Out-of-network/non-contracted providers are under no obligation to treat MeridianComplete members, except in emergency situations. If we fall short, you can file a grievance or appeal. 167 0 obj <> endobj endstream endobj startxref Please contact the plan for more details. The Member Handbook, along with your enrollment form, serves as Meridian Medicare-Medicaid Plan's (MMP) contract with you. This handbook will help you understand your coverage. 2500 0 obj <>stream Complete the Member Notification of Pregnancy(PDF) form in the Member Portal. Language Assistance & Notice of Nondiscrimination. It outlines services and benefits that areand are notcovered. Prior Authorization, Step Therapy and Quantity Limits, Coverage Determinations and Redeterminations for Drugs, Notice of Nondiscrimination & Language Assistance. 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. If you need help finding a network provider and/or pharmacy, please call 1-855-580-1689 (TTY: 711) or visit mmp.ILmeridian.com to access our online searchable directory. Your call will be returned within the next business day. 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. You can get this document in Spanish, or speak with someone about this information in other languages for free. With HealthChoice Illinois, you have a health plan partner to turn to for help. Monday-Friday, 7:00 a.m. to 5:30 p.m. (TTY: 711) Ser vice area . The call is free. Fill out the Member Notification of Pregnancy form(PDF)to let us know if you are pregnant. You also need to make sure that the Department of Healthcare & Family Services (HFS) has your new address. Moving? 0000025980 00000 n 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. Your Member Handbook is a great resource if you have any questions or just want to learn more about your coverage. 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. 2369 0 obj <> endobj 199 0 obj <>stream 0000067553 00000 n HFS sends paperwork in the mail that you need to renew your Medicaid coverage. 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. 0000041209 00000 n 0000040678 00000 n 1-855-580-1689 (TTY 711) This site contains various Meridian Medicare-Medicaid Plan (MMP) links and resources. 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. Each link will open a new window and is either a PDF or a website. MeridianComplete is a health plan that contracts with both Medicare and Illinois Medicaid to provide benefits of both programs to enrollees. Other pharmacies/physicians/providers are available in our network. 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. Our Population Health Management Programs are offered to Meridian members and designed to improve your overall health and quality of care. Other pharmacies/physicians/providers are available in our network. Each link will open a new window and is either a PDF or a website. 0000040481 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 Your Member Handbook is a great resource if you have any questions or just want to learn more about your coverage. This site contains various Meridian Medicare-Medicaid Plan (MMP) links and resources. Copays for prescription drugs may vary based on the level of Extra Help you receive. 0000041585 00000 n 2023 The handbook will explain your rights, benefits, and responsibilities as a member of Meridian. 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. Check out the Interoperability page to learn more. providerhelp.IL@mhplan.com, The Interoperability and Patient Access Rule. Meridian Medicare-Medicaid Plan (MMP) is a health plan that contracts with both Medicare and Illinois Medicaid to provide benefits of both programs to enrollees. Want a paper copy? https://www.illinois.gov/hfs/healthchoice/Pages/HealthPlans.aspx, https://www.illinois.gov/hfs/healthchoice/reportcard. Monday-Friday, 8 a.m. to 5 p.m. CST La llamada es gratis. 0000080946 00000 n 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. 0000000956 00000 n The handbook will explain your rights, benefits, and responsibilities as a member of MeridianComplete. It will also explain our responsibilities to you, as well as outline the following details: Youll tell us about any health conditions, recent hospital visits, medications, and more. At the right time and place. Call 1-855-580-1689 (TTY: 711). 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)! 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). 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 <. 0000046799 00000 n 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. // ]]>. Be sure to read your Meridian Member Handbook and keep it handy. The benefit information is a brief summary, not a complete description of benefits. You will need Adobe Reader to open PDFs on this site. %PDF-1.4 % 0000025639 00000 n We need to be able to send you important information in the mail. ATTENTION: If you speak a language other than English, language assistance services, free of charge, are available to you. Find a doctor, explore coverage, review documents and much more. Llame al 1-855-580-1689 (los usuarios de TTY deben llamar al 711). xref View our Frequently Asked Questions page. ATENCIN: Si habla espaol, tiene a su disposicin servicios gratuitos de asistencia lingstica. 0000001708 00000 n The COC lays out all the details so that you can stay on top of your coverage. 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. You are now able to view your health information from a third-party app on a mobile device or PC! With HealthChoice Illinois, you have a health plan partner to turn to for help. There are a few ways to complete the form: We want you to have a safe, healthy, and happy pregnancy! MeridianComplete (Medicare-Medicaid Plan) is a health plan that contracts with both Medicare and Michigan Medicaid to provide benefits of both programs to enrollees. 0000002131 00000 n La llamada es gratis. Llame al. For a more comprehensive description of the plan benefits, please refer to your Member Handbook. 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. Your call will be returned within the next business day. Monday-Friday, 8 a.m. to 8 p.m. CST If you wish to stay on this website, please click Cancel. 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. Call MeridianComplete at 1-855-323-4578 (TTY users should call 711), 8 a.m to 8 p.m., seven days a week. <<0B5A082EC79D7049BD46C1656B63CA22>]/Prev 539953>> 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. 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. 