0000000016 00000 n Download the Member Handbook (PDF). v4P+r-k E`:8\TV%F1MeLT=LyMit+GYrUn*mH gp`x Y;EgPCSSphf>op!mOQtkC v^K#x" The call is free. We will send you a notice before we make a change that affects you. It will also explain our responsibilities to you, as well as outline the following details: 0000068680 00000 n The handbook will explain your rights, benefits, and responsibilities as a member of MeridianComplete. Meridian Member Services . For more information contact the plan or read the MeridianComplete Member Handbook. 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)! Open Enrollment 6. When you go to file, youll want to write when and where the incident took place, and what happened. Want a paper copy? The call is free. 0000001708 00000 n You will be able to work with one health plan for all of your health insurance needs. Call 1-855-580-1689 (TTY: 711). Out-of-network/non-contracted providers are under no obligation to treat Meridian members, except in emergency situations. With added benefits like support making smart health choices, personal care coordination, 24-hour nursing help line, and more. h|kPQevkmNRIDrDI-)Vw*DYS7cgcr!349g3. Meridian will help make your Medicare and Medicaid benefits work better together and work better for you. Fill out the Member Notification of Pregnancy form(PDF)to let us know if you are pregnant. Out-of-network/non-contracted providers are under no obligation to treat Meridian members, except in emergency situations. Making healthcare decisions can be tough--who to see for care, what to ask, when to go. Complete the Member Notification of Pregnancy(PDF) form in the Member Portal. 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. Your Member Handbook is a great resource if you have any questions or just want to learn more about your coverage. Meridian 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. 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. 0000151745 00000 n Please visit our new website to see up to date information about your plan. The benefit information is a brief summary, not a complete description of benefits. 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 <. Moving? For a more comprehensive description of the plan benefits, please refer to your Member Handbook. 167 0 obj <> endobj 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. For information regarding our Pharmacy Benefit Manager (PBM), MeridianRx, visit the MeridianRx website. The Health Library is a free resource exclusively for MeridianComplete members and providers. We need to be able to send you important information in the mail. Your call will be returned within the next business day. 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 Your handbook is full of important information about your health care and Meridian. 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. 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. 0000040481 00000 n 0000001774 00000 n // $ $= @+D C[} "Fod(AE+ For more information, call MeridianComplete Member Services or read the MeridianComplete Member Handbook. Call 1-855-580-1689 (TTY: 711). It also explains how to find care and how to earn rewards. This site contains various MeridianComplete (Medicare-Medicaid Plan) links and resources. You can also file a grievance or appeal on the phone by calling Member Services or in writing via mail or fax. You are now able to view your health information from a third-party app on a mobile device or PC! Su llamada ser devuelta dentro del siguiente da hbil. 1-855-580-1689 (TTY 711) xref If your address changes, let us know. Prior Authorization, Step Therapy and Quantity Limits, Coverage Determinations and Redeterminations for Drugs, Notice of Nondiscrimination & Language Assistance. For more information contact the plan or read the Meridian Member Handbook. endstream endobj startxref Out-of-network/non-contracted providers are under no obligation to treat Meridian members, except in emergency situations. Other pharmacies/physicians/providers are available in our network. Limitations, copays, and restrictions may apply. 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. ATENCIN: Si habla espaol, tiene a su disposicin servicios gratuitos de asistencia lingstica. 0000080946 00000 n 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 way, we can connect you with the right care. If you have any questions, call Meridian Member Services toll-free at 866-606-3700. Your call will be returned within the next business day. Copays for prescription drugs may vary based on the level of Extra Help you receive. 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. At the right time and place. <<0B5A082EC79D7049BD46C1656B63CA22>]/Prev 539953>> On weekends and on state or federal holidays, you may be asked to leave a message. 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. 866-606-3700 . HFS sends paperwork in the mail that you need to renew your Medicaid coverage. 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! 0 If you wish to stay on this website, please click Cancel. 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. MeridianComplete is a health plan that contracts with both Medicare and Illinois Medicaid to provide benefits of both programs to enrollees. Representatives are available Monday-Friday, 8 a.m. to 8 p.m. to assist you. 2369 0 obj <> endobj 0000046799 00000 n The handbook will explain your rights, benefits, and responsibilities as a member of Meridian. It will also explain our responsibilities to you, as well as outline the following details: 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. 