meridian illinois member handbook

The benefit information is a brief summary, not a complete description of benefits. If you have questions, please call MeridianComplete (Medicare-Medicaid Plan) Member Services at 1-855-580-1689 (TTY users should call 711). Download the Member Handbook (PDF). For a more comprehensive description of the plan benefits, please refer to your Member Handbook. For more information contact the plan or read the Meridian Member Handbook. The benefit information is a brief summary, not a complete description of benefits. The call is free. It will also explain our responsibilities to you, as well as outline the following details: The benefit information is a brief summary, not a complete description of benefits. Each link will open a new window and is either a PDF or a website. Each link will open a new window and is either a PDF or a website. On weekends and on state or federal holidays, you may be asked to leave a message. Its full of tips and resources for pregnant members and new parents. 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. // ]]>. You also need to make sure that the Department of Healthcare & Family Services (HFS) has your new address. Su llamada ser devuelta dentro del siguiente da hbil. On weekends and on state or federal holidays, you may be asked to leave a message. You are leaving this website to go to a website managed by a contracted company, which provides service on our behalf. 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. 0000001774 00000 n It will help you get the care you need. It explains the medical, dental, vision, and pharmacy services that are covered by your plan. %PDF-1.4 % 0000041585 00000 n 1-855-580-1689 (TTY 711) 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! Other pharmacies/physicians/providers are available in our network. If you wish to stay on this website, please click Cancel. 0000046799 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. This site contains various MeridianComplete (Medicare-Medicaid Plan) links and resources. For more information, or to find out how to get enrolled, please contact Meridian at 888-437-0606. It will also explain our responsibilities to you, as well as outline the following details: 0000002041 00000 n 0000002220 00000 n 1-855-580-1689 (TTY 711) With added benefits like support making smart health choices, personal care coordination, 24-hour nursing help line, and more. Material ID:H6080_WEBSITE_2023_Accepted_09282022. 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. A grievance is a complaint about a provider or about the quality of care or services you received. Out-of-network/non-contracted providers are under no obligation to treat MeridianComplete members, except in emergency situations. Important Phone Numbers & Contacts In an Emergency 911 Meridian Member Services 866-606-3700 Meridian 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. If you have any questions, call Meridian Member Services toll-free at 866-606-3700. Provider Network 6 This site contains various Meridian Medicare-Medicaid Plan (MMP) links and resources. Meridian covers all counties in Illinois. Meridian Out-of-network/non-contracted providers are under no obligation to treat Meridian members, except in emergency situations. Open Enrollment 6. Check out the Interoperability page to learn more. The Health Library is a free resource exclusively for MeridianComplete members and providers. Each link will open a new window and is either a PDF or a website. More information is in your Member Handbook(PDF). Limitations, copays, and restrictions may apply. You can also visit the Illinois Client Enrollment Services website. Language Assistance & Notice of Nondiscrimination. Your call will be returned within the next business day. Llame al. You are leaving this website to go to a website managed by a contracted company, which provides service on our behalf. https://www.illinois.gov/hfs/healthchoice/Pages/HealthPlans.aspx, https://www.illinois.gov/hfs/healthchoice/reportcard. It explains the medical, dental, vision, and pharmacy services that are covered by your plan. Call MeridianComplete at 1-855-323-4578 (TTY users should call 711), 8 a.m to 8 p.m., seven days a week. 2023 The right care for you. You are leaving this website to go to a website managed by a contracted company, which provides service on our behalf. member.ILmeridian.com. Call 1-855-580-1689 (TTY: 711). It also explains how to find care and how to earn rewards. ATTENTION: If you speak a language other than English, language assistance services, free of charge, are available to you. 0000067354 00000 n The call is free. Catching a Breath Complex Case Management Flu Outreach Opioids On weekends and on state or federal holidays, you may be asked to leave a message. Other pharmacies/physicians/providers are available in our network. It explains the medical, dental, vision, and pharmacy services that are covered by your plan. You can also file a grievance or appeal on the phone by calling Member Services or in writing via mail or fax. 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. For more information, call MeridianComplete Member Services or read the MeridianComplete Member Handbook. 