meridian illinois member handbook

If you wish to stay on this website, please click Cancel. Su llamada ser devuelta dentro del siguiente da hbil. 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. We are excited to share that MeridianCare, a WellCare company, is changing its name to WellCare, effective January 1, 2020! Out-of-network/non-contracted providers are under no obligation to treat Meridian members, except in emergency situations. You will be able to work with one health plan for all of your health insurance needs. You can also file a grievance or appeal on the phone by calling Member Services or in writing via mail or fax. This way, we can connect you with the right care. 2023 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. Please review the various programs below. For certain kinds of drugs, you can use the plans network mail-order services. 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. Out-of-network/non-contracted providers are under no obligation to treat MeridianComplete members, except in emergency situations. Your Member Handbook is a great resource if you have any questions or just want to learn more about your coverage. 199 0 obj <>stream For a more comprehensive description of the plan benefits, please refer to your Member Handbook which can also be found on this page. 0000151745 00000 n For more information contact the plan or read the Meridian Member Handbook. La llamada es gratis. xref You will need Adobe Reader to open PDFs on this site. The Member Handbook, along with your enrollment form, serves as Meridian Medicare-Medicaid Plan's (MMP) contract with you. For more information, call MeridianComplete Member Services or read the MeridianComplete Member Handbook. On weekends and on state or federal holidays, 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. The Health Library is a free resource exclusively for MeridianComplete members and providers. For more information contact the plan or read the MeridianComplete Member Handbook. Click the link below to view or save a copy. All Rights Reserved. You will need Adobe Reader to open PDFs on this site. This site contains various MeridianComplete (Medicare-Medicaid Plan) links and resources. 0000002131 00000 n With our Medicare-Medicaid Plan (MMP) youre getting: An assigned care manager to help answer questions and coordinate your care. The Member Handbook, along with your enrollment form, serves asMeridian Medicare-Medicaid Plan's (MMP) contract with you. Report an address update to HFS online. More information is in your Member Handbook(PDF). It also explains how to find care and how to earn rewards. With HealthChoice Illinois, you have a health plan partner to turn to for help. 866-606-3700 . Just call Member Services with your new address. For more information contact the plan or read the Meridian Member Handbook. Su llamada ser devuelta dentro del siguiente da hbil. It will also explain our responsibilities to you, as well as outline the following details: 1-855-580-1689 (TTY 711) Representatives are available Monday-Friday, 8 a.m. to 8 p.m. to assist you. window.location.replace("https://mmp.ilmeridian.com/member/benefits-coverage/whats-covered/member-handbook.html"); Representatives are available Monday-Friday, 8 a.m. to 8 p.m. to assist you. %PDF-1.4 % If your address changes, let us know. 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. When you go to file, youll want to write when and where the incident took place, and what happened. 0000010510 00000 n With added benefitslike supportmakingsmart health choices, personal care coordination, 24-hour nursing help line, and more. 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 3. Be sure to read your Meridian Member Handbook and keep it handy. MeridianComplete (Medicare-Medicaid Plan) is a health plan that contracts with both Medicare and Michigan Medicaid to provide benefits of both programs to enrollees. 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 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. https://www.illinois.gov/hfs/healthchoice/Pages/HealthPlans.aspx, https://www.illinois.gov/hfs/healthchoice/reportcard. 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. It explains the medical, dental, vision, and pharmacy services that are covered by your plan. 0000025639 00000 n It outlines services and benefits that areand are notcovered. The Member Handbook, along with your enrollment form, serves as Meridian Medicare-Medicaid Plan's (MMP) contract with you. Llame al 1-855-580-1689 (los usuarios de TTY deben llamar al 711). Monday-Friday, 7:00 a.m. to 5:30 p.m. (TTY: 711) Ser vice area . Out-of-network/non-contracted providers are under no obligation to treat Meridian members, except in emergency situations. You can make an appeal if you disagree with our verdict. 0000014634 00000 n Prior Authorization, Step Therapy and Quantity Limits, Coverage Determinations and Redeterminations for Drugs, Notice of Nondiscrimination & Language Assistance. Don't forget to call your local HFS oce and Meridian Member Services with your new address. This is not a complete list. Each link will open a new window and is either a PDF or a website. The Provider Manual has everything you need to know about member benefits, coverage, and provider guidelines. If you wish to stay on this website, please click Cancel. Each link will open a new window and is either a PDF or a website. Your call will be returned within the next business day. 