meridian illinois member handbook

It explains the medical, dental, vision, and pharmacy services that are covered by your plan. You are leaving this website to go to a website managed by a contracted company, which provides service on our behalf. With added benefitslike supportmakingsmart health choices, personal care coordination, 24-hour nursing help line, and more. 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. 866-606-3700 . Meridian covers all counties in Illinois. %%EOF The Provider Manual has everything you need to know about member benefits, coverage, and provider guidelines. Call 1-855-580-1689 (TTY: 711). Download the Member Handbook(PDF). This way, we can connect you with the right care. The benefit information is a brief summary, not a complete description of benefits. 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. You will need Adobe Reader to open PDFs on this site. Copyright 2023 Meridian All Rights Reserved. Monday-Friday, 7:00 a.m. to 5:30 p.m. (TTY: 711) Ser vice area . If you experience any problems receiving your mail order prescription, call Member Services at. // ]]>. Catching a Breath Complex Case Management Flu Outreach Opioids 0000151745 00000 n 0000025639 00000 n 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. It also explains how to find care and how to earn rewards. 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. We want you to be happy with the treatment and services you get from Meridian and our providers. 2022 Provider Manual (PDF) Meridian Provider Manual Errata Sheet (PDF) Documents and Forms Medical Referrals & Authorizations Pharmacy Billing Mandatory Training Attestation For certain kinds of drugs, you can use the plans network mail-order services. Out-of-network/non-contracted providers are under no obligation to treat Meridian members, except in emergency situations. 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. (los usuarios de TTY deben llamar al 711), lunes a domingo, de 8 a.m. a 8 p.m. La llamada es gratuita. The call is free. 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 For more information, call MeridianComplete Member Services or read the MeridianComplete Member Handbook. 0000047422 00000 n 0 All Rights Reserved. The benefit information is a brief summary, not a complete description of benefits. member.ILmeridian.com. 0000002131 00000 n It will help you get the care you need. Want a paper copy? It also explains how to find care and how to earn rewards. Looking for your plan home page or interested in becoming a member? Meridian Each link will open a new window and is either a PDF or a website. 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. For more information contact the plan or read the MeridianComplete Member Handbook. The Member Handbook, along with your enrollment form, serves as Meridian Medicare-Medicaid Plan's (MMP) contract with you. You can also visit the Illinois Client Enrollment Services website. We can connect you with support, services, and even rewards. You are leaving this website to go to a website managed by a contracted company, which provides service on our behalf. Provider Network 6 The handbook will explain your rights, benefits, and responsibilities as a member of Meridian. Limitations, copays, and restrictions may apply. The Member Handbook, along with your enrollment form, serves asMeridian Medicare-Medicaid Plan's (MMP) contract with you. Representatives are available Monday-Friday, 8 a.m. to 8 p.m. to assist you. Fill out the Member Notification of Pregnancy form(PDF)to let us know if you are pregnant. 1-855-580-1689 (TTY 711) The right care for you. HealthChoice Illinois is the smart way most Medicaid members get quality care. Llame al. Complete the Member Notification of Pregnancy(PDF) form in the Member Portal. The Member Handbook, along with your enrollment form, serves as Meridian Medicare-Medicaid Plan's (MMP) contract with you. %%EOF Out-of-network/non-contracted providers are under no obligation to treat Meridian members, except in emergency situations. 0000002220 00000 n Su llamada ser devuelta dentro del siguiente da hbil. 0000080946 00000 n Su llamada ser devuelta dentro del siguiente da hbil. 0000046576 00000 n It looks like your browser does not have JavaScript enabled. On weekends and on state or federal holidays, Call Member Services if youd like paper copies of any of these documents. Moving? Your Member Handbook is a great resource if you have any questions or just want to learn more about your coverage. 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 [email protected], The Interoperability and Patient Access Rule. Download the Member Handbook (PDF). 0000017969 00000 n Please turn on JavaScript and try again. More information is in your Member Handbook(PDF). 