Out-of-network/non-contracted providers are under no obligation to treat Meridian members, except in emergency situations. 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. Each link will open a new window and is either a PDF or a website. 2021 Member Handbook Illinois Counties: Cook, DuPage, Kane, Kankakee, Lake, Will . 0000072727 00000 n v4P+r-k E`:8\TV%F1MeLT=LyMit+GYrUn*mH gp`x Y;EgPCSSphf>op!mOQtkC v^K#x" For certain kinds of drugs, you can use the plans network mail-order services. 0000080946 00000 n Fill out the Member Notification of Pregnancy form(PDF)to let us know if you are pregnant. La llamada es gratis. For a more comprehensive description of the plan benefits, please refer to your Member Handbook which can also be found on this page. The call is free. HealthChoice Illinois | HFS Meridian is for people eligible for both Medicaid and Medicare. 1-855-580-1689 (TTY 711) %PDF-1.4 % The handbook will explain your rights, benefits, and responsibilities as a member of Meridian. Meridian Medicare-Medicaid Plan (MMP) is a health plan that contracts with both Medicare and Illinois Medicaid to provide benefits of both programs to enrollees. Your Member Handbook is a great resource if you have any questions or just want to learn more about your coverage. Each link will open a new window and is either a PDF or a website. Your Member Handbook is a great resource if you have any questions or just want to learn more about your coverage. It will also explain our responsibilities to you, as well as outline the following details: 0000046576 00000 n 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. For a more comprehensive description of the plan benefits, please refer to your Member Handbook. Moving? La llamada es gratis. You are leaving this website to go to a website managed by a contracted company, which provides service on our behalf. All Rights Reserved. Call MeridianComplete at 1-855-323-4578 (TTY users should call 711), 8 a.m to 8 p.m., seven days a week. It will help you get the care you need. It outlines services and benefits that areand are notcovered. Open Enrollment 6. Just call Member Services with your new address. You will be able to work with one health plan for all of your health insurance needs. For Members | Meridian The handbook will explain your rights, benefits, and responsibilities as a member of MeridianComplete. Providers - MeridianComplete Want a paper copy? The call is free. Language Assistance & Notice of Nondiscrimination. Monday-Friday, 8 a.m. to 8 p.m. CST 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. If you wish to stay on this website, please click Cancel. ATENCIN: Si habla espaol, tiene a su disposicin servicios gratuitos de asistencia lingstica. Your call will be returned within the next business day. With added benefits like support making smart health choices, personal care coordination, 24-hour nursing help line, and more. Keep in mind that everything you choose to share is confidential. Your call will be returned within the next business day. Llame al 1-855-580-1689 (los usuarios de TTY deben llamar al 711). It explains the medical, dental, vision, and pharmacy services that are covered by your plan. The benefit information is a brief summary, not a complete description of benefits. For more information contact the plan or read the Meridian Member Handbook. Starting January 1, 2018, the Illinois Medicaid Managed Care Program is expanding to include all 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. 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. window.location.replace("https://mmp.ilmeridian.com/member/benefits-coverage/whats-covered/member-handbook.html"); If we fall short, you can file a grievance or appeal. Copyright 2023 Meridian All Rights Reserved. This site contains various Meridian Medicare-Medicaid Plan (MMP) 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. PDF ILLINOIS MEMBER HANDBOOK - Meridian Illinois Managed Care Plans The call is free. Want a paper copy? It also explains how to find care and how to earn rewards. Member Handbooks and Forms // /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 At the right time and place. 0000002074 00000 n Under our plan, you will have one card for your Medicare and Medicaid services, including long-term services and supports and prescriptions. +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 You will need Adobe Reader to open PDFs on this site. Copays for prescription drugs may vary based on the level of Extra Help you receive. If you have questions, please call MeridianComplete (Medicare-Medicaid Plan) Member Services at 1-855-580-1689 (TTY users should call 711). Please note that once you have left our website, you may be able to access portions of the contracted company's website that are not related to your plan. 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. It explains the medical, dental, vision, and pharmacy services that are covered by your plan. fm.formularynavigator.com,medicare.entrykeyid.com,member.membersecurelogin.com,mmp.ilmeridian.com,findaprovider.mmp.ilmeridian.com,provider.mmp.mimeridian.com, Prior Authorization, Step Therapy and Quantity Limits, Coverage Determinations and Redeterminations for Drugs, 2022 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 are excited to share that MeridianCare, a WellCare company, is changing its name to WellCare, effective January 1, 2020! PDF here's your member handbook. 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. This handbook will help you understand your coverage. Important Phone Numbers & Contacts In an Emergency 911 Meridian Member Services 866-606-3700 Limitations, copays, and restrictions may apply. 167 0 obj <> endobj You also need to make sure that the Department of Healthcare & Family Services (HFS) has your new address. 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. 