<<0B5A082EC79D7049BD46C1656B63CA22>]/Prev 539953>> If you wish to stay on this website, please click Cancel. It will also explain our responsibilities to you, as well as outline the following details: JB Pritzker, Governor Theresa Eagleson, Director. If you have questions, please call MeridianComplete (Medicare-Medicaid Plan) Member Services at 1-855-580-1689 (TTY users should call 711). The Member Handbook, along with your enrollment form, serves as MeridianCompletes contract with you. Su llamada ser devuelta dentro del siguiente da hbil. You can also visit the Illinois Client Enrollment Services website. Llame al 1-855-580-1689 (los usuarios de TTY deben llamar al 711). With added benefits like support making smart health choices, personal care coordination, 24-hour nursing help line, and more. 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. providerhelp.IL@mhplan.com. 2021 Member Handbook Illinois Counties: Cook, DuPage, Kane, Kankakee, Lake, Will . 0000025639 00000 n [CDATA[ Your call will be returned within the next business day. 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. When you go to file, youll want to write when and where the incident took place, and what happened. 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. More information is in your Member Handbook(PDF). This is not a complete list. Please contact the plan for more details. It outlines services and benefits that areand are notcovered. 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. Other pharmacies/physicians/providers are available in our network. 0000068208 00000 n 0000010510 00000 n We are excited to share that MeridianCare, a WellCare company, is changing its name to WellCare, effective January 1, 2020! You are leaving this website to go to a website managed by a contracted company, which provides service on our behalf. 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 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. Learn more about how being a Meridian provider benefits you. 0000025980 00000 n Please turn on JavaScript and try again. This way, we can connect you with the right care. 0000002074 00000 n MeridianComplete (Medicare-Medicaid Plan) is a health plan that contracts with both Medicare and Michigan Medicaid to provide benefits of both programs to enrollees. You can also visit the Illinois Client Enrollment Services website. 0000002131 00000 n Llame al. Want a paper copy? Copyright 2023 Meridian All Rights Reserved. For more information, call MeridianComplete Member Services or read the MeridianComplete Member Handbook. All Rights Reserved. A grievance is a complaint about a provider or about the quality of care or services you received. This is not a complete list. For a more comprehensive description of the plan benefits, please refer to your Member Handbook. Please review the various programs below. 0000002041 00000 n You can get this document in Spanish, or speak with someone about this information in other languages for free. 0000046966 00000 n 866-606-3700 . 167 33 On weekends and on state or federal holidays, you may be asked to leave a message. 0000040481 00000 n Meridian Member Services . You will need Adobe Reader to open PDFs on this site. Monday-Friday, 8 a.m. to 5 p.m. CST On weekends and on state or federal holidays, 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 we fall short, you can file a grievance or appeal. Download the Member Handbook (PDF). With HealthChoice Illinois, you have a health plan partner to turn to for help. This is not a complete list. v4P+r-k E`:8\TV%F1MeLT=LyMit+GYrUn*mH gp`x Y;EgPCSSphf>op!mOQtkC v^K#x" Keep in mind that everything you choose to share is confidential. Prior Authorization, Step Therapy and Quantity Limits, Coverage Determinations and Redeterminations for Drugs, Notice of Nondiscrimination & Language Assistance. Download the Member Handbook (PDF). 0000046799 00000 n This is not a complete list. Your call will be returned within the next business day. With our Medicare-Medicaid Plan (MMP) youre getting: An assigned care manager to help answer questions and coordinate your care. 0000000956 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. 199 0 obj <>stream View our Frequently Asked Questions page. 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. 2023 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. For example, we may not approve your providers request for a certain drug. On weekends and on state or federal holidays, you may be asked to leave a message. startxref With added benefitslike supportmakingsmart health choices, personal care coordination, 24-hour nursing help line, and more. The handbook will explain your rights, benefits, and responsibilities as a member of MeridianComplete. The handbook will explain your rights, benefits, and responsibilities as a member of Meridian. This site contains various MeridianComplete (Medicare-Medicaid Plan) links and resources. The handbook will explain your rights, benefits, and responsibilities as a member of Meridian. Representatives are available Monday-Friday, 8 a.m. to 8 p.m. to assist you. Your handbook is full of important information about your health care and Meridian. 0000047422 00000 n Representatives are available Monday-Friday, 8 a.m. to 8 p.m. to assist you. Representatives are available Monday-Friday, 8 a.m. to 8 p.m. to assist you. ATENCIN: Si habla espaol, tiene a su disposicin servicios gratuitos de asistencia lingstica. Making healthcare decisions can be tough--who to see for care, what to ask, when to go. The call is free. 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. 