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. 0000151745 00000 n 0000047422 00000 n This is not a complete list. You can get this document in Spanish, or speak with someone about this information in other languages for free. Language Assistance & Notice of Nondiscrimination. 0000001708 00000 n 0 The Member Handbook, along with your enrollment form, serves as MeridianCompletes contract with you. This is not a complete list. Limitations, copays, and restrictions may apply. All Rights Reserved. Your call will be returned within the next business day. 1-855-580-1689 (TTY 711) Other pharmacies/physicians/providers are available in our network. Representatives are available Monday-Friday, 8 a.m. to 8 p.m. to assist you. La llamada es gratis. Please turn on JavaScript and try again. Keep in mind that everything you choose to share is confidential. Click the link below to view or save a copy. Download the Member Handbook (PDF). Call MeridianComplete at 1-855-323-4578 (TTY users should call 711), 8 a.m to 8 p.m., seven days a week. %PDF-1.7 % It also explains how to find care and how to earn rewards. 0000002074 00000 n The COC lays out all the details so that you can stay on top of your coverage. 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. We want you to be happy with your healthcare services. Each link will open a new window and is either a PDF or a website. If you are using a Meridian provider, you will not have to pay a plan premium, deductible, or copay. Your call will be returned within the next business day. For more information, call MeridianComplete Member Services or read the MeridianComplete Member Handbook. This is not a complete list. 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. 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. La llamada es gratis. You are now able to view your health information from a third-party app on a mobile device or PC! 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 benefit information is a brief summary, not a complete description of benefits. Open Enrollment 6. 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. Provider Network 6 Complete the Member Notification of Pregnancy(PDF) form in the Member Portal. On weekends and on state or federal holidays, With our Medicare-Medicaid Plan (MMP) youre getting: An assigned care manager to help answer questions and coordinate your care. 866-606-3700 . Catching a Breath Complex Case Management Flu Outreach Opioids 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. 167 33 Monday-Friday, 8 a.m. to 8 p.m. CST View your Provider Manual, important plan information and more. If you have any questions, call Meridian Member Services toll-free at 866-606-3700. h|kPQevkmNRIDrDI-)Vw*DYS7cgcr!349g3. 0000017969 00000 n The handbook will explain your rights, benefits, and responsibilities as a member of Meridian. 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. Fill out the Member Notification of Pregnancy form(PDF)to let us know if you are pregnant. You are leaving this website to go to a website managed by a contracted company, which provides service on our behalf. 2021 Member Handbook Illinois Counties: Cook, DuPage, Kane, Kankakee, Lake, Will . https://www.illinois.gov/hfs/healthchoice/Pages/HealthPlans.aspx, https://www.illinois.gov/hfs/healthchoice/reportcard. For more information contact the plan or read the Meridian Member Handbook. 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 <. The call is free. The Member Handbook, along with your enrollment form, serves as Meridian Medicare-Medicaid Plan's (MMP) contract with you. With HealthChoice Illinois, you have a health plan partner to turn to for help. 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. window.location.replace("https://mmp.ilmeridian.com/member/benefits-coverage/whats-covered/member-handbook.html"); Each link will open a new window and is either a PDF or a website. We want you to be happy with the treatment and services you get from Meridian and our providers. You are leaving this website to go to a website managed by a contracted company, which provides service on our behalf. hKq?wNe?t!ARk;v6[IqK,h!i2jLnn}>^| ! 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 Making healthcare decisions can be tough--who to see for care, what to ask, when to go. The Personal Wellness Assessment is a short form about you and your health journey. Out-of-network/non-contracted providers are under no obligation to treat Meridian members, except in emergency situations. 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. Its full of tips and resources for pregnant members and new parents. For more information contact the plan or read the Meridian Member Handbook. xref 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. // stream Your call will be returned within the next business day. 0000001774 00000 n This site contains various MeridianComplete (Medicare-Medicaid Plan) links and resources. Call 1-855-580-1689 (TTY: 711). Monday-Friday, 7:00 a.m. to 5:30 p.m. (TTY: 711) Ser vice area . 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)! 0000010510 00000 n Meridian Understanding the ins and outs of your health plan can be difficult. 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. 2023 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. The call is free. HFS sends paperwork in the mail that you need to renew your Medicaid coverage. ATENCIN: Si habla espaol, tiene a su disposicin servicios gratuitos de asistencia lingstica. Meridian will help make your Medicare and Medicaid benefits work better together and work better for you. 