An appeal is a way for you to ask for a review of our actions. trailer 0000068208 00000 n Find a doctor, explore coverage, review documents and much more. Meridian is for people eligible for both Medicaid and Medicare. For example, we may not approve your providers request for a certain drug. 0000072727 00000 n With added benefits like support making smart health choices, personal care coordination, 24-hour nursing help line, and more. 0000041209 00000 n 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. providerhelp.IL@mhplan.com, The Interoperability and Patient Access Rule. The call is free. 0000002177 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. 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. Don't forget to call your local HFS oce and Meridian Member Services with your new address. If we fall short, you can file a grievance or appeal. Your Member Handbook is a great resource if you have any questions or just want to learn more about your coverage. On weekends and on state or federal holidays, you may be asked to leave a message. 167 33 Download the Member Handbook (PDF). Learn more about how being a Meridian provider benefits you. Su llamada ser devuelta dentro del siguiente da hbil. It also explains how to find care and how to earn rewards. 1-855-580-1689 (TTY 711) <<0B5A082EC79D7049BD46C1656B63CA22>]/Prev 539953>> For more information contact the plan or read the Meridian Member Handbook. member.ILmeridian.com. 0000040678 00000 n You are leaving this website to go to a website managed by a contracted company, which provides service on our behalf. Material ID:H6080_WEBSITE_2023_Accepted_09282022. Meridian will help make your Medicare and Medicaid benefits work better together and work better for you. 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. You can join our Start Smart for Your Baby program. 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 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. We are excited to share that MeridianCare, a WellCare company, is changing its name to WellCare, effective January 1, 2020! %%EOF Each link will open a new window and is either a PDF or a website. %PDF-1.7 % The Member Handbook, along with your enrollment form, serves as Meridian Medicare-Medicaid Plan's (MMP) contract with you. Just call Member Services with your new address. 2021 Member Handbook Illinois Counties: Cook, DuPage, Kane, Kankakee, Lake, Will . We can connect you with support, services, and even rewards. Moving? 0 Representatives are available Monday-Friday, 8 a.m. to 8 p.m. to assist you. La llamada es gratis. 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. This is not a complete list. Your call will be returned within the next business day. Usually a mail-order pharmacy order will get to you in no more than 5 days. 0000001708 00000 n 2023 Your handbook is full of important information about your health care and Meridian. 0000006553 00000 n Under our plan, you will have one card for your Medicare and Medicaid services, including long-term services and supports and prescriptions. 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. Su llamada ser devuelta dentro del siguiente da hbil. Looking for your plan home page or interested in becoming a member? You will need Adobe Reader to open PDFs on this site. Your call will be returned within the next business day. Other pharmacies/physicians/providers are available in our network. 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. You can also visit the Illinois Client Enrollment Services website. Report an address update to HFS online. ATENCIN: Si habla espaol, tiene a su disposicin servicios gratuitos de asistencia lingstica. 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. Other pharmacies/physicians/providers are available in our network. When you go to file, youll want to write when and where the incident took place, and what happened. 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. There are a few ways to complete the form: We want you to have a safe, healthy, and happy pregnancy! You also need to make sure that the Department of Healthcare & Family Services (HFS) has your new address. 0000002074 00000 n Each link will open a new window and is either a PDF or a website. Limitations, copays, and restrictions may apply. Understanding the ins and outs of your health plan can be difficult. hKq?wNe?t!ARk;v6[IqK,h!i2jLnn}>^| ! 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: The Annual Notice of Changes (ANOC) is a brief summary of benefits and benefit changes that occurred from one year to the next. Other pharmacies/physicians/providers are available in our network. Your call will be returned within the next business day. Catching a Breath Complex Case Management Flu Outreach Opioids Out-of-network/non-contracted providers are under no obligation to treat MeridianComplete members, except in emergency situations. A certificate of coverage (COC) tells you what to expect from your healthcare plan. 0 The Member Handbook, along with your enrollment form, serves as Meridian Medicare-Medicaid Plan's (MMP) contract with you. If you wish to stay on this website, please click Cancel. You will need Adobe Reader to open PDFs on this site. Llame al 1-855-580-1689 (los usuarios de TTY deben llamar al 711). %%EOF The call is free. For more information contact the plan or read the Meridian Member Handbook. For a more comprehensive description of the plan benefits, please refer to your Member Handbook which can also be found on this page. ATENCIN: Si habla espaol, tiene a su disposicin servicios gratuitos de asistencia lingstica. Member ID Cards 5. 