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Each link will open a new window and is either a PDF or a website. xref
You will need Adobe Reader to open PDFs on this site. We need to be able to send you important information in the mail. Other pharmacies/physicians/providers are available in our network. PDF Welcome to MeridianHealth Intro to Plan You are leaving this website to go to a website managed by a contracted company, which provides service on our behalf. You will be able to work with one health plan for all of your health insurance needs. It also explains how to find care and how to earn rewards. %PDF-1.7
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This handbook will help you understand your coverage. Visit your Member Portal or call Member Services. 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. Meridian Medicare Medicaid Plan We are excited to share that MeridianCare, a WellCare company, is changing its name to WellCare, effective January 1, 2020! Download the Member Handbook(PDF). 0000000956 00000 n
You will need Adobe Reader to open PDFs on this site. Representatives are available Monday-Friday, 8 a.m. to 8 p.m. to assist you. endstream
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On weekends and on state or federal holidays, you may be asked to leave a message. 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. You can get this document for free in other formats, such as large print, braille, or audio. Meridian will work with you to make sure you get all of the care you need, when you need it. 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)! With HealthChoice Illinois, you have a health plan partner to turn to for help. The handbook will explain your rights, benefits, and responsibilities as a member of MeridianComplete. 0000041668 00000 n
At the right time and place. 0000040481 00000 n
Member Handbook - Meridian Medicare Medicaid Plan HealthChoice Illinois | HFS 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. Member Handbooks and Forms Starting January 1, 2018, the Illinois Medicaid Managed Care Program is expanding to include all 0000072727 00000 n
Your call will be returned within the next business day. 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. It explains the medical, dental, vision, and pharmacy services that are covered by your plan. 0000068680 00000 n
Your Member Handbook is a great resource if you have any questions or just want to learn more about your coverage. member.ILmeridian.com. Provider Manual | Meridian Health Plan of Illinois 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: The COC lays out all the details so that you can stay on top of your coverage. 1-855-580-1689 (TTY 711) Representatives are available Monday-Friday, 8 a.m. to 8 p.m. to assist you. For Members | Meridian Please visit our new website to see up to date information about your plan. 2023
It will also explain our responsibilities to you, as well as outline the following details: For example, we may not approve your providers request for a certain drug. 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. You will need Adobe Reader to open PDFs on this site. Your call will be returned within the next business day. For more information contact the plan or read the Meridian Member Handbook. Find a doctor, explore coverage, review documents and much more. Su llamada ser devuelta dentro del siguiente da hbil. For certain kinds of drugs, you can use the plans network mail-order services. Documents and Forms - Meridian Medicare Medicaid Plan See if you qualify, and explore the HealthChoice Illinois advantage. The handbook will explain your rights, benefits, and responsibilities as a member of Meridian. 199 0 obj
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The call is free. The Member Handbook, along with your enrollment form, serves as Meridian Medicare-Medicaid Plan's (MMP) contract with you. 0000025980 00000 n
This site contains various MeridianComplete (Medicare-Medicaid Plan) links and resources. 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. [CDATA[ startxref
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. Call Member Services if youd like paper copies of any of these documents. ATENCIN: Si habla espaol, tiene a su disposicin servicios gratuitos de asistencia lingstica. Complete the Member Notification of Pregnancy(PDF) form in the Member Portal. 0000151745 00000 n
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Meridian
HFS sends paperwork in the mail that you need to renew your Medicaid coverage. 0000068208 00000 n
MeridianHealth is now Meridian! Llame al 1-855-580-1689 (los usuarios de TTY deben llamar al 711). Member Handbook | Meridian Complete of Illinois JB Pritzker, Governor Theresa Eagleson, Director. Su llamada ser devuelta dentro del siguiente da hbil. The right care for you. 0000002220 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. This is not a complete list. Meridian
Material ID:H6080_WEBSITE_2023_Accepted_09282022. 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! You can get this document in Spanish, or speak with someone about this information in other languages for free. Monday-Friday, 7:00 a.m. to 5:30 p.m. (TTY: 711) Ser vice area . 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. 2023
Call 1-855-580-1689 (TTY: 711). We are excited to share that MeridianCare, a WellCare company, is changing its name to WellCare, effective January 1, 2020! ATTENTION: If you speak a language other than English, language assistance services, free of charge, are available to you. A certificate of coverage (COC) tells you what to expect from your healthcare plan. Out-of-network/non-contracted providers are under no obligation to treat MeridianComplete members, except in emergency situations. Meridian will help make your Medicare and Medicaid benefits work better together and work better for you. Call 1-855-580-1689 (TTY: 711). The Member Handbook, along with your enrollment form, serves as MeridianCompletes contract with you. %%EOF
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. With added benefitslike supportmakingsmart health choices, personal care coordination, 24-hour nursing help line, and more. <<0B5A082EC79D7049BD46C1656B63CA22>]/Prev 539953>>
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Llame al. MeridianComplete (Medicare-Medicaid Plan) is a health plan that contracts with both Medicare and Michigan Medicaid to provide benefits of both programs to enrollees. Call MeridianComplete at 1-855-323-4578 (TTY users should call 711), 8 a.m to 8 p.m., seven days a week. Representatives are available Monday-Friday, 8 a.m. to 8 p.m. to assist 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. The call is free. 0000000016 00000 n
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You are now able to view your health information from a third-party app on a mobile device or PC! 0000041585 00000 n