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. The Member Handbook, along with your enrollment form, serves asMeridian Medicare-Medicaid Plan's (MMP) contract with you. Starting January 1, 2018, the Illinois Medicaid Managed Care Program is expanding to include all Llame al 1-855-580-1689 (los usuarios de TTY deben llamar al 711). La llamada es gratis. Download the free version of Adobe Reader. See if you qualify, and explore the HealthChoice Illinois advantage. 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. Material ID:H6080_WEBSITE_2023_Accepted_09282022. Out-of-network/non-contracted providers are under no obligation to treat MeridianComplete members, except in emergency situations. On weekends and on state or federal holidays, you may be asked to leave a message. View our Frequently Asked Questions page. Out-of-network/non-contracted providers are under no obligation to treat Meridian members, except in emergency situations. You can join our Start Smart for Your Baby program. We are excited to share that MeridianCare, a WellCare company, is changing its name to WellCare, effective January 1, 2020! Meridian There are a few ways to complete the form: We want you to have a safe, healthy, and happy pregnancy! hbbd``b`R@AH&="> $ $= @+D C[} "Fod(AE+ Meridian is for people eligible for both Medicaid and Medicare. 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 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: The Annual Notice of Changes (ANOC) is a brief summary of benefits and benefit changes that occurred from one year to the next. HealthChoice Illinois is the smart way most Medicaid members get quality care. 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 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. Call 1-855-580-1689 (TTY: 711). When you go to file, youll want to write when and where the incident took place, and what happened. With added benefits like support making smart health choices, personal care coordination, 24-hour nursing help line, and more. v4P+r-k E`:8\TV%F1MeLT=LyMit+GYrUn*mH gp`x Y;EgPCSSphf>op!mOQtkC v^K#x" 0000046576 00000 n The handbook will explain your rights, benefits, and responsibilities as a member of MeridianComplete. Youll tell us about any health conditions, recent hospital visits, medications, and more. If we fall short, you can file a grievance or appeal. ATENCIN: Si habla espaol, tiene a su disposicin servicios gratuitos de asistencia lingstica. We need to be able to send you important information in the mail. 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. If you wish to stay on this website, please click Cancel. Want a paper copy? 0000021917 00000 n Llame al. 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. 0000002041 00000 n Download the Member Handbook (PDF). Check out the Interoperability page to learn more. 1-855-580-1689 (TTY 711) For certain kinds of drugs, you can use the plans network mail-order services. 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. Your call will be returned within the next business day. If you wish to stay on this website, please click Cancel. It looks like your browser does not have JavaScript enabled. 0000002177 00000 n This way, we can connect you with the right care. We will send you a notice before we make a change that affects you. The call is free. Your handbook is full of important information about your health care and Meridian. Your Member Handbook is a great resource if you have any questions or just want to learn more about your coverage. Member ID Cards 5. Monday-Friday, 8 a.m. to 5 p.m. CST Our Population Health Management Programs are offered to Meridian members and designed to improve your overall health and quality of care. On weekends and on state or federal holidays, you may be asked to leave a message. // ]]>. 0 Meridian will work with you to make sure you get all of the care you need, when you need it. Su llamada ser devuelta dentro del siguiente da hbil. 0000014634 00000 n Other pharmacies/physicians/providers are available in our network. 0000002131 00000 n 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. providerhelp.IL@mhplan.com. 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 is not a complete list. 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: Your call will be returned within the next business day. Report an address update to HFS online. You will need Adobe Reader to open PDFs on this site. Copyright 2023 Meridian All Rights Reserved. 0000046799 00000 n At the right time and place. Other pharmacies/physicians/providers are available in our network. It explains the medical, dental, vision, and pharmacy services that are covered by your plan. 2023 3. 0000002220 00000 n If you have questions, please call MeridianComplete (Medicare-Medicaid Plan) Member Services at 1-855-580-1689 (TTY users should call 711). endstream endobj startxref For more information contact the plan or read the Meridian Member Handbook. Call Member Services if youd like paper copies of any of these documents. The benefit information is a brief summary, not a complete description of benefits. You also need to make sure that the Department of Healthcare & Family Services (HFS) has your new address. You can also file a grievance or appeal on the phone by calling Member Services or in writing via mail or fax. If you wish to stay on this website, please click Cancel. 