meridian illinois member handbook

It outlines services and benefits that areand are notcovered. Its full of tips and resources for pregnant members and new parents. 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. MeridianHealth is now Meridian! h|kPQevkmNRIDrDI-)Vw*DYS7cgcr!349g3. You are leaving this website to go to a website managed by a contracted company, which provides service on our behalf. On weekends and on state or federal holidays, you may be asked to leave a message. 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. providerhelp.IL@mhplan.com. The benefit information is a brief summary, not a complete description of benefits. View your Provider Manual, important plan information and more. The handbook will explain your rights, benefits, and responsibilities as a member of MeridianComplete. Monday-Friday, 8 a.m. to 8 p.m. CST 0000025639 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. You are now able to view your health information from a third-party app on a mobile device or PC! 0 0000002131 00000 n 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. 0000072727 00000 n For information regarding our Pharmacy Benefit Manager (PBM), MeridianRx, visit the MeridianRx website. JB Pritzker, Governor Theresa Eagleson, Director. // /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 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. This is not a complete list. It looks like your browser does not have JavaScript enabled. 0000010510 00000 n Meridian Medicare-Medicaid Plan (MMP) is a health plan that contracts with both Medicare and Illinois Medicaid to provide benefits of both programs to enrollees. Other pharmacies/physicians/providers are available in our network. 0000068208 00000 n 866-606-3700 . Su llamada ser devuelta dentro del siguiente da hbil. Looking for your plan home page or interested in becoming a member? Complete the Member Notification of Pregnancy(PDF) form in the Member Portal. Meridian 2021 Member Handbook Illinois Counties: Cook, DuPage, Kane, Kankakee, Lake, Will . Your call will be returned within the next business day. For more information contact the plan or read the Meridian Member Handbook. You will need Adobe Reader to open PDFs on this site. Please review the various programs below. There are a few ways to complete the form: We want you to have a safe, healthy, and happy pregnancy! You can get this document for free in other formats, such as large print, braille, or audio. Llame al 1-855-580-1689 (los usuarios de TTY deben llamar al 711). // ]]>. Call Member Services if youd like paper copies of any of these documents. 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. Each link will open a new window and is either a PDF or a website. fm.formularynavigator.com,medicare.entrykeyid.com,member.membersecurelogin.com,mmp.ilmeridian.com,findaprovider.mmp.ilmeridian.com,provider.mmp.mimeridian.com, You are now able to view your health information from a third-party app on a mobile device or PC! The benefit information is a brief summary, not a complete description of benefits. If you experience any problems receiving your mail order prescription, call Member Services at. 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 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. Download the Member Handbook (PDF). 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. Your Member Handbook is a great resource if you have any questions or just want to learn more about your coverage. Your Member Handbook is a great resource if you have any questions or just want to learn more about your coverage. Your Member Handbook is a great resource if you have any questions or just want to learn more about your coverage. This is not a complete list. 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. This site contains various Meridian Medicare-Medicaid Plan (MMP) links and resources. It also explains how to find care and how to earn rewards. Your call will be returned within the next business day. Fill out the Member Notification of Pregnancy form(PDF)to let us know if you are pregnant. On weekends and on state or federal holidays, you may be asked to leave a message. The call is free. La llamada es gratis. 0000046799 00000 n We are excited to share that MeridianCare, a WellCare company, is changing its name to WellCare, effective January 1, 2020! If your address changes, let us know. You can also file a grievance or appeal on the phone by calling Member Services or in writing via mail or fax. Meridian will help make your Medicare and Medicaid benefits work better together and work better for you. The Member Handbook, along with your enrollment form, serves as MeridianCompletes contract with you. %%EOF 1-855-580-1689 (TTY 711) 0000041668 00000 n Other pharmacies/physicians/providers are available in our network. 