0000000956 00000 n With HealthChoice Illinois, you have a health plan partner to turn to for help. 167 33 Meridian 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. 0000021917 00000 n https://www.illinois.gov/hfs/healthchoice/Pages/HealthPlans.aspx, https://www.illinois.gov/hfs/healthchoice/reportcard. 2500 0 obj <>stream 0000002220 00000 n 0000002131 00000 n If you wish to stay on this website, please click Cancel. 0000068208 00000 n La llamada es gratis. If you wish to stay on this website, please click Cancel. We can connect you with support, services, and even rewards. On weekends and on state or federal holidays, you may be asked to leave a message. 0000041209 00000 n We want you to be happy with your healthcare 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. 2023 You can join our Start Smart for Your Baby program. More information is in your Member Handbook(PDF). Each link will open a new window and is either a PDF or a website. Please review the various programs below. The handbook will explain your rights, benefits, and responsibilities as a member of Meridian. Under our plan, you will have one card for your Medicare and Medicaid services, including long-term services and supports and prescriptions. ATENCIN: Si habla espaol, tiene a su disposicin servicios gratuitos de asistencia lingstica. You will need Adobe Reader to open PDFs on this site. The call is free. You will need Adobe Reader to open PDFs on this site. 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. The call is free. Important Phone Numbers & Contacts In an Emergency 911 Meridian Member Services 866-606-3700 A grievance is a complaint about a provider or about the quality of care or services you received. You are leaving this website to go to a website managed by a contracted company, which provides service on our behalf. You can also visit the Illinois Client Enrollment Services website. Your call will be returned within the next business day. Your call will be returned within the next business day. // ]]>. Provider Network 6 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 List of Covered Drugs and/or pharmacy and provider networks may change throughout the 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. JB Pritzker, Governor Theresa Eagleson, Director. Llame al 1-855-580-1689 (los usuarios de TTY deben llamar al 711). member.ILmeridian.com. Monday-Friday, 8 a.m. to 8 p.m. CST It also explains how to find care and how to earn rewards. Its full of tips and resources for pregnant members and new parents. View your Provider Manual, important plan information and more. This is not a complete list. 0000002041 00000 n Just call Member Services with your new address. Keep in mind that everything you choose to share is confidential. Be sure to read your Meridian Member Handbook and keep it handy. Your call will be returned within the next business day. Meridian will work with you to make sure you get all of the care you need, when you need it. All Rights Reserved. The Personal Wellness Assessment is a short form about you and your health journey. Representatives are available Monday-Friday, 8 a.m. to 8 p.m. to assist you. View our Frequently Asked Questions page. 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) The Member Handbook, along with your enrollment form, serves asMeridian Medicare-Medicaid Plan's (MMP) contract with you. Report an address update to HFS online. 3. If you experience any problems receiving your mail order prescription, call Member Services at. Download the Member Handbook (PDF). For example, we may not approve your providers request for a certain drug. 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. Copyright 2023 Meridian All Rights Reserved. 0000041585 00000 n Our Population Health Management Programs are offered to Meridian members and designed to improve your overall health and quality of care. startxref Monday-Friday, 8 a.m. to 8 p.m. CST MeridianComplete (Medicare-Medicaid Plan) is a health plan that contracts with both Medicare and Michigan Medicaid to provide benefits of both programs to enrollees. La llamada es gratis. 1-855-580-1689 (TTY 711) 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. Su llamada ser devuelta dentro del siguiente da hbil. Check out the Interoperability page to learn more. 0000017969 00000 n Starting January 1, 2018, the Illinois Medicaid Managed Care Program is expanding to include all This site contains various Meridian Medicare-Medicaid Plan (MMP) links and resources. On weekends and on state or federal holidays, Understanding the ins and outs of your health plan can be difficult. The right care for you. hKq?wNe?t!ARk;v6[IqK,h!i2jLnn}>^| ! The call is free. 0000040678 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 ID Cards 5. 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. A certificate of coverage (COC) tells you what to expect from your healthcare plan. 0000002074 00000 n 0000046966 00000 n On weekends and on state or federal holidays, you may be asked to leave a message. 199 0 obj <>stream Monday-Friday, 7:00 a.m. to 5:30 p.m. (TTY: 711) Ser vice area . trailer Representatives are available Monday-Friday, 8 a.m. to 8 p.m. to assist you. 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. The Member Handbook, along with your enrollment form, serves as MeridianCompletes contract with you. We are excited to share that MeridianCare, a WellCare company, is changing its name to WellCare, effective January 1, 2020! Call, Usted puede obtener gratuitamente este documento en espaol o hablar con alguien sobre esta informacin en otros idiomas. 