meridian illinois member handbook meridian illinois member handbook

Member Handbook | Meridian Complete of Illinois Important Phone Numbers & Contacts In an Emergency 911 Meridian Member Services 866-606-3700 Other pharmacies/physicians/providers are available in our network. You can get this document in Spanish, or speak with someone about this information in other languages for free. Learn more about how being a Meridian provider benefits you. Want a paper copy? Out-of-network/non-contracted providers are under no obligation to treat Meridian members, except in emergency situations. Monday-Friday, 7:00 a.m. to 5:30 p.m. (TTY: 711) Ser vice area . 167 33 Meridian Medicare Medicaid Plan (los usuarios de TTY deben llamar al 711), lunes a domingo, de 8 a.m. a 8 p.m. La llamada es gratuita. 0000046799 00000 n We want you to be happy with your healthcare services. The Member Handbook, along with your enrollment form, serves as Meridian Medicare-Medicaid Plan's (MMP) contract with you. Your Member Handbook is a great resource if you have any questions or just want to learn more about your coverage. Documents and Forms - Meridian Medicare Medicaid Plan The COC lays out all the details so that you can stay on top of your coverage. 0000067354 00000 n 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. This is not a complete list. Member ID Cards 5. Meridian will help make your Medicare and Medicaid benefits work better together and work better for you. Meridian Your call will be returned within the next business day. 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. This is not a complete list. More information is in your Member Handbook(PDF). 0000010510 00000 n ATENCIN: Si habla espaol, tiene a su disposicin servicios gratuitos de asistencia lingstica. You can also file a grievance or appeal on the phone by calling Member Services or in writing via mail or fax. 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 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. You are leaving this website to go to a website managed by a contracted company, which provides service on our behalf. Su llamada ser devuelta dentro del siguiente da hbil. 1-855-580-1689 (TTY 711) 0000068680 00000 n 0000046386 00000 n 0000000016 00000 n It will help you get the care you need. 0000017969 00000 n The Member Handbook, along with your enrollment form, serves as Meridian Medicare-Medicaid Plan's (MMP) contract with you. Your handbook is full of important information about your health care and Meridian. 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. 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. With HealthChoice Illinois, you have a health plan partner to turn to for help. For example, we may not approve your providers request for a certain drug. 866-606-3700 . Copyright 2023 Meridian All Rights Reserved. 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. Llame al 1-855-580-1689 (los usuarios de TTY deben llamar al 711). For more information contact the plan or read the Meridian Member Handbook. 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. It will also explain our responsibilities to you, as well as outline the following details: You are leaving this website to go to a website managed by a contracted company, which provides service on our behalf. Call 1-855-580-1689 (TTY: 711). We are excited to share that MeridianCare, a WellCare company, is changing its name to WellCare, effective January 1, 2020! 1-855-580-1689 (TTY 711) You are now able to view your health information from a third-party app on a mobile device or PC! Copays for prescription drugs may vary based on the level of Extra Help you receive. Be sure to read your Meridian Member Handbook and keep it handy. If you wish to stay on this website, please click Cancel. 199 0 obj <>stream Provider Network 6 Please review the various programs below. Download the free version of Adobe Reader. You will be able to work with one health plan for all of your health insurance needs. Download the Member Handbook(PDF). Llame al. Meridian Member Services . %PDF-1.7 % Meridian is for people eligible for both Medicaid and Medicare. 0000001708 00000 n We will send you a notice before we make a change that affects you. This site contains various MeridianComplete (Medicare-Medicaid Plan) links and resources. Youll tell us about any health conditions, recent hospital visits, medications, and more. 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. trailer You are leaving this website to go to a website managed by a contracted company, which provides service on our behalf. 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. The benefit information is a brief summary, not a complete description of benefits. Meridian will work with you to make sure you get all of the care you need, when you need it. 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. Making healthcare decisions can be tough--who to see for care, what to ask, when to go. Find a doctor, explore coverage, review documents and much more. The handbook will explain your rights, benefits, and responsibilities as a member of MeridianComplete. 