2023 It will help you get the care you need. For more information, call MeridianComplete Member Services or read the MeridianComplete Member Handbook. ATTENTION: If you speak a language other than English, language assistance services, free of charge, are available to you. 1-855-580-1689 (TTY 711) Material ID:H6080_WEBSITE_2023_Accepted_09282022. 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. Representatives are available Monday-Friday, 8 a.m. to 8 p.m. to assist you. We need to be able to send you important information in the mail. We can connect you with support, services, and even rewards. <<0B5A082EC79D7049BD46C1656B63CA22>]/Prev 539953>> 0000001708 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. 2022 Provider Manual (PDF) Meridian Provider Manual Errata Sheet (PDF) Documents and Forms Medical Referrals & Authorizations Pharmacy Billing Mandatory Training Attestation Check out the Interoperability page to learn more. 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. 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. 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. Llame al 1-855-580-1689 (los usuarios de TTY deben llamar al 711). 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. xref Call 1-855-580-1689 (TTY: 711). If you wish to stay on this website, please click Cancel. The Personal Wellness Assessment is a short form about you and your health journey. Download the free version of Adobe Reader. 0000046386 00000 n With added benefits like support making smart health choices, personal care coordination, 24-hour nursing help line, and more. Your call will be returned within the next business day. You will need Adobe Reader to open PDFs on this site. ATENCIN: Si habla espaol, tiene a su disposicin servicios gratuitos de asistencia lingstica. It explains the medical, dental, vision, and pharmacy services that are covered by your plan. 0000014634 00000 n 0000002177 00000 n If you wish to stay on this website, please click Cancel. The call is free. 0000041209 00000 n %PDF-1.7 % 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. Your call will be returned within the next business day. Out-of-network/non-contracted providers are under no obligation to treat Meridian members, except in emergency situations. See if you qualify, and explore the HealthChoice Illinois advantage. Want a paper copy? Call 1-855-580-1689 (TTY: 711). Understanding the ins and outs of your health plan can be difficult. Provider Network 6 hbbd``b`R@AH&="> $ $= @+D C[} "Fod(AE+ 199 0 obj <>stream This site contains various MeridianComplete (Medicare-Medicaid Plan) links and resources. You can join our Start Smart for Your Baby program. fm.formularynavigator.com,medicare.entrykeyid.com,member.membersecurelogin.com,mmp.ilmeridian.com,findaprovider.mmp.ilmeridian.com,provider.mmp.mimeridian.com, Prior Authorization, Step Therapy and Quantity Limits, Coverage Determinations and Redeterminations for Drugs, 2022 IL Prior Authorization Fax Submission Forms - Inpatient (PDF), 2022 IL Prior Authorization Fax Submission Forms - Outpatient (PDF), 2020 MeridianComplete Authorization Lookup (PDF), Behavioral Health Discharge Transition of Care Form (PDF), HealthHelp and eviCore Provider Notification (PDF), Primary Care Provider Reassignment Form (PDF), Annual Care for Older Adults (COA) Form (PDF), Breast Cancer Screening Exclusion Form (PDF), Colorectal Cancer Screening Exclusion Form (PDF), Timely Submission of Encounter Data by Medicare-Medicaid Plans (MMPs) to CMS (PDF), Prohibition Billing Dually Eligible Individuals Enrolled in the Qualified Medicare Beneficiary (QMB) Program (PDF), Part D Coverage Determination Request Form (PDF), Part D Redetermination Request Form (PDF), Hospice Information for Medicare Part D plans (PDF), 2021 IL Prior Authorization Fax Submission Forms - Inpatient (PDF), 2021 IL Prior Authorization Fax Submission Forms - Outpatient (PDF), Partnership for Quality (P4Q Program) (PDF), Language Assistance & Notice of Nondiscrimination. We also have an optional automatic mail-order delivery program under which we will automatically fill all new prescriptions your health care provider sends to us, as well as refills for prescriptions that have already been filled but are running out. 2369 0 obj <> endobj An appeal is a way for you to ask for a review of our actions. +t x1Rdt!v8,1{1"sAS*.~Y|U:d\e6qXaI1,JSh\0y7x'zz|:nY\bnLM H\Bd ;,|Xt$Au*5Ndt:|_bLR[QcO?