199 0 obj <>stream 0000067553 00000 n Your call will be returned within the next business day. [CDATA[ You are leaving this website to go to a website managed by a contracted company, which provides service on our behalf. Please visit our new website to see up to date information about your plan. La llamada es gratis. Out-of-network/non-contracted providers are under no obligation to treat Meridian members, except in emergency situations. If you wish to stay on this website, please click Cancel. MeridianComplete is a health plan that contracts with both Medicare and Illinois Medicaid to provide benefits of both programs to enrollees. 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 [email protected]. Please review the various programs below. Material ID:H6080_WEBSITE_2023_Accepted_09282022. 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. Llame al 1-855-580-1689 (los usuarios de TTY deben llamar al 711). The benefit information is a brief summary, not a complete description of benefits. This is not a complete list. Representatives are available Monday-Friday, 8 a.m. to 8 p.m. to assist you. 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. 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. For more information contact the plan or read the Meridian Member Handbook. Starting January 1, 2018, the Illinois Medicaid Managed Care Program is expanding to include all It will also explain our responsibilities to you, as well as outline the following details: Su llamada ser devuelta dentro del siguiente da hbil. Click the link below to view or save a copy. 0000041209 00000 n Want a paper copy? The handbook will explain your rights, benefits, and responsibilities as a member of MeridianComplete. [email protected]. 0000046386 00000 n 0000002041 00000 n trailer For more information contact the plan or read the Meridian Member Handbook. The call is free. On weekends and on state or federal holidays, you may be asked to leave a message. ATENCIN: Si habla espaol, tiene a su disposicin servicios gratuitos de asistencia lingstica. ATTENTION: If you speak a language other than English, language assistance services, free of charge, are available to you. 2023 For a more comprehensive description of the plan benefits, please refer to your Member Handbook which can also be found on this page. https://www.illinois.gov/hfs/healthchoice/Pages/HealthPlans.aspx, https://www.illinois.gov/hfs/healthchoice/reportcard. 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. 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. Call MeridianComplete at 1-855-323-4578 (TTY users should call 711), 8 a.m to 8 p.m., seven days a week. You are now able to view your health information from a third-party app on a mobile device or PC! 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 [email protected]. If you wish to stay on this website, please click Cancel. The Health Library is a free resource exclusively for MeridianComplete members and providers. It explains the medical, dental, vision, and pharmacy services that are covered by your plan. Prior Authorization, Step Therapy and Quantity Limits, Coverage Determinations and Redeterminations for Drugs, Notice of Nondiscrimination & Language Assistance. A certificate of coverage (COC) tells you what to expect from your healthcare plan. You also need to make sure that the Department of Healthcare & Family Services (HFS) has your new address. You will be able to work with one health plan for all of your health insurance needs. +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 Monday-Friday, 8 a.m. to 5 p.m. CST 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. Los representantes estn disponibles para ayudarle de lunes a viernes de 8 a.m. a 8 p.m. Los fines de semana y los das feriados estatales o federales, es posible que se le solicite que deje un mensaje. For 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. 0000068680 00000 n 0000046966 00000 n We are excited to share that MeridianCare, a WellCare company, is changing its name to WellCare, effective January 1, 2020! 0000002177 00000 n Your call will be returned within the next business day. Download the free version of Adobe Reader. For a more comprehensive description of the plan benefits, please refer to your Member Handbook. Making healthcare decisions can be tough--who to see for care, what to ask, when to go. 167 0 obj <> endobj Out-of-network/non-contracted providers are under no obligation to treat MeridianComplete members, except in emergency situations. HFS sends paperwork in the mail that you need to renew your Medicaid coverage. 0000072727 00000 n 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. 0000010510 00000 n 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. Your handbook is full of important information about your health care and Meridian. Each link will open a new window and is either a PDF or a website. 0000046799 00000 n 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. On weekends and on state or federal holidays, you may be asked to leave a message. Other pharmacies/physicians/providers are available in our network. Your Member Handbook is a great resource if you have any questions or just want to learn more about your coverage. 