0000046576 00000 n PDF Welcome to MeridianHealth Intro to Plan 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. Just call Member Services with your new address. You will need Adobe Reader to open PDFs on this site. 0000002074 00000 n providerhelp.IL@mhplan.com. providerhelp.IL@mhplan.com, The Interoperability and Patient Access Rule. 0 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. ATENCIN: Si habla espaol, tiene a su disposicin servicios gratuitos de asistencia lingstica. Open Enrollment 6. This is not a complete list. Monday-Friday, 8 a.m. to 8 p.m. CST 0000068208 00000 n PDF here's your member handbook. You also need to make sure that the Department of Healthcare & Family Services (HFS) has your new address. This site contains various Meridian Medicare-Medicaid Plan (MMP) links and resources. 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. 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. h|kPQevkmNRIDrDI-)Vw*DYS7cgcr!349g3. 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. window.location.replace("https://mmp.ilmeridian.com/member/benefits-coverage/whats-covered/member-handbook.html"); 1-855-580-1689 (TTY 711) 0000041209 00000 n %PDF-1.4 % This handbook will help you understand your coverage. 0000047422 00000 n On weekends and on state or federal holidays, you may be asked to leave a message. 0000072727 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. Member Handbook | Meridian Health Plan of Illinois Representatives are available Monday-Friday, 8 a.m. to 8 p.m. to assist you. 2022 Provider Manual (PDF) Meridian Provider Manual Errata Sheet (PDF) Documents and Forms Medical Referrals & Authorizations Pharmacy Billing Mandatory Training Attestation If your address changes, let us know. 0000006553 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. 0000002177 00000 n Your call will be returned within the next business day. Member Handbooks and Forms On weekends and on state or federal holidays, you may be asked to leave a message. View our Frequently Asked Questions page. 0000041585 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. On weekends and on state or federal holidays, you may be asked to leave a message. 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. For Members | Meridian The handbook will explain your rights, benefits, and responsibilities as a member of Meridian. For more information, call MeridianComplete Member Services or read the MeridianComplete Member Handbook. 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. Understanding the ins and outs of your health plan can be difficult. [CDATA[ 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. It will also explain our responsibilities to you, as well as outline the following details: For more information contact the plan or read the Meridian Member Handbook. Each link will open a new window and is either a PDF or a website. 0000040481 00000 n If you are using a Meridian provider, you will not have to pay a plan premium, deductible, or copay. v4P+r-k E`:8\TV%F1MeLT=LyMit+GYrUn*mH gp`x Y;EgPCSSphf>op!mOQtkC v^K#x" 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 <. Call MeridianComplete at 1-855-323-4578 (TTY users should call 711), 8 a.m to 8 p.m., seven days a week. Prior Authorization, Step Therapy and Quantity Limits, Coverage Determinations and Redeterminations for Drugs, Notice of Nondiscrimination & Language Assistance. 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. We want you to be happy with the treatment and services you get from Meridian and our providers. 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. 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 Provider Manual | Meridian Health Plan of Illinois // endobj Meridian You will need Adobe Reader to open PDFs on this site. It also explains how to find care and how to earn rewards. Click the link below to view or save a copy. 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. Call Member Services if youd like paper copies of any of these documents. Please turn on JavaScript and try again. You can get this document for free in other formats, such as large print, braille, or audio. Su llamada ser devuelta dentro del siguiente da hbil. Llame al 1-855-580-1689 (los usuarios de TTY deben llamar al 711). At the right time and place. Want a paper copy? 0000014634 00000 n When you go to file, youll want to write when and where the incident took place, and what happened. It looks like your browser does not have JavaScript enabled. 0000002131 00000 n Check out the Interoperability page to learn more. %%EOF 0000046966 00000 n The Provider Manual has everything you need to know about member benefits, coverage, and provider guidelines. 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. If you wish to stay on this website, please click Cancel. 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. 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. This way, we can connect you with the right care. 0000025980 00000 n PDF 2021 Member Handbook - Meridian Medicare Medicaid Plan Under our plan, you will have one card for your Medicare and Medicaid services, including long-term services and supports and prescriptions. // ]]>. You are leaving this website to go to a website managed by a contracted company, which provides service on our behalf. 