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. The handbook will explain your rights, benefits, and responsibilities as a member of Meridian. We want you to be happy with the treatment and services you get from Meridian and our providers. 1-855-580-1689 (TTY 711) 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. For more information, call MeridianComplete Member Services or read the MeridianComplete Member Handbook. You can also file a grievance or appeal on the phone by calling Member Services or in writing via mail or fax. 0000041585 00000 n Be sure to read your Meridian Member Handbook and keep it handy. 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. Documents and Forms - Meridian Medicare Medicaid Plan If you are using a Meridian provider, you will not have to pay a plan premium, deductible, or copay. Meridian covers all counties in Illinois. Representatives are available Monday-Friday, 8 a.m. to 8 p.m. to assist you. This is not a complete list. Meridian will work with you to make sure you get all of the care you need, when you need it. The handbook will explain your rights, benefits, and responsibilities as a member of Meridian. // ]]>. Monday-Friday, 7:00 a.m. to 5:30 p.m. (TTY: 711) Ser vice area . You can join our Start Smart for Your Baby program. 0000001774 00000 n When you go to file, youll want to write when and where the incident took place, and what happened. On weekends and on state or federal holidays, you may be asked to leave a message. Understanding the ins and outs of your health plan can be difficult. Meridian Medicare Medicaid Plan Meridian 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. 866-606-3700 . You are leaving this website to go to a website managed by a contracted company, which provides service on our behalf. Member ID Cards 5. You can also visit the Illinois Client Enrollment Services website. We can connect you with support, services, and even rewards. The Health Library is a free resource exclusively for MeridianComplete members and providers. With our Medicare-Medicaid Plan (MMP) youre getting: An assigned care manager to help answer questions and coordinate your care. Click the link below to view or save a copy. 2023 Don't forget to call your local HFS oce and Meridian Member Services with your new address. All Rights Reserved. 0000017969 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. MeridianHealth is now Meridian! 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. This is not a complete list. You will need Adobe Reader to open PDFs on this site. 0000014634 00000 n providerhelp.IL@mhplan.com. Provider Network 6 ATENCIN: Si habla espaol, tiene a su disposicin servicios gratuitos de asistencia lingstica. %%EOF 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. Complete the Member Notification of Pregnancy(PDF) form in the Member Portal. The Member Handbook, along with your enrollment form, serves as Meridian Medicare-Medicaid Plan's (MMP) contract with you. 0000021917 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. The Provider Manual has everything you need to know about member benefits, coverage, and provider guidelines. The List of Covered Drugs and/or pharmacy and provider networks may change throughout the year. Your call will be returned within the next business day. Its full of tips and resources for pregnant members and new parents. 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. Usually a mail-order pharmacy order will get to you in no more than 5 days. On weekends and on state or federal holidays, 0000151745 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. This way, we can connect you with the right care. Provider Manual | Meridian Health Plan of Illinois We want you to be happy with your healthcare services. With HealthChoice Illinois, you have a health plan partner to turn to for help. 0000040481 00000 n There are a few ways to complete the form: We want you to have a safe, healthy, and happy pregnancy! 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. Member Handbook | Meridian Health Plan of Illinois 0 0000000016 00000 n https://www.illinois.gov/hfs/healthchoice/Pages/HealthPlans.aspx, https://www.illinois.gov/hfs/healthchoice/reportcard. member.ILmeridian.com. 0000025639 00000 n For example, we may not approve your providers request for a certain drug. 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 MeridianCompletes contract with you. You will need Adobe Reader to open PDFs on this site. 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 <. 2369 0 obj <> endobj See if you qualify, and explore the HealthChoice Illinois advantage. The handbook will explain your rights, benefits, and responsibilities as a member of 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. Member Handbook - Meridian Medicare Medicaid Plan HFS sends paperwork in the mail that you need to renew your Medicaid coverage. 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. This site contains various Meridian Medicare-Medicaid Plan (MMP) links and resources. 199 0 obj <>stream MeridianComplete (Medicare-Medicaid Plan) is a health plan that contracts with both Medicare and Michigan Medicaid to provide benefits of both programs to enrollees. It also explains how to find care and how to earn rewards. If you have any questions, call Meridian Member Services toll-free at 866-606-3700. 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. Call 1-855-580-1689 (TTY: 711). Looking for your plan home page or interested in becoming a member? JB Pritzker, Governor Theresa Eagleson, Director. Llame al 1-855-580-1689 (los usuarios de TTY deben llamar al 711). On weekends and on state or federal holidays, you may be asked to leave a message. More information is in your Member Handbook(PDF). 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. 