This site contains various Meridian Medicare-Medicaid Plan (MMP) links and resources. Please visit our new website to see up to date information about your plan. With added benefits like support making smart health choices, personal care coordination, 24-hour nursing help line, and more. This handbook will help you understand your coverage. Under our plan, you will have one card for your Medicare and Medicaid services, including long-term services and supports and prescriptions. 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. %PDF-1.4 % 0000001708 00000 n member.ILmeridian.com. 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. 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. 3. The handbook will explain your rights, benefits, and responsibilities as a member of MeridianComplete. You will need Adobe Reader to open PDFs on this site. Prior Authorization, Step Therapy and Quantity Limits, Coverage Determinations and Redeterminations for Drugs, Notice of Nondiscrimination & Language Assistance. There are a few ways to complete the form: We want you to have a safe, healthy, and happy pregnancy! Your call will be returned within the next business day. endstream endobj startxref JB Pritzker, Governor Theresa Eagleson, Director. You can get this document for free in other formats, such as large print, braille, or audio. 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. La llamada es gratis. 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. 2023 On weekends and on state or federal holidays, This is not a complete list. Our Population Health Management Programs are offered to Meridian members and designed to improve your overall health and quality of care. 0000025980 00000 n Please review the various programs below. It will help you get the care you need. If you wish to stay on this website, please click Cancel. Please contact the plan for more details. 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. Your Member Handbook is a great resource if you have any questions or just want to learn more about your coverage. Llame al 1-855-580-1689 (los usuarios de TTY deben llamar al 711). The COC lays out all the details so that you can stay on top of your coverage. Su llamada ser devuelta dentro del siguiente da hbil. providerhelp.IL@mhplan.com, The Interoperability and Patient Access Rule. Catching a Breath Complex Case Management Flu Outreach Opioids ATENCIN: Si habla espaol, tiene a su disposicin servicios gratuitos de asistencia lingstica. 0000067553 00000 n Call Member Services if youd like paper copies of any of these documents. For example, we may not approve your providers request for a certain drug. 1-855-580-1689 (TTY 711) The call is free. 2021 Member Handbook Illinois Counties: Cook, DuPage, Kane, Kankakee, Lake, Will . For information regarding our Pharmacy Benefit Manager (PBM), MeridianRx, visit the MeridianRx website. 0000047422 00000 n It will also explain our responsibilities to you, as well as outline the following details: 199 0 obj <>stream The benefit information is a brief summary, not a complete description of benefits. We want you to be happy with the treatment and services you get from Meridian and our providers. We need to be able to send you important information in the mail. 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. Your call will be returned within the next business day. A grievance is a complaint about a provider or about the quality of care or services you received. h|kPQevkmNRIDrDI-)Vw*DYS7cgcr!349g3. 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. Each link will open a new window and is either a PDF or a website. 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 It outlines services and benefits that areand are notcovered. Su llamada ser devuelta dentro del siguiente da hbil. Provider Network 6 The Member Handbook, along with your enrollment form, serves asMeridian Medicare-Medicaid Plan's (MMP) contract with you. xref 1-855-580-1689 (TTY 711) Call 1-855-580-1689 (TTY: 711). If you have any questions, call Meridian Member Services toll-free at 866-606-3700. The benefit information is a brief summary, not a complete description of benefits. This site contains various MeridianComplete (Medicare-Medicaid Plan) links and resources. HealthChoice Illinois is the smart way most Medicaid members get quality care. You can also visit the Illinois Client Enrollment Services website. 0000046386 00000 n 0000041668 00000 n Call, Usted puede obtener gratuitamente este documento en espaol o hablar con alguien sobre esta informacin en otros idiomas. Out-of-network/non-contracted providers are under no obligation to treat Meridian members, except in emergency situations. The benefit information is a brief summary, not a complete description of benefits. 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. Report an address update to HFS online. 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. For more information contact the plan or read the Meridian Member Handbook. The Provider Manual has everything you need to know about member benefits, coverage, and provider guidelines. On weekends and on state or federal holidays, you may be asked to leave a message. 0000072727 00000 n You will need Adobe Reader to open PDFs on this site. Meridian covers all counties in Illinois. The Health Library is a free resource exclusively for MeridianComplete members and providers. Looking for your plan home page or interested in becoming a member? You can join our Start Smart for Your Baby program. The handbook will explain your rights, benefits, and responsibilities as a member of Meridian. 