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. You also need to make sure that the Department of Healthcare & Family Services (HFS) has your new address. Provider Network 6 Call Member Services if youd like paper copies of any of these documents. Out-of-network/non-contracted providers are under no obligation to treat MeridianComplete members, except in emergency situations. Want a paper copy? Download the free version of Adobe Reader. For more information contact the plan or read the Meridian Member Handbook. Understanding the ins and outs of your health plan can be difficult. Starting January 1, 2018, the Illinois Medicaid Managed Care Program is expanding to include all 0000014634 00000 n 0000041668 00000 n 0000000016 00000 n Language Assistance & Notice of Nondiscrimination. 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. For certain kinds of drugs, you can use the plans network mail-order services. %%EOF The Provider Manual has everything you need to know about member benefits, coverage, and provider guidelines. Each link will open a new window and is either a PDF or a website. 0000072727 00000 n Call 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. Check out the Interoperability page to learn more. 0000002220 00000 n You can get this document for free in other formats, such as large print, braille, or audio. 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.mi@mhplan.com. For more information contact the plan or read the Meridian Member Handbook. There are a few ways to complete the form: We want you to have a safe, healthy, and happy pregnancy! 0000017969 00000 n ATTENTION: If you speak a language other than English, language assistance services, free of charge, are available to you. It also explains how to find care and how to earn rewards. View your Provider Manual, important plan information and more. Be sure to read your Meridian Member Handbook and keep it handy. 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. You can also file a grievance or appeal on the phone by calling Member Services or in writing via mail or fax. Call 1-855-580-1689 (TTY: 711). This handbook will help you understand your coverage. Material ID:H6080_WEBSITE_2023_Accepted_09282022. The COC lays out all the details so that you can stay on top of your coverage. You can join our Start Smart for Your Baby program. 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. Just call Member Services with your new address. Other pharmacies/physicians/providers are available in our network. If you experience any problems receiving your mail order prescription, call Member Services at. Meridian is for people eligible for both Medicaid and Medicare. For information regarding our Pharmacy Benefit Manager (PBM), MeridianRx, visit the MeridianRx website. 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. 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: At the right time and place. Meridian covers all counties in Illinois. 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 wish to stay on this website, please click Cancel. The call is free. Representatives are available Monday-Friday, 8 a.m. to 8 p.m. to assist you. Visit your Member Portal or call Member Services. Meridian The call is free. La llamada es gratis. The call is free. Please visit our new website to see up to date information about your plan. h|kPQevkmNRIDrDI-)Vw*DYS7cgcr!349g3. The Member Handbook, along with your enrollment form, serves asMeridian Medicare-Medicaid Plan's (MMP) contract with you. Don't forget to call your local HFS oce and Meridian Member Services with your new address. Each link will open a new window and is either a PDF or a website. Usually a mail-order pharmacy order will get to you in no more than 5 days. Your Member Handbook is a great resource if you have any questions or just want to learn more about your coverage. Its full of tips and resources for pregnant members and new parents. MeridianHealth is now Meridian! It explains the medical, dental, vision, and pharmacy services that are covered by your plan. The benefit information is a brief summary, not a complete description of benefits. Su llamada ser devuelta dentro del siguiente da hbil. Moving? If your address changes, let us know. 3. Click the link below to view or save a copy. The Health Library is a free resource exclusively for MeridianComplete members and providers. 2022 Provider Manual (PDF) Meridian Provider Manual Errata Sheet (PDF) Documents and Forms Medical Referrals & Authorizations Pharmacy Billing Mandatory Training Attestation 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. Making healthcare decisions can be tough--who to see for care, what to ask, when to go. You are leaving this website to go to a website managed by a contracted company, which provides service on our behalf. // ]]>. xref 1-855-580-1689 (TTY 711) 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. Material ID:H6080_WEBSITE_2023_Accepted_09282022. +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 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. %%EOF endstream endobj startxref trailer Your Member Handbook is a great resource if you have any questions or just want to learn more about your coverage. The right care for you. It will help you get the care you need. A certificate of coverage (COC) tells you what to expect from your healthcare plan. 0000151745 00000 n 0000002177 00000 n 0000040678 00000 n 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 wish to stay on this website, please click Cancel. Your call will be returned within the next business day. The call is free. 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 call is free. All Rights Reserved. It looks like your browser does not have JavaScript enabled. 