The call is free. 2022 Provider Manual (PDF) Meridian Provider Manual Errata Sheet (PDF) Documents and Forms Medical Referrals & Authorizations Pharmacy Billing Mandatory Training Attestation 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. Understanding the ins and outs of your health plan can be difficult. Download the Member Handbook (PDF). You are leaving this website to go to a website managed by a contracted company, which provides service on our behalf. Member Handbook | Meridian Health Plan of Illinois
On weekends and on state or federal holidays, 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. Other pharmacies/physicians/providers are available in our network. 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. You can get this document for free in other formats, such as large print, braille, or audio. On weekends and on state or federal holidays, you may be asked to leave a message. The benefit information is a brief summary, not a complete description of benefits. It outlines services and benefits that areand are notcovered. 0000001708 00000 n
Click the link below to view or save a copy. The List of Covered Drugs and/or pharmacy and provider networks may change throughout the year. Download the free version of Adobe Reader. The Member Handbook, along with your enrollment form, serves as Meridian Medicare-Medicaid Plan's (MMP) contract with you. +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
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If you wish to stay on this website, please click Cancel. 0
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PDF here's your member handbook. A grievance is a complaint about a provider or about the quality of care or services you received. ATENCIN: Si habla espaol, tiene a su disposicin servicios gratuitos de asistencia lingstica. You can make an appeal if you disagree with our verdict. Copyright 2023 Meridian All Rights Reserved. If we fall short, you can file a grievance or appeal. Be sure to read your Meridian Member Handbook and keep it handy. 0000025639 00000 n
Each link will open a new window and is either a PDF or a website. The benefit information is a brief summary, not a complete description of benefits. Please contact the plan for more details. Catching a Breath Complex Case Management Flu Outreach Opioids Out-of-network/non-contracted providers are under no obligation to treat Meridian members, except in emergency situations. Check out the Interoperability page to learn more. Learn more about how being a Meridian provider benefits you. The handbook will explain your rights, benefits, and responsibilities as a member of Meridian. Just call Member Services with your new address. Your call will be returned within the next business day. %%EOF
Monday-Friday, 8 a.m. to 8 p.m. CST 0000010510 00000 n
The Health Library is a free resource exclusively for MeridianComplete members and providers. 0000002177 00000 n
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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 Member Handbook is a great resource if you have any questions or just want to learn more about your coverage. You also need to make sure that the Department of Healthcare & Family Services (HFS) has your new address. Youll tell us about any health conditions, recent hospital visits, medications, and more. Meridian is for people eligible for both Medicaid and Medicare. 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. You are leaving this website to go to a website managed by a contracted company, which provides service on our behalf. 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. On weekends and on state or federal holidays, you may be asked to leave a message. This is not a complete list. 0000002074 00000 n
Other pharmacies/physicians/providers are available in our network. 167 0 obj
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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. 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? 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. Limitations, copays, and restrictions may apply. Meridian covers all counties in Illinois. 0000041209 00000 n
If you are using a Meridian provider, you will not have to pay a plan premium, deductible, or copay. Open Enrollment 6. 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. Under our plan, you will have one card for your Medicare and Medicaid services, including long-term services and supports and prescriptions. 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. Keep in mind that everything you choose to share is confidential. 0000021917 00000 n
View our Frequently Asked Questions page. If your pregnancy is at high risk, we may call you. You can also visit the Illinois Client Enrollment Services website. PDF ILLINOIS MEMBER HANDBOOK - Meridian Illinois Managed Care Plans https://www.illinois.gov/hfs/healthchoice/Pages/HealthPlans.aspx, https://www.illinois.gov/hfs/healthchoice/reportcard. You can join our Start Smart for Your Baby program. Want a paper copy? Prior Authorization, Step Therapy and Quantity Limits, Coverage Determinations and Redeterminations for Drugs, Notice of Nondiscrimination & Language Assistance. 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. If you wish to stay on this website, please click Cancel. 0000002041 00000 n
Its full of tips and resources for pregnant members and new parents. For more information contact the plan or read the Meridian Member Handbook. La llamada es gratis. 0000067354 00000 n
You can also visit the Illinois Client Enrollment Services website. Our Population Health Management Programs are offered to Meridian members and designed to improve your overall health and quality of care. La llamada es gratis. For more information, call MeridianComplete Member Services or read the MeridianComplete Member Handbook. 0000046966 00000 n
Member ID Cards 5. The benefit information is a brief summary, not a complete description of benefits. Providers - MeridianComplete 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. Call 1-855-580-1689 (TTY: 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. 0000040678 00000 n
This site contains various Meridian Medicare-Medicaid Plan (MMP) links and resources. More information is in your Member Handbook(PDF). MeridianComplete is a health plan that contracts with both Medicare and Illinois Medicaid to provide benefits of both programs to enrollees. 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. h|kPQevkmNRIDrDI-)Vw*DYS7cgcr!349g3. Representatives are available Monday-Friday, 8 a.m. to 8 p.m. to assist you. 0
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Call, Usted puede obtener gratuitamente este documento en espaol o hablar con alguien sobre esta informacin en otros idiomas.