0 Click the link below to view or save a copy. It looks like your browser does not have JavaScript enabled. If you experience any problems receiving your mail order prescription, call Member Services at. 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. Want a paper copy? 0000046799 00000 n Monday-Friday, 8 a.m. to 8 p.m. CST Be sure to read your Meridian Member Handbook and keep it handy. You are leaving this website to go to a website managed by a contracted company, which provides service on our behalf. With added benefitslike supportmakingsmart health choices, personal care coordination, 24-hour nursing help line, and more. You will be able to work with one health plan for all of your health insurance needs. This site contains various Meridian Medicare-Medicaid Plan (MMP) links and resources. 0000025639 00000 n 2369 0 obj <> endobj Out-of-network/non-contracted providers are under no obligation to treat MeridianComplete members, except in emergency situations. La llamada es gratis. View your Provider Manual, important plan information and more. If your address changes, let us know. We will send you a notice before we make a change that affects 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.mi@mhplan.com. You can get this document in Spanish, or speak with someone about this information in other languages for free. Monday-Friday, 8 a.m. to 5 p.m. CST 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. You can also file a grievance or appeal on the phone by calling Member Services or in writing via mail or fax. Language Assistance & Notice of Nondiscrimination. You are leaving this website to go to a website managed by a contracted company, which provides service on our behalf. You are leaving this website to go to a website managed by a contracted company, which provides service on our behalf. Making healthcare decisions can be tough--who to see for care, what to ask, when to go. Other pharmacies/physicians/providers are available in our network. Call MeridianComplete at 1-855-323-4578 (TTY users should call 711), 8 a.m to 8 p.m., seven days a week. 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! For certain kinds of drugs, you can use the plans network mail-order services. hbbd``b`R@AH&="> $ $= @+D C[} "Fod(AE+ It will also explain our responsibilities to you, as well as outline the following details: Download the Member Handbook(PDF). v4P+r-k E`:8\TV%F1MeLT=LyMit+GYrUn*mH gp`x Y;EgPCSSphf>op!mOQtkC v^K#x" 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. 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. You can get this document for free in other formats, such as large print, braille, or audio. Usually a mail-order pharmacy order will get to you in no more than 5 days. We are excited to share that MeridianCare, a WellCare company, is changing its name to WellCare, effective January 1, 2020! HFS sends paperwork in the mail that you need to renew your Medicaid coverage. Llame al. The handbook will explain your rights, benefits, and responsibilities as a member of Meridian. For a more comprehensive description of the plan benefits, please refer to your Member Handbook. 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. Want a paper copy? Want a paper copy? You are now able to view your health information from a third-party app on a mobile device or PC! See if you qualify, and explore the HealthChoice Illinois advantage. 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. 0000041585 00000 n 1-855-580-1689 (TTY 711) You will need Adobe Reader to open PDFs on this site. ATTENTION: If you speak a language other than English, language assistance services, free of charge, are available to you. Out-of-network/non-contracted providers are under no obligation to treat Meridian members, except in emergency situations. <<0B5A082EC79D7049BD46C1656B63CA22>]/Prev 539953>> The handbook will explain your rights, benefits, and responsibilities as a member of Meridian. Download the Member Handbook (PDF). 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. 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. Just call Member Services with your new address. Your call will be returned within the next business day. Visit your Member Portal or call Member Services. For more information, call MeridianComplete Member Services or read the MeridianComplete Member Handbook. It also explains how to find care and how to earn rewards. The right care for you. Each link will open a new window and is either a PDF or a website. Material ID:H6080_WEBSITE_2023_Accepted_09282022. You can make an appeal if you disagree with our verdict. 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. 0000068208 00000 n 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 is for people eligible for both Medicaid and Medicare. If you are using a Meridian provider, you will not have to pay a plan premium, deductible, or copay. 2023 Starting January 1, 2018, the Illinois Medicaid Managed Care Program is expanding to include all %%EOF If your pregnancy is at high risk, we may call you. Copays for prescription drugs may vary based on the level of Extra Help you receive. You will need Adobe Reader to open PDFs on this site. 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) Each link will open a new window and is either a PDF or a website. Learn more about how being a Meridian provider benefits you. 0000006553 00000 n 0000067354 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. Moving? 167 33 For more information, or to find out how to get enrolled, please contact Meridian at 888-437-0606. Other pharmacies/physicians/providers are available in our network. The call is free. All Rights Reserved. 