0000067553 00000 n If you experience any problems receiving your mail order prescription, call Member Services at. The handbook will explain your rights, benefits, and responsibilities as a member of Meridian. %PDF-1.4 % MeridianComplete is a health plan that contracts with both Medicare and Illinois Medicaid to provide benefits of both programs to enrollees. Moving? Copays for prescription drugs may vary based on the level of Extra Help you receive. The Provider Manual has everything you need to know about member benefits, coverage, and provider guidelines. Making healthcare decisions can be tough--who to see for care, what to ask, when to go. 0000080946 00000 n 0000041668 00000 n You can also visit the Illinois Client Enrollment Services website. It also explains how to find care and how to earn rewards. On weekends and on state or federal holidays, you may be asked to leave a message. Monday-Friday, 8 a.m. to 8 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. Learn more about how being a Meridian provider benefits you. You will need Adobe Reader to open PDFs on this site. 0000041585 00000 n 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. A grievance is a complaint about a provider or about the quality of care or services you received. 0000000016 00000 n Meridian Member Services . 0000006553 00000 n 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. Your call will be returned within the next business day. You will need Adobe Reader to open PDFs on this site. For information regarding our Pharmacy Benefit Manager (PBM), MeridianRx, visit the MeridianRx website. member.ILmeridian.com. Other pharmacies/physicians/providers are available in our network. startxref [CDATA[ It outlines services and benefits that areand are notcovered. 0000067354 00000 n 0000046966 00000 n 0000040678 00000 n ATTENTION: If you speak a language other than English, language assistance services, free of charge, are available to you. JB Pritzker, Governor Theresa Eagleson, Director. 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. Want a paper copy? On weekends and on state or federal holidays, you may be asked to leave a message. Su llamada ser devuelta dentro del siguiente da hbil. It also explains how to find care and how to earn rewards. It will help you get the care you need. A certificate of coverage (COC) tells you what to expect from your healthcare plan. 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. trailer Representatives are available Monday-Friday, 8 a.m. to 8 p.m. to assist you. 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. Don't forget to call your local HFS oce and Meridian Member Services with your new address. You are leaving this website to go to a website managed by a contracted company, which provides service on our behalf. 0000040481 00000 n Just call Member Services with your new address. MeridianComplete (Medicare-Medicaid Plan) is a health plan that contracts with both Medicare and Michigan Medicaid to provide benefits of both programs to enrollees. 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) 0000025980 00000 n With HealthChoice Illinois, you have a health plan partner to turn to for help. With added benefitslike supportmakingsmart health choices, personal care coordination, 24-hour nursing help line, and more. Want a paper copy? Each link will open a new window and is either a PDF or a website. The handbook will explain your rights, benefits, and responsibilities as a member of Meridian. 0000000956 00000 n For example, we may not approve your providers request for a certain drug. The call is free. 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. +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. (los usuarios de TTY deben llamar al 711), lunes a domingo, de 8 a.m. a 8 p.m. La llamada es gratuita. 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. Your Member Handbook is a great resource if you have any questions or just want to learn more about your coverage. You can get this document for free in other formats, such as large print, braille, or audio. You will need Adobe Reader to open PDFs on this site. Please contact the plan for more details. 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. Visit your Member Portal or call Member Services. All Rights Reserved. It explains the medical, dental, vision, and pharmacy services that are covered by your plan. An appeal is a way for you to ask for a review of our actions. 2369 0 obj <> endobj 0000025639 00000 n If you wish to stay on this website, please click Cancel. <<0B5A082EC79D7049BD46C1656B63CA22>]/Prev 539953>> The right care for you. Call, Usted puede obtener gratuitamente este documento en espaol o hablar con alguien sobre esta informacin en otros idiomas. This site contains various Meridian Medicare-Medicaid Plan (MMP) links and resources. 0000068680 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. 1-855-580-1689 (TTY 711) It will also explain our responsibilities to you, as well as outline the following details: 0000068208 00000 n ATENCIN: Si habla espaol, tiene a su disposicin servicios gratuitos de asistencia lingstica. Find a doctor, explore coverage, review documents and much more. For a more comprehensive description of the plan benefits, please refer to your Member Handbook. You are leaving this website to go to a website managed by a contracted company, which provides service on our behalf. Prior Authorization, Step Therapy and Quantity Limits, Coverage Determinations and Redeterminations for Drugs, Notice of Nondiscrimination & Language Assistance. If your address changes, let us know. 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. 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. The call is free. 167 0 obj <> endobj 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. For a more comprehensive description of the plan benefits, please refer to your Member Handbook which can also be found on this page.