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. It also explains how to find care and how to earn rewards. You will need Adobe Reader to open PDFs on this site. 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 right care for 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. 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. Our Population Health Management Programs are offered to Meridian members and designed to improve your overall health and quality of care. Meridian 0000006553 00000 n La llamada es gratis. Representatives are available Monday-Friday, 8 a.m. to 8 p.m. to assist you. Each link will open a new window and is either a PDF or a website. For more information contact the plan or read the Meridian Member Handbook. Your handbook is full of important information about your health care and Meridian. 167 33 The List of Covered Drugs and/or pharmacy and provider networks may change throughout the year. We want you to be happy with your healthcare services. This is not a complete list. There are a few ways to complete the form: We want you to have a safe, healthy, and happy pregnancy! On weekends and on state or federal holidays, you may be asked to leave a message. The call is free. 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. You are leaving this website to go to a website managed by a contracted company, which provides service on our behalf. Important Phone Numbers & Contacts In an Emergency 911 Meridian Member Services 866-606-3700 Other pharmacies/physicians/providers are available in our network. 0000000956 00000 n With added benefits like support making smart health choices, personal care coordination, 24-hour nursing help line, and more. Its full of tips and resources for pregnant members and new parents. 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. hbbd``b`R@AH&="> $ $= @+D C[} "Fod(AE+ We will send you a notice before we make a change that affects you. If you have questions, please call MeridianComplete (Medicare-Medicaid Plan) Member Services at 1-855-580-1689 (TTY users should call 711). View your Provider Manual, important plan information and more. ATENCIN: Si habla espaol, tiene a su disposicin servicios gratuitos de asistencia lingstica. The call is free. Usually a mail-order pharmacy order will get to you in no more than 5 days. HFS sends paperwork in the mail that you need to renew your Medicaid coverage. MeridianHealth is now Meridian! Meridian will work with you to make sure you get all of the care you need, when you need it. 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, 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 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). 0000000016 00000 n providerhelp.IL@mhplan.com, The Interoperability and Patient Access Rule. We are excited to share that MeridianCare, a WellCare company, is changing its name to WellCare, effective January 1, 2020! Your Member Handbook is a great resource if you have any questions or just want to learn more about your coverage. 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. +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 The call is free. Please contact the plan for more details. 0000017969 00000 n At the right time and place. 2500 0 obj <>stream %%EOF The COC lays out all the details so that you can stay on top of your coverage. Moving? The handbook will explain your rights, benefits, and responsibilities as a member of Meridian. Monday-Friday, 8 a.m. to 5 p.m. CST Meridian Member Services . You can get this document for free in other formats, such as large print, braille, or audio. 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. 0000021917 00000 n Learn more about how being a Meridian provider benefits you. ATENCIN: Si habla espaol, tiene a su disposicin servicios gratuitos de asistencia lingstica. With HealthChoice Illinois, you have a health plan partner to turn to for help. This is not a complete list. Meridian It explains the medical, dental, vision, and pharmacy services that are covered by your plan. If you experience any problems receiving your mail order prescription, call Member Services at. startxref Representatives are available Monday-Friday, 8 a.m. to 8 p.m. to assist you. Want a paper copy? Please turn on JavaScript and try again. 0000001708 00000 n For information regarding our Pharmacy Benefit Manager (PBM), MeridianRx, visit the MeridianRx website. 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 help make your Medicare and Medicaid benefits work better together and work better for you. The handbook will explain your rights, benefits, and responsibilities as a member of Meridian. (los usuarios de TTY deben llamar al 711), lunes a domingo, de 8 a.m. a 8 p.m. La llamada es gratuita. You are now able to view your health information from a third-party app on a mobile device or PC! Making healthcare decisions can be tough--who to see for care, what to ask, when to go. Complete the Member Notification of Pregnancy(PDF) form in the Member Portal. Call MeridianComplete at 1-855-323-4578 (TTY users should call 711), 8 a.m to 8 p.m., seven days a week. Download the Member Handbook(PDF). Your call will be returned within the next business day. Open Enrollment 6. Call, Usted puede obtener gratuitamente este documento en espaol o hablar con alguien sobre esta informacin en otros idiomas. 0000068680 00000 n Want a paper copy? 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! 