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.mi@mhplan.com. 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. You will need Adobe Reader to open PDFs on this site. Complete the Member Notification of Pregnancy(PDF) form in the Member Portal. ATENCIN: Si habla espaol, tiene a su disposicin servicios gratuitos de asistencia lingstica. endstream endobj startxref 0000001708 00000 n You will need Adobe Reader to open PDFs on this site. You are leaving this website to go to a website managed by a contracted company, which provides service on our behalf. The handbook will explain your rights, benefits, and responsibilities as a member of Meridian. Your call will be returned within the next business day. For certain kinds of drugs, you can use the plans network mail-order services. 0000000016 00000 n <<0B5A082EC79D7049BD46C1656B63CA22>]/Prev 539953>> We want you to be happy with your healthcare services. La llamada es gratis. The call is free. Please visit our new website to see up to date information about your plan. We are excited to share that MeridianCare, a WellCare company, is changing its name to WellCare, effective January 1, 2020! Please turn on JavaScript and try again. 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. Out-of-network/non-contracted providers are under no obligation to treat Meridian members, except in emergency situations. 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. If you experience any problems receiving your mail order prescription, call Member Services at. HealthChoice Illinois is the smart way most Medicaid members get quality care. We will send you a notice before we make a change that affects you. 0000068680 00000 n We want you to be happy with the treatment and services you get from Meridian and our providers. This way, we can connect you with the right care. At the right time and place. La llamada es gratis. 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)! For more information contact the plan or read the Meridian Member Handbook. 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. Call, Usted puede obtener gratuitamente este documento en espaol o hablar con alguien sobre esta informacin en otros idiomas. The List of Covered Drugs and/or pharmacy and provider networks may change throughout the year. Your Member Handbook is a great resource if you have any questions or just want to learn more about your coverage. 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. Want a paper copy? MeridianComplete is a health plan that contracts with both Medicare and Illinois Medicaid to provide benefits of both programs to enrollees. HFS sends paperwork in the mail that you need to renew your Medicaid coverage. You are now able to view your health information from a third-party app on a mobile device or PC! All Rights Reserved. %%EOF 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. 0000025639 00000 n Please call our Member Services number or see your Member Handbook for more information, including the cost-sharing that applies to out-of-network services. 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. 0000067553 00000 n Be sure to read your Meridian Member Handbook and keep it handy. 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. providerhelp.IL@mhplan.com, The Interoperability and Patient Access Rule. Please review the various programs below. 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 <. If your pregnancy is at high risk, we may call you. Representatives are available Monday-Friday, 8 a.m. to 8 p.m. to assist you. 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) Youll tell us about any health conditions, recent hospital visits, medications, and more. 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. 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 wish to stay on this website, please click Cancel. Keep in mind that everything you choose to share is confidential. 2369 0 obj <> endobj startxref La llamada es gratis. Starting January 1, 2018, the Illinois Medicaid Managed Care Program is expanding to include all Your call will be returned within the next business day. 0000002074 00000 n It also explains how to find care and how to earn rewards. Monday-Friday, 8 a.m. to 8 p.m. CST 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. Member ID Cards 5. 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. Each link will open a new window and is either a PDF or a website. 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. With HealthChoice Illinois, you have a health plan partner to turn to for help. 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. A certificate of coverage (COC) tells you what to expect from your healthcare plan. Monday-Friday, 8 a.m. to 8 p.m. CST 0000014634 00000 n 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. The Member Handbook, along with your enrollment form, serves asMeridian Medicare-Medicaid Plan's (MMP) contract with you. Llame al 1-855-580-1689 (los usuarios de TTY deben llamar al 711). If you would like a Provider/Pharmacy Directory mailed to you, you may call the number above, request one at the website link provided above, or email memberservices.il@mhplan.com. You can join our Start Smart for Your Baby program. Llame al 1-855-580-1689 (los usuarios de TTY deben llamar al 711). Out-of-network/non-contracted providers are under no obligation to treat Meridian members, except in emergency situations. 