2369 0 obj <> endobj 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. Each link will open a new window and is either a PDF or a website. window.location.replace("https://mmp.ilmeridian.com/member/benefits-coverage/whats-covered/member-handbook.html"); Important Phone Numbers & Contacts In an Emergency 911 Meridian Member Services 866-606-3700 You are leaving this website to go to a website managed by a contracted company, which provides service on our behalf. 0000080946 00000 n 167 0 obj <> endobj 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. It also explains how to find care and how to earn rewards. 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. See if you qualify, and explore the HealthChoice Illinois advantage. 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. Out-of-network/non-contracted providers are under no obligation to treat Meridian members, except in emergency situations. 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. 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. Other pharmacies/physicians/providers are available in our network. Monday-Friday, 7:00 a.m. to 5:30 p.m. (TTY: 711) Ser vice area . 1-855-580-1689 (TTY 711) %PDF-1.4 % ATENCIN: Si habla espaol, tiene a su disposicin servicios gratuitos de asistencia lingstica. Member ID Cards 5. 0000021917 00000 n You've got questions and we've got answers. Call MeridianComplete at 1-855-323-4578 (TTY users should call 711), 8 a.m to 8 p.m., seven days a week. Fill out the Member Notification of Pregnancy form(PDF)to let us know if you are pregnant. Limitations, copays, and restrictions may apply. This site contains various Meridian Medicare-Medicaid Plan (MMP) links and resources. You can make an appeal if you disagree with our verdict. member.ILmeridian.com. 0000046576 00000 n The benefit information is a brief summary, not a complete description of benefits. Find a doctor, explore coverage, review documents and much more. HealthChoice Illinois is the smart way most Medicaid members get quality care. 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. Call 1-855-580-1689 (TTY: 711). It explains the medical, dental, vision, and pharmacy services that are covered by your plan. The Personal Wellness Assessment is a short form about you and your health journey. HFS sends paperwork in the mail that you need to renew your Medicaid coverage. 0000041585 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. 2500 0 obj <>stream The Member Handbook, along with your enrollment form, serves as Meridian Medicare-Medicaid Plan's (MMP) contract with you. 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 On weekends and on state or federal holidays, you may be asked to leave a message. 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. Want a paper copy? An appeal is a way for you to ask for a review of our actions. Llame al 1-855-580-1689 (los usuarios de TTY deben llamar al 711). 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. Open Enrollment 6. 1-855-580-1689 (TTY 711) Out-of-network/non-contracted providers are under no obligation to treat Meridian members, except in emergency situations. We are excited to share that MeridianCare, a WellCare company, is changing its name to WellCare, effective January 1, 2020! 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. You will be able to work with one health plan for all of your health insurance needs. La llamada es gratis. You can get this document for free in other formats, such as large print, braille, or audio. Complete the Member Notification of Pregnancy(PDF) form in the Member Portal. We want you to be happy with the treatment and services you get from Meridian and our providers. Catching a Breath Complex Case Management Flu Outreach Opioids 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. Each link will open a new window and is either a PDF or a website. You are now able to view your health information from a third-party app on a mobile device or PC! Your Member Handbook is a great resource if you have any questions or just want to learn more about your coverage. For more information, or to find out how to get enrolled, please contact Meridian at 888-437-0606. 0000046386 00000 n 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. If you are using a Meridian provider, you will not have to pay a plan premium, deductible, or copay. providerhelp.IL@mhplan.com, The Interoperability and Patient Access Rule. 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. Meridian will work with you to make sure you get all of the care you need, when you need it. It also explains how to find care and how to earn rewards. 0000067553 00000 n Monday-Friday, 8 a.m. to 8 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. // ^| ! Report an address update to HFS online. If you have any questions, call Meridian Member Services toll-free at 866-606-3700. La llamada es gratis. %PDF-1.7 % You will need Adobe Reader to open PDFs on this site. Meridian You are leaving this website to go to a website managed by a contracted company, which provides service on our behalf. For more information contact the plan or read the MeridianComplete Member Handbook. 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 will need Adobe Reader to open PDFs on this site. 0000041209 00000 n 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)! Your call will be returned within the next business day. 0000006553 00000 n Out-of-network/non-contracted providers are under no obligation to treat Meridian members, except in emergency situations. 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.

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