0000047422 00000 n It explains the medical, dental, vision, and pharmacy services that are covered by your plan. Other pharmacies/physicians/providers are available in our network. This handbook will help you understand your coverage. 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. Download the Member Handbook(PDF). window.location.replace("https://mmp.ilmeridian.com/member/benefits-coverage/whats-covered/member-handbook.html"); It also explains how to find care and how to earn rewards. The call is free. 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 your pregnancy is at high risk, we may call you. 2021 Member Handbook Illinois Counties: Cook, DuPage, Kane, Kankakee, Lake, Will . This is not a complete list. Usually a mail-order pharmacy order will get to you in no more than 5 days. If you have questions, please call MeridianComplete (Medicare-Medicaid Plan) Member Services at 1-855-580-1689 (TTY users should call 711). 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. We want you to be happy with the treatment and services you get from Meridian and our providers. Llame al 1-855-580-1689 (los usuarios de TTY deben llamar al 711). 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. 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. 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. 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. +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 The handbook will explain your rights, benefits, and responsibilities as a member of Meridian. Download the free version of Adobe Reader. This is not a complete list. For more information contact the plan or read the Meridian Member Handbook. %PDF-1.4 % ATENCIN: Si habla espaol, tiene a su disposicin servicios gratuitos de asistencia lingstica. You will need Adobe Reader to open PDFs on this site. 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. Looking for your plan home page or interested in becoming a member? 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. On weekends and on state or federal holidays, you may be asked to leave a message. There are a few ways to complete the form: We want you to have a safe, healthy, and happy pregnancy! With added benefitslike supportmakingsmart health choices, personal care coordination, 24-hour nursing help line, and more. 0000046386 00000 n 0000067553 00000 n Each link will open a new window and is either a PDF or a website. Other pharmacies/physicians/providers are available in our network. La llamada es gratis. For more information, or to find out how to get enrolled, please contact Meridian at 888-437-0606. %%EOF 0 providerhelp.IL@mhplan.com, The Interoperability and Patient Access Rule. You can make an appeal if you disagree with our verdict. The COC lays out all the details so that you can stay on top of your coverage. [CDATA[ Call 1-855-580-1689 (TTY: 711). 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. Material ID:H6080_WEBSITE_2023_Accepted_09282022. For more information contact the plan or read the Meridian Member Handbook. It will help you get the care you need. Out-of-network/non-contracted providers are under no obligation to treat MeridianComplete members, except in emergency situations. All Rights Reserved. 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 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. Call MeridianComplete at 1-855-323-4578 (TTY users should call 711), 8 a.m to 8 p.m., seven days a week. With our Medicare-Medicaid Plan (MMP) youre getting: An assigned care manager to help answer questions and coordinate your care. Making healthcare decisions can be tough--who to see for care, what to ask, when to go. Your Member Handbook is a great resource if you have any questions or just want to learn more about your coverage. You will need Adobe Reader to open PDFs on this site. HealthChoice Illinois is the smart way most Medicaid members get quality care. Monday-Friday, 8 a.m. to 5 p.m. CST 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. If you are using a Meridian provider, you will not have to pay a plan premium, deductible, or copay. MeridianHealth is now Meridian! Llame al 1-855-580-1689 (los usuarios de TTY deben llamar al 711). For a more comprehensive description of the plan benefits, please refer to your Member Handbook which can also be found on this page. Each link will open a new window and is either a PDF or a website. Llame al. (los usuarios de TTY deben llamar al 711), lunes a domingo, de 8 a.m. a 8 p.m. La llamada es gratuita. You will need Adobe Reader to open PDFs on this site. 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. Click the link below to view or save a copy. Find a doctor, explore coverage, review documents and much more. 0000014634 00000 n 0000041668 00000 n 2022 Provider Manual (PDF) Meridian Provider Manual Errata Sheet (PDF) Documents and Forms Medical Referrals & Authorizations Pharmacy Billing Mandatory Training Attestation Language Assistance & Notice of Nondiscrimination. Want a paper copy? providerhelp.IL@mhplan.com. 0000025980 00000 n The Provider Manual has everything you need to know about member benefits, coverage, and provider guidelines. 0000046576 00000 n Your call will be returned within the next business day. This site contains various Meridian Medicare-Medicaid Plan (MMP) links and resources. Please contact the plan for more details. 2023 1-855-580-1689 (TTY 711) 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. 0000006553 00000 n 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, 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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