#VJ2VH n6 (_`/}^v}~/ OZ1?.9H Pl;-wrZi}wSzpibGlU}~/r B5[AuJL~2P1W^ j}Y@5( ?d On weekends and on state or federal holidays, you may be asked to leave a message. v4P+r-k E`:8\TV%F1MeLT=LyMit+GYrUn*mH gp`x Y;EgPCSSphf>op!mOQtkC v^K#x" 167 33 You will need Adobe Reader to open PDFs on this site. The call is free. 0000041585 00000 n The Member Handbook, along with your enrollment form, serves as Meridian Medicare-Medicaid Plan's (MMP) contract with you. Usually a mail-order pharmacy order will get to you in no more than 5 days. For a more comprehensive description of the plan benefits, please refer to your Member Handbook which can also be found on this page. We are excited to share that MeridianCare, a WellCare company, is changing its name to WellCare, effective January 1, 2020! You can get this document in Spanish, or speak with someone about this information in other languages for free. Making healthcare decisions can be tough--who to see for care, what to ask, when to go. 0000025980 00000 n Meridian will work with you to make sure you get all of the care you need, when you need it. Learn more about how being a Meridian provider benefits you. Find a doctor, explore coverage, review documents and much more. 0000046966 00000 n Download the Member Handbook(PDF). HFS sends paperwork in the mail that you need to renew your Medicaid coverage. Starting January 1, 2018, the Illinois Medicaid Managed Care Program is expanding to include all 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. Each link will open a new window and is either a PDF or a website. Download the Member Handbook (PDF). Please visit our new website to see up to date information about your plan. The benefit information is a brief summary, not a complete description of benefits. 0000002074 00000 n Keep in mind that everything you choose to share is confidential. A grievance is a complaint about a provider or about the quality of care or services you received. 0000068680 00000 n Under our plan, you will have one card for your Medicare and Medicaid services, including long-term services and supports and prescriptions. If you wish to stay on this website, please click Cancel. La llamada es gratis. The Health Library is a free resource exclusively for MeridianComplete members and providers. A certificate of coverage (COC) tells you what to expect from your healthcare plan. Monday-Friday, 7:00 a.m. to 5:30 p.m. (TTY: 711) Ser vice area . 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. 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. When you go to file, youll want to write when and where the incident took place, and what happened. Representatives are available Monday-Friday, 8 a.m. to 8 p.m. to assist you. Your call will be returned within the next business day. 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. You can get this document for free in other formats, such as large print, braille, or audio. 167 0 obj <> endobj Please contact the plan for more details. 2023 Meridian is for people eligible for both Medicaid and Medicare. Visit your Member Portal or call Member Services. If your pregnancy is at high risk, we may call you. %%EOF 0000001774 00000 n 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. startxref 0000047422 00000 n More information is in your Member Handbook(PDF). If you wish to stay on this website, please click Cancel. La llamada es gratis. You will need Adobe Reader to open PDFs on this site. Llame al. Don't forget to call your local HFS oce and Meridian Member Services with your new address. 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. 0 At the right time and place. It explains the medical, dental, vision, and pharmacy services that are covered by your plan. The handbook will explain your rights, benefits, and responsibilities as a member of Meridian. Su llamada ser devuelta dentro del siguiente da hbil. Our Population Health Management Programs are offered to Meridian members and designed to improve your overall health and quality of care. With our Medicare-Medicaid Plan (MMP) youre getting: An assigned care manager to help answer questions and coordinate your care. You will be able to work with one health plan for all of your health insurance needs. Out-of-network/non-contracted providers are under no obligation to treat Meridian members, except in emergency situations. The Provider Manual has everything you need to know about member benefits, coverage, and provider guidelines. You are leaving this website to go to a website managed by a contracted company, which provides service on our behalf. Youll tell us about any health conditions, recent hospital visits, medications, and more. MeridianComplete (Medicare-Medicaid Plan) is a health plan that contracts with both Medicare and Michigan Medicaid to provide benefits of both programs to enrollees. The benefit information is a brief summary, not a complete description of benefits. 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)! Copyright 2023 Meridian All Rights Reserved. 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. You've got questions and we've got answers. The handbook will explain your rights, benefits, and responsibilities as a member of Meridian. Monday-Friday, 8 a.m. to 5 p.m. CST 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 we fall short, you can file a grievance or appeal. Meridian For example, we may not approve your providers request for a certain drug. 0000021917 00000 n On weekends and on state or federal holidays, you may be asked to leave a message. Each link will open a new window and is either a PDF or a website. 0000151745 00000 n Report an address update to HFS online. You can get this document for free in other formats, such as large print, braille, or audio. 