, when to go. 866-606-3700 . +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 La llamada es gratis. This site contains various Meridian Medicare-Medicaid Plan (MMP) links and resources. Your call will be returned within the next business day. 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. It also explains how to find care and how to earn rewards. 0000080946 00000 n The benefit information is a brief summary, not a complete description of benefits. 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 be able to work with one health plan for all of your health insurance needs. Call MeridianComplete at 1-855-323-4578 (TTY users should call 711), 8 a.m to 8 p.m., seven days a week. Call Member Services if youd like paper copies of any of these documents. We are excited to share that MeridianCare, a WellCare company, is changing its name to WellCare, effective January 1, 2020! Monday-Friday, 8 a.m. to 8 p.m. CST 0000002131 00000 n It looks like your browser does not have JavaScript enabled. On weekends and on state or federal holidays, you may be asked to leave a message. You will need Adobe Reader to open PDFs on this site. PDF <DATE> Program called HealthChoice Illinois . We have been working hard Meridian is for people eligible for both Medicaid and Medicare. The List of Covered Drugs and/or pharmacy and provider networks may change throughout the year. It explains the medical, dental, vision, and pharmacy services that are covered by your plan. 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. Check out the Interoperability page to learn more. La llamada es gratis. On weekends and on state or federal holidays, Other pharmacies/physicians/providers are available in our network. You will need Adobe Reader to open PDFs on this site. We want you to be happy with the treatment and services you get from Meridian and our providers. 0000068680 00000 n The call is free. 0000046576 00000 n We will send you a notice before we make a change that affects you. We want you to be happy with your healthcare services. endstream endobj startxref We can connect you with support, services, and even rewards. Meridian providerhelp.IL@mhplan.com, The Interoperability and Patient Access Rule. Member ID Cards 5. v4P+r-k E`:8\TV%F1MeLT=LyMit+GYrUn*mH gp`x Y;EgPCSSphf>op!mOQtkC v^K#x" PDF 2021 Member Handbook - Meridian Medicare Medicaid Plan Meridian With added benefits like support making smart health choices, personal care coordination, 24-hour nursing help line, and more. 0000151745 00000 n Copays for prescription drugs may vary based on the level of Extra Help you receive. Limitations, copays, and restrictions may apply. All Rights Reserved. Your Member Handbook is a great resource if you have any questions or just want to learn more about your coverage. HealthChoice Illinois is the smart way most Medicaid members get quality care. 2022 Provider Manual (PDF) Meridian Provider Manual Errata Sheet (PDF) Documents and Forms Medical Referrals & Authorizations Pharmacy Billing Mandatory Training Attestation This handbook will help you understand your coverage. // ]]>. This way, we can connect you with the right care. You are leaving this website to go to a website managed by a contracted company, which provides service on our behalf. Don't forget to call your local HFS oce and Meridian Member Services with your new address. member.ILmeridian.com. The Health Library is a free resource exclusively for MeridianComplete members and providers. Catching a Breath Complex Case Management Flu Outreach Opioids 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, 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. 0000041585 00000 n Material ID:H6080_WEBSITE_2023_Accepted_09282022. 2023 When you go to file, youll want to write when and where the incident took place, and what happened. Member Handbook | Meridian Health Plan of Illinois For more information contact the plan or read the Meridian Member Handbook. Material ID:H6080_WEBSITE_2023_Accepted_09282022. Providers - MeridianComplete More information is in your Member Handbook(PDF). The benefit information is a brief summary, not a complete description of benefits. 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. Language Assistance & Notice of Nondiscrimination. 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 <. A grievance is a complaint about a provider or about the quality of care or services you received. Representatives are available Monday-Friday, 8 a.m. to 8 p.m. to assist you. Learn more about how being a Meridian provider benefits you. A certificate of coverage (COC) tells you what to expect from your healthcare plan. On weekends and on state or federal holidays, you may be asked to leave a message. This is not a complete list. Your handbook is full of important information about your health care and Meridian. You've got questions and we've got answers. Llame al 1-855-580-1689 (los usuarios de TTY deben llamar al 711). %%EOF This is not a complete list. Each link will open a new window and is either a PDF or a website. 0000040678 00000 n Each link will open a new window and is either a PDF or a website. Documents and Forms - Meridian Medicare Medicaid Plan If you would like a Provider/Pharmacy Directory mailed to you, you may call the number above, request one at the website link provided above, or email memberservices.mi@mhplan.com. You can also file a grievance or appeal on the phone by calling Member Services or in writing via mail or fax. 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. Meridian will work with you to make sure you get all of the care you need, when you need it. If we fall short, you can file a grievance or appeal. Click the link below to view or save a copy. At the right time and place. If you experience any problems receiving your mail order prescription, call Member Services at. Looking for your plan home page or interested in becoming a member? Provider Manual | Meridian Health Plan of Illinois ATENCIN: Si habla espaol, tiene a su disposicin servicios gratuitos de asistencia lingstica. Representatives are available Monday-Friday, 8 a.m. to 8 p.m. to assist you. This is not a complete list. %%EOF Moving? 0000047422 00000 n Please contact the plan for more details. Please call our Member Services number or see your Member Handbook for more information, including the cost-sharing that applies to out-of-network services. 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. This site contains various Meridian Medicare-Medicaid Plan (MMP) links and resources. The handbook will explain your rights, benefits, and responsibilities as a member of Meridian. Other pharmacies/physicians/providers are available in our network. Keep in mind that everything you choose to share is confidential. You can also visit the Illinois Client Enrollment Services website. It also explains how to find care and how to earn rewards. Be sure to read your Meridian Member Handbook and keep it handy. Visit your Member Portal or call Member Services. The call is free. 1-855-580-1689 (TTY 711) 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. PDF Welcome to MeridianHealth Intro to Plan If you wish to stay on this website, please click Cancel. We are excited to share that MeridianCare, a WellCare company, is changing its name to WellCare, effective January 1, 2020! 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 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. xref PDF ILLINOIS MEMBER HANDBOOK - Meridian Illinois Managed Care Plans Starting January 1, 2018, the Illinois Medicaid Managed Care Program is expanding to include all Other pharmacies/physicians/providers are available in our network. For certain kinds of drugs, you can use the plans network mail-order services. If you have any questions, call Meridian Member Services toll-free at 866-606-3700. providerhelp.IL@mhplan.com. MeridianHealth is now Meridian! You can get this document for free in other formats, such as large print, braille, or audio. 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. Download the Member Handbook (PDF). Your call will be returned within the next business day. 0000006553 00000 n Your call will be returned within the next business day. Your Member Handbook is a great resource if you have any questions or just want to learn more about your coverage. JB Pritzker, Governor Theresa Eagleson, Director. 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. Meridian will help make your Medicare and Medicaid benefits work better together and work better for you. 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. The Provider Manual has everything you need to know about member benefits, coverage, and provider guidelines. 2021 Member Handbook Illinois Counties: Cook, DuPage, Kane, Kankakee, Lake, Will . If you are using a Meridian provider, you will not have to pay a plan premium, deductible, or copay. Please review the various programs below. On weekends and on state or federal holidays, you may be asked to leave a message.

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