0000040481 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. You are leaving this website to go to a website managed by a contracted company, which provides service on our behalf. Llame al. Material ID:H6080_WEBSITE_2023_Accepted_09282022. // ]]>. MeridianComplete is a health plan that contracts with both Medicare and Illinois Medicaid to provide benefits of both programs to enrollees. The handbook will explain your rights, benefits, and responsibilities as a member of Meridian. 0000041209 00000 n 0000046576 00000 n The handbook will explain your rights, benefits, and responsibilities as a member of MeridianComplete. You can join our Start Smart for Your Baby program. You can get this document for free in other formats, such as large print, braille, or audio. 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. You can get this document for free in other formats, such as large print, braille, or audio. 0000041585 00000 n The Member Handbook, along with your enrollment form, serves as MeridianCompletes contract with you. La llamada es gratis. Monday-Friday, 8 a.m. to 8 p.m. CST 0 You can get this document in Spanish, or speak with someone about this information in other languages for free. Youll tell us about any health conditions, recent hospital visits, medications, and more. 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 <. On weekends and on state or federal holidays, you may be asked to leave a message. Limitations, copays, and restrictions may apply. Your call will be returned within the next business day. 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. Making healthcare decisions can be tough--who to see for care, what to ask, when to go. Call 1-855-580-1689 (TTY: 711). Meridian is for people eligible for both Medicaid and Medicare. Provider Network 6 2369 0 obj <> endobj 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)! 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. h|kPQevkmNRIDrDI-)Vw*DYS7cgcr!349g3. %PDF-1.7 % Member ID Cards 5. 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. For more information, or to find out how to get enrolled, please contact Meridian at 888-437-0606. Understanding the ins and outs of your health plan can be difficult. You will need Adobe Reader to open PDFs on this site. 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. A grievance is a complaint about a provider or about the quality of care or services you received. 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. Language Assistance & Notice of Nondiscrimination. Call 1-855-580-1689 (TTY: 711). 0000067354 00000 n 0000047422 00000 n 1-855-580-1689 (TTY 711) The Personal Wellness Assessment is a short form about you and your health journey. The benefit information is a brief summary, not a complete description of benefits. Material ID:H6080_WEBSITE_2023_Accepted_09282022. 2023 For a more comprehensive description of the plan benefits, please refer to your Member Handbook. Looking for your plan home page or interested in becoming a member? 0000002177 00000 n On weekends and on state or federal holidays, you may be asked to leave a message. This site contains various Meridian Medicare-Medicaid Plan (MMP) links and resources. The call is free. An appeal is a way for you to ask for a review of our actions. [CDATA[ Download the Member Handbook (PDF). Under our plan, you will have one card for your Medicare and Medicaid services, including long-term services and supports and prescriptions. You can also visit the Illinois Client Enrollment Services website. If you are using a Meridian provider, you will not have to pay a plan premium, deductible, or copay. Visit your Member Portal or call Member Services. Each link will open a new window and is either a PDF or a website. Your call will be returned within the next business day. Copyright 2023 Meridian All Rights Reserved. You can also visit the Illinois Client Enrollment Services website. 0000002041 00000 n It will help you get the care you need. trailer 1-855-580-1689 (TTY 711) Call Member Services if youd like paper copies of any of these documents. JB Pritzker, Governor Theresa Eagleson, Director. 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. 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. 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. 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. On weekends and on state or federal holidays, you may be asked to leave a message. Llame al 1-855-580-1689 (los usuarios de TTY deben llamar al 711). Other pharmacies/physicians/providers are available in our network. Your call will be returned within the next business day. 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 wish to stay on this website, please click Cancel. The call is free. The benefit information is a brief summary, not a complete description of benefits. You are leaving this website to go to a website managed by a contracted company, which provides service on our behalf. 0000002074 00000 n member.ILmeridian.com. hKq?wNe?t!ARk;v6[IqK,h!i2jLnn}>^| ! For example, we may not approve your providers request for a certain drug. 0000002220 00000 n Call 1-855-580-1689 (TTY: 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. 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. Meridian covers all counties in Illinois. Keep in mind that everything you choose to share is confidential. 0000046799 00000 n You also need to make sure that the Department of Healthcare & Family Services (HFS) has your new address.

Please Find Attached Email Correspondence, Articles M