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. The call is free. Meridian covers all counties in Illinois. The handbook will explain your rights, benefits, and responsibilities as a member of Meridian. 0000002220 00000 n 0000040678 00000 n Out-of-network/non-contracted providers are under no obligation to treat MeridianComplete members, except in emergency situations. 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. Out-of-network/non-contracted providers are under no obligation to treat Meridian members, except in emergency situations. ATENCIN: Si habla espaol, tiene a su disposicin servicios gratuitos de asistencia lingstica. If you are using a Meridian provider, you will not have to pay a plan premium, deductible, or copay. 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. You can also visit the Illinois Client Enrollment Services website. For more information contact the plan or read the MeridianComplete Member Handbook. It will also explain our responsibilities to you, as well as outline the following details: Representatives are available Monday-Friday, 8 a.m. to 8 p.m. to assist you. If you have any questions, call Meridian Member Services toll-free at 866-606-3700. You will need Adobe Reader to open PDFs on this site. 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. With HealthChoice Illinois, you have a health plan partner to turn to for help. This is not a complete list. Please turn on JavaScript and try again. 1-855-580-1689 (TTY 711) With added benefitslike supportmakingsmart health choices, personal care coordination, 24-hour nursing help line, and more. 0000006553 00000 n The Member Handbook, along with your enrollment form, serves as Meridian Medicare-Medicaid Plan's (MMP) contract with you. 0000000016 00000 n 0000017969 00000 n 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. The Member Handbook, along with your enrollment form, serves as Meridian Medicare-Medicaid Plan's (MMP) contract with you. The Member Handbook, along with your enrollment form, serves asMeridian Medicare-Medicaid Plan's (MMP) contract with you. You can also visit the Illinois Client Enrollment Services website. All Rights Reserved. Member ID Cards 5. [CDATA[ 0000040481 00000 n 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. providerhelp.IL@mhplan.com, The Interoperability and Patient Access Rule. 2500 0 obj <>stream This is not a complete list. 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 have questions, please call MeridianComplete (Medicare-Medicaid Plan) Member Services at 1-855-580-1689 (TTY users should call 711). Material ID:H6080_WEBSITE_2023_Accepted_09282022. hKq?wNe?t!ARk;v6[IqK,h!i2jLnn}>^| ! Moving? All Rights Reserved. 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) endstream endobj startxref 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. 0000080946 00000 n For more information contact the plan or read the Meridian Member Handbook. For certain kinds of drugs, you can use the plans network mail-order services. View our Frequently Asked Questions page. This site contains various Meridian Medicare-Medicaid Plan (MMP) links and resources. You are leaving this website to go to a website managed by a contracted company, which provides service on our behalf. Be sure to read your Meridian Member Handbook and keep it handy. 0000002041 00000 n The List of Covered Drugs and/or pharmacy and provider networks may change throughout the year. 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. Prior Authorization, Step Therapy and Quantity Limits, Coverage Determinations and Redeterminations for Drugs, Notice of Nondiscrimination & Language Assistance. 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. 0000067553 00000 n Want a paper copy? Call 1-855-580-1689 (TTY: 711). 0000000956 00000 n window.location.replace("https://mmp.ilmeridian.com/member/benefits-coverage/whats-covered/member-handbook.html"); Open Enrollment 6. We want you to be happy with the treatment and services you get from Meridian and our providers. We will send you a notice before we make a change that affects you. On weekends and on state or federal holidays, Important Phone Numbers & Contacts In an Emergency 911 Meridian Member Services 866-606-3700 Su llamada ser devuelta dentro del siguiente da hbil. Catching a Breath Complex Case Management Flu Outreach Opioids 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. %PDF-1.4 % member.ILmeridian.com. 0000067354 00000 n We want you to be happy with your healthcare services. 0000046576 00000 n ATENCIN: Si habla espaol, tiene a su disposicin servicios gratuitos de asistencia lingstica. This handbook will help you understand your coverage. trailer Call, Usted puede obtener gratuitamente este documento en espaol o hablar con alguien sobre esta informacin en otros idiomas. https://www.illinois.gov/hfs/healthchoice/Pages/HealthPlans.aspx, https://www.illinois.gov/hfs/healthchoice/reportcard.

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