0000151745 00000 n This way, we can connect you with the right care. It explains the medical, dental, vision, and pharmacy services that are covered by your plan. 866-606-3700 . Provider Network 6 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. Material ID:H6080_WEBSITE_2023_Accepted_09282022. It will also explain our responsibilities to you, as well as outline the following details: You will need Adobe Reader to open PDFs on this site. The Provider Manual has everything you need to know about member benefits, coverage, and provider guidelines. All Rights Reserved. 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. Representatives are available Monday-Friday, 8 a.m. to 8 p.m. to assist you. Learn more about how being a Meridian provider benefits you. ATENCIN: Si habla espaol, tiene a su disposicin servicios gratuitos de asistencia lingstica. If you wish to stay on this website, please click Cancel. Visit your Member Portal or call Member Services. Each link will open a new window and is either a PDF or a website. Limitations, copays, and restrictions may apply. Meridian Making healthcare decisions can be tough--who to see for care, what to ask, when to go. You can make an appeal if you disagree with our verdict. See if you qualify, and explore the HealthChoice Illinois advantage. Don't forget to call your local HFS oce and Meridian Member Services with your new address. For more information contact the plan or read the MeridianComplete Member Handbook. The call is free. Your call will be returned within the next business day. The call is free. 1-855-580-1689 (TTY 711) You can also file a grievance or appeal on the phone by calling Member Services or in writing via mail or fax. Want a paper copy? The call is free. Call 1-855-580-1689 (TTY: 711). Please visit our new website to see up to date information about your plan. h|kPQevkmNRIDrDI-)Vw*DYS7cgcr!349g3. startxref Su llamada ser devuelta dentro del siguiente da hbil. Keep in mind that everything you choose to share is confidential. We can connect you with support, services, and even rewards. 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. 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! Download the Member Handbook(PDF). The Member Handbook, along with your enrollment form, serves as Meridian Medicare-Medicaid Plan's (MMP) contract with you. 0 If you have any questions, call Meridian Member Services toll-free at 866-606-3700. Meridian Member Services . You can join our Start Smart for Your Baby program. Download the free version of Adobe Reader. Material ID:H6080_WEBSITE_2023_Accepted_09282022. 0000067354 00000 n 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. MeridianHealth is now Meridian! 0000046386 00000 n %PDF-1.7 % Open Enrollment 6. Click the link below to view or save a copy. 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. Your handbook is full of important information about your health care and Meridian. // $ $= @+D C[} "Fod(AE+ A certificate of coverage (COC) tells you what to expect from your healthcare plan. This is not a complete list. 167 33 For more information contact the plan or read the Meridian Member Handbook. You can get this document for free in other formats, such as large print, braille, or audio. 1-855-580-1689 (TTY 711) The call is free. View your Provider Manual, important plan information and more. Making healthcare decisions can be tough--who to see for care, what to ask, when to go. On weekends and on state or federal holidays, 3. 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. 0000047422 00000 n 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. Copyright 2023 Meridian All Rights Reserved. 0000041668 00000 n La llamada es gratis. For a more comprehensive description of the plan benefits, please refer to your Member Handbook which can also be found on this page. 0 Download the Member Handbook (PDF). Call, Usted puede obtener gratuitamente este documento en espaol o hablar con alguien sobre esta informacin en otros idiomas. With our Medicare-Medicaid Plan (MMP) youre getting: An assigned care manager to help answer questions and coordinate your care. For more information, call MeridianComplete Member Services or read the MeridianComplete Member Handbook. The benefit information is a brief summary, not a complete description of benefits. 0000002041 00000 n It will help you get the care you need. [CDATA[ For information regarding our Pharmacy Benefit Manager (PBM), MeridianRx, visit the MeridianRx website. 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 MeridianCompletes contract with you. We are excited to share that MeridianCare, a WellCare company, is changing its name to WellCare, effective January 1, 2020! 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 right care for you. The Member Handbook, along with your enrollment form, serves as Meridian Medicare-Medicaid Plan's (MMP) contract with you. hKq?wNe?t!ARk;v6[IqK,h!i2jLnn}>^| ! 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. HealthChoice Illinois is the smart way most Medicaid members get quality care. Meridian The benefit information is a brief summary, not a complete description of benefits. Usually a mail-order pharmacy order will get to you in no more than 5 days. You will need Adobe Reader to open PDFs on this site. For example, we may not approve your providers request for a certain drug. 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. You can also visit the Illinois Client Enrollment Services website. Your call will be returned within the next business day. 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. 0000014634 00000 n The Personal Wellness Assessment is a short form about you and your health journey. If you are using a Meridian provider, you will not have to pay a plan premium, deductible, or copay. For more information, or to find out how to get enrolled, please contact Meridian at 888-437-0606. Monday-Friday, 8 a.m. to 8 p.m. CST More information is in your Member Handbook(PDF). 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. If your pregnancy is at high risk, we may call you. Meridian covers all counties in Illinois. Meridian will work with you to make sure you get all of the care you need, when you need it. Meridian will help make your Medicare and Medicaid benefits work better together and work better for you. 0000002220 00000 n Your call will be returned within the next business day. Representatives are available Monday-Friday, 8 a.m. to 8 p.m. to assist you. You are leaving this website to go to a website managed by a contracted company, which provides service on our behalf. 0000010510 00000 n Understanding the ins and outs of your health plan can be difficult. When you go to file, youll want to write when and where the incident took place, and what happened.