0000002177 00000 n 0000046966 00000 n startxref Report an address update to HFS online. The Member Handbook, along with your enrollment form, serves asMeridian Medicare-Medicaid Plan's (MMP) contract with you. If your address changes, let us know. You can get this document in Spanish, or speak with someone about this information in other languages for free. Our Population Health Management Programs are offered to Meridian members and designed to improve your overall health and quality of care. 0 The call is free. The Member Handbook, along with your enrollment form, serves as Meridian Medicare-Medicaid Plan's (MMP) contract with you. Material ID:H6080_WEBSITE_2023_Accepted_09282022. Download the Member Handbook(PDF). The benefit information is a brief summary, not a complete description of benefits. 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! PDF Welcome to MeridianHealth Intro to Plan This is not a complete list. Representatives are available Monday-Friday, 8 a.m. to 8 p.m. to assist you. You will need Adobe Reader to open PDFs on this site. Your handbook is full of important information about your health care and Meridian. You can make an appeal if you disagree with our verdict. Prior Authorization, Step Therapy and Quantity Limits, Coverage Determinations and Redeterminations for Drugs, Notice of Nondiscrimination & Language Assistance. We are excited to share that MeridianCare, a WellCare company, is changing its name to WellCare, effective January 1, 2020! Download the Member Handbook (PDF). You've got questions and we've got answers. This site contains various MeridianComplete (Medicare-Medicaid Plan) links and resources. This is not a complete list. On weekends and on state or federal holidays, you may be asked to leave a message. 0000067553 00000 n 2500 0 obj <>stream A certificate of coverage (COC) tells you what to expect from your healthcare plan. 1-855-580-1689 (TTY 711) 2023 Member Handbook | Meridian Complete of Illinois Check out the Interoperability page to learn more. The COC lays out all the details so that you can stay on top of your coverage. 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. Monday-Friday, 8 a.m. to 8 p.m. CST It looks like your browser does not have JavaScript enabled. A grievance is a complaint about a provider or about the quality of care or services you received. If you wish to stay on this website, please click Cancel. Llame al 1-855-580-1689 (los usuarios de TTY deben llamar al 711). endstream endobj startxref Meridian Member Services . It also explains how to find care and how to earn rewards. The Personal Wellness Assessment is a short form about you and your health journey. 2022 Provider Manual (PDF) Meridian Provider Manual Errata Sheet (PDF) Documents and Forms Medical Referrals & Authorizations Pharmacy Billing Mandatory Training Attestation Download the Member Handbook (PDF). Other pharmacies/physicians/providers are available in our network. 0000041668 00000 n Other pharmacies/physicians/providers are available in our network. Please visit our new website to see up to date information about your plan. PDF 2021 Member Handbook - Meridian Medicare Medicaid Plan If you need help finding a network provider and/or pharmacy, please call 1-855-323-4578 (TTY 711) or visit mmp.mimeridian.com to access our online searchable directory. Llame al. 0000010510 00000 n Download the free version of Adobe Reader. <<0B5A082EC79D7049BD46C1656B63CA22>]/Prev 539953>> For more information contact the plan or read the MeridianComplete Member Handbook. 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) Meridian Please contact the plan for more details. Monday-Friday, 8 a.m. to 5 p.m. CST Please note that once you have left our website, you may be able to access portions of the contracted company's website that are not related to your plan. La llamada es gratis. Want a paper copy? 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. (los usuarios de TTY deben llamar al 711), lunes a domingo, de 8 a.m. a 8 p.m. La llamada es gratuita. MeridianComplete is a health plan that contracts with both Medicare and Illinois Medicaid to provide benefits of both programs to enrollees. The benefit information is a brief summary, not a complete description of benefits. 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. 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. Out-of-network/non-contracted providers are under no obligation to treat Meridian members, except in emergency situations. We need to be able to send you important information in the mail. Su llamada ser devuelta dentro del siguiente da hbil. 0000002131 00000 n 0000002220 00000 n trailer Please review the various programs below. Your call will be returned within the next business day. Youll tell us about any health conditions, recent hospital visits, medications, and more. 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. %PDF-1.7 % h|kPQevkmNRIDrDI-)Vw*DYS7cgcr!349g3. 167 33 If you experience any problems receiving your mail order prescription, call Member Services at. With HealthChoice Illinois, you have a health plan partner to turn to for help. %%EOF 0000002041 00000 n You are leaving this website to go to a website managed by a contracted company, which provides service on our behalf. If you wish to stay on this website, please click Cancel. Making healthcare decisions can be tough--who to see for care, what to ask, when to go. The benefit information is a brief summary, not a complete description of benefits. It explains the medical, dental, vision, and pharmacy services that are covered by your plan. You can get this document for free in other formats, such as large print, braille, or audio. Call Member Services if youd like paper copies of any of these documents. You can also visit the Illinois Client Enrollment Services website. Please turn on JavaScript and try again. 0000067354 00000 n 0000068208 00000 n ATENCIN: Si habla espaol, tiene a su disposicin servicios gratuitos de asistencia lingstica. If you wish to stay on this website, please click Cancel. You are leaving this website to go to a website managed by a contracted company, which provides service on our behalf. 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)!