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. 2500 0 obj <>stream 0000041668 00000 n 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. This is not a complete list. The call is free. Language Assistance & Notice of Nondiscrimination. Your call will be returned within the next business day. Fill out the Member Notification of Pregnancy form(PDF)to let us know if you are pregnant. 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. 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 benefit information is a brief summary, not a complete description of benefits. Want a paper copy? It looks like your browser does not have JavaScript enabled. JB Pritzker, Governor Theresa Eagleson, Director. Starting January 1, 2018, the Illinois Medicaid Managed Care Program is expanding to include all 0000002041 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. 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. You can also visit the Illinois Client Enrollment Services website. For a more comprehensive description of the plan benefits, please refer to your Member Handbook. Copays for prescription drugs may vary based on the level of Extra Help you receive. This is not a complete list. 2023 Monday-Friday, 8 a.m. to 8 p.m. CST It explains the medical, dental, vision, and pharmacy services that are covered by your plan. It outlines services and benefits that areand are notcovered. You will need Adobe Reader to open PDFs on this site. %PDF-1.4 % Representatives are available Monday-Friday, 8 a.m. to 8 p.m. to assist you. Our Population Health Management Programs are offered to Meridian members and designed to improve your overall health and quality of care. Youll tell us about any health conditions, recent hospital visits, medications, and more. All Rights Reserved. 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. 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. Other pharmacies/physicians/providers are available in our network. At the right time and place. The Personal Wellness Assessment is a short form about you and your health journey. The handbook will explain your rights, benefits, and responsibilities as a member of Meridian. Los representantes estn disponibles para ayudarle de lunes a viernes de 8 a.m. a 8 p.m. Los fines de semana y los das feriados estatales o federales, es posible que se le solicite que deje un mensaje. You will need Adobe Reader to open PDFs on this site. 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! If you wish to stay on this website, please click Cancel. 0000014634 00000 n You can also file a grievance or appeal on the phone by calling Member Services or in writing via mail or fax. Its full of tips and resources for pregnant members and new parents. You can get this document in Spanish, or speak with someone about this information in other languages for free. You can get this document for free in other formats, such as large print, braille, or audio. 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. ATTENTION: If you speak a language other than English, language assistance services, free of charge, are available to you. This is not a complete list. On weekends and on state or federal holidays, you may be asked to leave a message. HealthChoice Illinois is the smart way most Medicaid members get quality care. You are leaving this website to go to a website managed by a contracted company, which provides service on our behalf. Download the Member Handbook(PDF). With added benefitslike supportmakingsmart health choices, personal care coordination, 24-hour nursing help line, and more. It will help you get the care you need. Call 1-855-580-1689 (TTY: 711). 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. Call, Usted puede obtener gratuitamente este documento en espaol o hablar con alguien sobre esta informacin en otros idiomas. If your pregnancy is at high risk, we may call you. // ]]>. If your address changes, let us know. On weekends and on state or federal holidays, 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. The Member Handbook, along with your enrollment form, serves as Meridian Medicare-Medicaid Plan's (MMP) contract with you. The handbook will explain your rights, benefits, and responsibilities as a member of MeridianComplete. Llame al 1-855-580-1689 (los usuarios de TTY deben llamar al 711). The right care for you. 