0000040481 00000 n Just call Member Services with your new address. hKq?wNe?t!ARk;v6[IqK,h!i2jLnn}>^| ! If you wish to stay on this website, please click Cancel. You can also visit the Illinois Client Enrollment Services website. 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. This site contains various Meridian Medicare-Medicaid Plan (MMP) links and resources. Important Phone Numbers & Contacts In an Emergency 911 Meridian Member Services 866-606-3700 All Rights Reserved. Other pharmacies/physicians/providers are available in our network. You can join our Start Smart for Your Baby program. MeridianComplete (Medicare-Medicaid Plan) is a health plan that contracts with both Medicare and Michigan Medicaid to provide benefits of both programs to enrollees. 0000001708 00000 n We are excited to share that MeridianCare, a WellCare company, is changing its name to WellCare, effective January 1, 2020! Under our plan, you will have one card for your Medicare and Medicaid services, including long-term services and supports and prescriptions. Open Enrollment 6. Check out the Interoperability page to learn more. 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. 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. Meridian is for people eligible for both Medicaid and Medicare. The Personal Wellness Assessment is a short form about you and your health journey. Report an address update to HFS online. 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 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 [email protected]. It will also explain our responsibilities to you, as well as outline the following details: window.location.replace("https://mmp.ilmeridian.com/member/benefits-coverage/whats-covered/member-handbook.html"); Usually a mail-order pharmacy order will get to you in no more than 5 days. 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. 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. On weekends and on state or federal holidays, you may be asked to leave a message. Monday-Friday, 8 a.m. to 8 p.m. CST You can make an appeal if you disagree with our verdict. 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. See if you qualify, and explore the HealthChoice Illinois advantage. %PDF-1.4 % h|kPQevkmNRIDrDI-)Vw*DYS7cgcr!349g3. Other pharmacies/physicians/providers are available in our network. 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. 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 call is free. 1-855-580-1689 (TTY 711) A grievance is a complaint about a provider or about the quality of care or services you received. 0000001774 00000 n Please contact the plan for more details. Each link will open a new window and is either a PDF or a website. This is not a complete list. 3. For more information contact the plan or read the Meridian Member Handbook. It explains the medical, dental, vision, and pharmacy services that are covered by your plan. You can also file a grievance or appeal on the phone by calling Member Services or in writing via mail or fax. If we fall short, you can file a grievance or appeal. 2500 0 obj <>stream You will need Adobe Reader to open PDFs on this site. 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)! For more information, or to find out how to get enrolled, please contact Meridian at 888-437-0606. 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. Don't forget to call your local HFS oce and Meridian Member Services with your new address. 0 It outlines services and benefits that areand are notcovered. 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. 0000067354 00000 n We want you to be happy with your healthcare services. JB Pritzker, Governor Theresa Eagleson, Director. You are leaving this website to go to a website managed by a contracted company, which provides service on our behalf. This site contains various Meridian Medicare-Medicaid Plan (MMP) links and resources. If you are using a Meridian provider, you will not have to pay a plan premium, deductible, or copay. hbbd``b`R@AH&="> $ $= @+D C[} "Fod(AE+ Your call will be returned within the next business day. The List of Covered Drugs and/or pharmacy and provider networks may change throughout the year. 2369 0 obj <> endobj 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. Want a paper copy? 0000000956 00000 n 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. Find a doctor, explore coverage, review documents and much more. When you go to file, youll want to write when and where the incident took place, and what happened. With added benefits like support making smart health choices, personal care coordination, 24-hour nursing help line, and more. This site contains various MeridianComplete (Medicare-Medicaid Plan) links and resources. MeridianHealth is now Meridian! 0000041668 00000 n Meridian will help make your Medicare and Medicaid benefits work better together and work better for you. If your address changes, let us know. v4P+r-k E`:8\TV%F1MeLT=LyMit+GYrUn*mH gp`x Y;EgPCSSphf>op!mOQtkC v^K#x" 2023 La llamada es gratis. 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. //
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