0000000956 00000 n 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. If your address changes, let us know. Under our plan, you will have one card for your Medicare and Medicaid services, including long-term services and supports and prescriptions. Your call will be returned within the next business day. 167 0 obj <> endobj The COC lays out all the details so that you can stay on top of your coverage. 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. Su llamada ser devuelta dentro del siguiente da hbil. 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. Meridian will work with you to make sure you get all of the care you need, when you need it. This is not a complete list. Your Member Handbook is a great resource if you have any questions or just want to learn more about your coverage. Our Population Health Management Programs are offered to Meridian members and designed to improve your overall health and quality of care. JB Pritzker, Governor Theresa Eagleson, Director. 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. window.location.replace("https://mmp.ilmeridian.com/member/benefits-coverage/whats-covered/member-handbook.html"); Copyright 2023 Meridian All Rights Reserved. ATENCIN: Si habla espaol, tiene a su disposicin servicios gratuitos de asistencia lingstica. providerhelp.IL@mhplan.com. 0000040678 00000 n xref Su llamada ser devuelta dentro del siguiente da hbil. 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. This is not a complete list. 0 0000002177 00000 n The call is free. 167 33 hbbd``b`R@AH&="> $ $= @+D C[} "Fod(AE+ We are excited to share that MeridianCare, a WellCare company, is changing its name to WellCare, effective January 1, 2020! Prior Authorization, Step Therapy and Quantity Limits, Coverage Determinations and Redeterminations for Drugs, Notice of Nondiscrimination & Language Assistance. View your Provider Manual, important plan information and more. [CDATA[ The Provider Manual has everything you need to know about member benefits, coverage, and provider guidelines. The benefit information is a brief summary, not a complete description of benefits. We need to be able to send you important information in the mail. Monday-Friday, 8 a.m. to 5 p.m. CST This is not a complete list. trailer 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. You will need Adobe Reader to open PDFs on this site. 0 Usually a mail-order pharmacy order will get to you in no more than 5 days. 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. You can get this document for free in other formats, such as large print, braille, or audio. 2021 Member Handbook Illinois Counties: Cook, DuPage, Kane, Kankakee, Lake, Will . Want a paper copy? Moving? 0000047422 00000 n An appeal is a way for you to ask for a review of our actions. 0000041668 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. 0000151745 00000 n MeridianHealth is now Meridian! %%EOF Other pharmacies/physicians/providers are available in our network. Representatives are available Monday-Friday, 8 a.m. to 8 p.m. to assist you. Download the Member Handbook(PDF). The handbook will explain your rights, benefits, and responsibilities as a member of Meridian. Other pharmacies/physicians/providers are available in our network. 2023 The Personal Wellness Assessment is a short form about you and your health journey. 0000068208 00000 n %PDF-1.7 % Report an address update to HFS online. ATENCIN: Si habla espaol, tiene a su disposicin servicios gratuitos de asistencia lingstica. This handbook will help you understand your coverage. We can connect you with support, services, and even rewards. 0000046576 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. Making healthcare decisions can be tough--who to see for care, what to ask, when to go. 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. 0000046386 00000 n 0000072727 00000 n The Member Handbook, along with your enrollment form, serves as Meridian Medicare-Medicaid Plan's (MMP) contract with you. For information regarding our Pharmacy Benefit Manager (PBM), MeridianRx, visit the MeridianRx website. With HealthChoice Illinois, you have a health plan partner to turn to for help. You've got questions and we've got answers. 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. 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. If you wish to stay on this website, please click Cancel. The Member Handbook, along with your enrollment form, serves as MeridianCompletes contract with you. There are a few ways to complete the form: We want you to have a safe, healthy, and happy pregnancy! 0000006553 00000 n The call is free. Representatives are available Monday-Friday, 8 a.m. to 8 p.m. to assist 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. You will need Adobe Reader to open PDFs on this site. You can get this document for free in other formats, such as large print, braille, or audio. 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.

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meridian illinois member handbook