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. View your Provider Manual, important plan information and more. The handbook will explain your rights, benefits, and responsibilities as a member of Meridian. You will need Adobe Reader to open PDFs on this site. The handbook will explain your rights, benefits, and responsibilities as a member of Meridian. 0000000016 00000 n xref The call is free. We will send you a notice before we make a change that affects you. Out-of-network/non-contracted providers are under no obligation to treat Meridian members, except in emergency situations. Keep in mind that everything you choose to share is confidential. If you have any questions, call Meridian Member Services toll-free at 866-606-3700. HFS sends paperwork in the mail that you need to renew your Medicaid coverage. Llame al. It also explains how to find care and how to earn rewards. You've got questions and we've got answers. 0000068680 00000 n +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 For more information contact the plan or read the Meridian Member Handbook. Want a paper copy? 0000046799 00000 n Representatives are available Monday-Friday, 8 a.m. to 8 p.m. to assist you. 0000047422 00000 n You are now able to view your health information from a third-party app on a mobile device or PC! Important Phone Numbers & Contacts In an Emergency 911 Meridian Member Services 866-606-3700 This site contains various Meridian Medicare-Medicaid Plan (MMP) links and resources. All Rights Reserved. Check out the Interoperability page to learn more. You can get this document for free in other formats, such as large print, braille, or audio. 1-855-580-1689 (TTY 711) If you wish to stay on this website, please click Cancel. ATENCIN: Si habla espaol, tiene a su disposicin servicios gratuitos de asistencia lingstica. You are leaving this website to go to a website managed by a contracted company, which provides service on our behalf. 866-606-3700 . The Health Library is a free resource exclusively for MeridianComplete members and providers. Meridian covers all counties in Illinois. Material ID:H6080_WEBSITE_2023_Accepted_09282022. 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. Out-of-network/non-contracted providers are under no obligation to treat Meridian members, except in emergency situations. The benefit information is a brief summary, not a complete description of benefits. Out-of-network/non-contracted providers are under no obligation to treat Meridian members, except in emergency situations. See if you qualify, and explore the HealthChoice Illinois advantage. It will also explain our responsibilities to you, as well as outline the following details: For information regarding our Pharmacy Benefit Manager (PBM), MeridianRx, visit the MeridianRx website. It explains the medical, dental, vision, and pharmacy services that are covered by your plan. 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)! 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) It explains the medical, dental, vision, and pharmacy services that are covered by your plan. 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. More information is in your Member Handbook(PDF). (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 have questions, please call MeridianComplete (Medicare-Medicaid Plan) Member Services at 1-855-580-1689 (TTY users should call 711). window.location.replace("https://mmp.ilmeridian.com/member/benefits-coverage/whats-covered/member-handbook.html"); On weekends and on state or federal holidays, you may be asked to leave a message. 0000010510 00000 n It will also explain our responsibilities to you, as well as outline the following details: Representatives are available Monday-Friday, 8 a.m. to 8 p.m. to assist 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. 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. 0000046576 00000 n With our Medicare-Medicaid Plan (MMP) youre getting: An assigned care manager to help answer questions and coordinate your care. 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. MeridianComplete (Medicare-Medicaid Plan) is a health plan that contracts with both Medicare and Michigan Medicaid to provide benefits of both programs to enrollees. The call is free. MeridianHealth is now Meridian! We want you to be happy with the treatment and services you get from Meridian and our providers. Monday-Friday, 7:00 a.m. to 5:30 p.m. (TTY: 711) Ser vice area . Meridian 0000046966 00000 n 0000001774 00000 n 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 <. 0000000956 00000 n 0000046386 00000 n Please contact the plan for more details. 0000041585 00000 n Visit your Member Portal or call Member Services. 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 Member Handbook, along with your enrollment form, serves asMeridian Medicare-Medicaid Plan's (MMP) contract with you. The benefit information is a brief summary, not a complete description of benefits. Your call will be returned within the next business day. 3. If you need help finding a network provider and/or pharmacy, please call 1-855-580-1689 (TTY: 711) or visit mmp.ILmeridian.com to access our online searchable directory. Please 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.