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. If you wish to stay on this website, please click Cancel. For more information contact the plan or read the Meridian Member Handbook. 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. You've got questions and we've got answers. ATENCIN: Si habla espaol, tiene a su disposicin servicios gratuitos de asistencia lingstica. 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)! This is not a complete list. 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. ATENCIN: Si habla espaol, tiene a su disposicin servicios gratuitos de asistencia lingstica. hKq?wNe?t!ARk;v6[IqK,h!i2jLnn}>^| ! Important Phone Numbers & Contacts In an Emergency 911 Meridian Member Services 866-606-3700 The Member Handbook, along with your enrollment form, serves as Meridian Medicare-Medicaid Plan's (MMP) contract with you. Representatives are available Monday-Friday, 8 a.m. to 8 p.m. to assist you. The Member Handbook, along with your enrollment form, serves as Meridian Medicare-Medicaid Plan's (MMP) contract with you. 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. 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. It also explains how to find care and how to earn rewards. +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 MeridianComplete (Medicare-Medicaid Plan) is a health plan that contracts with both Medicare and Michigan Medicaid to provide benefits of both programs to enrollees. Download the free version of Adobe Reader. window.location.replace("https://mmp.ilmeridian.com/member/benefits-coverage/whats-covered/member-handbook.html"); MeridianComplete is a health plan that contracts with both Medicare and Illinois Medicaid to provide benefits of both programs to enrollees. If you have questions, please call MeridianComplete (Medicare-Medicaid Plan) Member Services at 1-855-580-1689 (TTY users should call 711). 0000046576 00000 n 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. 0000041209 00000 n For more information contact the plan or read the Meridian Member Handbook. https://www.illinois.gov/hfs/healthchoice/Pages/HealthPlans.aspx, https://www.illinois.gov/hfs/healthchoice/reportcard. Material ID:H6080_WEBSITE_2023_Accepted_09282022. %PDF-1.7 % Open Enrollment 6. 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. 0000080946 00000 n Other pharmacies/physicians/providers are available in our network. 0000002220 00000 n Youll tell us about any health conditions, recent hospital visits, medications, and more. With HealthChoice Illinois, you have a health plan partner to turn to for help. 0000001774 00000 n Fill out the Member Notification of Pregnancy form(PDF)to let us know if you are pregnant. 0000010510 00000 n Meridian will work with you to make sure you get all of the care you need, when you need it. Keep in mind that everything you choose to share is confidential. Call 1-855-580-1689 (TTY: 711). Meridian will help make your Medicare and Medicaid benefits work better together and work better for you. If you wish to stay on this website, please click Cancel. Download the Member Handbook (PDF). La llamada es gratis. 0000151745 00000 n The call is free. The call is free. Monday-Friday, 7:00 a.m. to 5:30 p.m. (TTY: 711) Ser vice area . The Personal Wellness Assessment is a short form about you and your health journey. Each link will open a new window and is either a PDF or a website. startxref For more information contact the plan or read the MeridianComplete Member Handbook. The List of Covered Drugs and/or pharmacy and provider networks may change throughout the year. You are leaving this website to go to a website managed by a contracted company, which provides service on our behalf. // stream 0000017969 00000 n 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. Member ID Cards 5. If we fall short, you can file a grievance or appeal. Meridian 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. Your handbook is full of important information about your health care and Meridian. Monday-Friday, 8 a.m. to 8 p.m. CST Su llamada ser devuelta dentro del siguiente da hbil. 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. On weekends and on state or federal holidays, you may be asked to leave a message. Representatives are available Monday-Friday, 8 a.m. to 8 p.m. to assist you. It also explains how to find care and how to earn rewards. You can also visit the Illinois Client Enrollment Services website. Your call will be returned within the next business day. You can get this document for free in other formats, such as large print, braille, or audio. For a more comprehensive description of the plan benefits, please refer to your Member Handbook which can also be found on this page. We can connect you with support, services, and even rewards. Llame al 1-855-580-1689 (los usuarios de TTY deben llamar al 711). 0000002041 00000 n Don't forget to call your local HFS oce and Meridian Member Services with your new address. 0000068680 00000 n 0000040678 00000 n 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. // ]]>. 0000000016 00000 n Copyright 2023 Meridian All Rights Reserved. Understanding the ins and outs of your health plan can be difficult. 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 <. Meridian At the right time and place. Llame al 1-855-580-1689 (los usuarios de TTY deben llamar al 711). 0 0000002131 00000 n Making healthcare decisions can be tough--who to see for care, what to ask, when to go.
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