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. Limitations, copays, and restrictions may apply. Usually a mail-order pharmacy order will get to you in no more than 5 days. 0000001774 00000 n Each link will open a new window and is either a PDF or a website. 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. You can get this document for free in other formats, such as large print, braille, or audio. Representatives are available Monday-Friday, 8 a.m. to 8 p.m. to assist you. hKq?wNe?t!ARk;v6[IqK,h!i2jLnn}>^| ! On weekends and on state or federal holidays, 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. The Personal Wellness Assessment is a short form about you and your health journey. We can connect you with support, services, and even rewards. La llamada es gratis. 2021 Member Handbook Illinois Counties: Cook, DuPage, Kane, Kankakee, Lake, Will . 0000002220 00000 n PDF ILLINOIS MEMBER HANDBOOK - Meridian Illinois Managed Care Plans 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)! If you have questions, please call MeridianComplete (Medicare-Medicaid Plan) Member Services at 1-855-580-1689 (TTY users should call 711). member.ILmeridian.com. It outlines services and benefits that areand are notcovered. The call is free. Our Population Health Management Programs are offered to Meridian members and designed to improve your overall health and quality of care. View your Provider Manual, important plan information and more. Fill out the Member Notification of Pregnancy form(PDF)to let us know if you are pregnant. Visit your Member Portal or call Member Services. HealthChoice Illinois | HFS The handbook will explain your rights, benefits, and responsibilities as a member of Meridian. Report an address update to HFS online. You can make an appeal if you disagree with our verdict. xref You can join our Start Smart for Your Baby program. The Member Handbook, along with your enrollment form, serves as MeridianCompletes contract with you. Your Member Handbook is a great resource if you have any questions or just want to learn more about your coverage. Your call will be returned within the next business day. Keep in mind that everything you choose to share is confidential. La llamada es gratis. 2023 Each link will open a new window and is either a PDF or a website. 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. On weekends and on state or federal holidays, you may be asked to leave a message. If you wish to stay on this website, please click Cancel. 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: The Annual Notice of Changes (ANOC) is a brief summary of benefits and benefit changes that occurred from one year to the next. %%EOF Language Assistance & Notice of Nondiscrimination. 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. The call is free. Monday-Friday, 8 a.m. to 8 p.m. CST 0000021917 00000 n Please contact the plan for more details. If your pregnancy is at high risk, we may call you. 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. hbbd``b`R@AH&="> $ $= @+D C[} "Fod(AE+ The Member Handbook, along with your enrollment form, serves as Meridian Medicare-Medicaid Plan's (MMP) contract with you. If we fall short, you can file a grievance or appeal. This site contains various Meridian Medicare-Medicaid Plan (MMP) links and resources. For certain kinds of drugs, you can use the plans network mail-order services. It also explains how to find care and how to earn rewards. <<0B5A082EC79D7049BD46C1656B63CA22>]/Prev 539953>> With HealthChoice Illinois, you have a health plan partner to turn to for help. The right care for you. PDF <DATE> Program called HealthChoice Illinois . We have been working hard Other pharmacies/physicians/providers are available in our network. La llamada es gratis. 3. 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. Material ID:H6080_WEBSITE_2023_Accepted_09282022. Please visit our new website to see up to date information about your plan. 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. Catching a Breath Complex Case Management Flu Outreach Opioids 0000067553 00000 n The handbook will explain your rights, benefits, and responsibilities as a member of Meridian. Other pharmacies/physicians/providers are available in our network. endstream endobj startxref 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. 0000000956 00000 n MeridianComplete 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. Don't forget to call your local HFS oce and Meridian Member Services with your new address. 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've got questions and we've got answers. You can also visit the Illinois Client Enrollment Services website. It also explains how to find care and how to earn rewards. MeridianHealth is now Meridian! For a more comprehensive description of the plan benefits, please refer to your Member Handbook which can also be found on this page. You will need Adobe Reader to open PDFs on this site.