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. Complete the Member Notification of Pregnancy(PDF) form in the Member Portal. JB Pritzker, Governor Theresa Eagleson, Director. If you wish to stay on this website, please click Cancel. Meridian will help make your Medicare and Medicaid benefits work better together and work better for you. Member Handbook | Meridian Health Plan of Illinois Download the free version of Adobe Reader. Member ID Cards 5. Representatives are available Monday-Friday, 8 a.m. to 8 p.m. to assist you. Meridian Member Services . 3. A certificate of coverage (COC) tells you what to expect from your healthcare plan. 0000002177 00000 n You will need Adobe Reader to open PDFs on this site. This is not a complete list. Your call will be returned within the next business day. 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. 0000001708 00000 n This is not a complete list. Its full of tips and resources for pregnant members and new parents. Monday-Friday, 8 a.m. to 5 p.m. CST 0000072727 00000 n %%EOF It will help you get the care you need. The benefit information is a brief summary, not a complete description of benefits. Representatives are available Monday-Friday, 8 a.m. to 8 p.m. to assist you. Out-of-network/non-contracted providers are under no obligation to treat Meridian members, except in emergency situations. Your Member Handbook is a great resource if you have any questions or just want to learn more about your coverage. Member Handbook | Meridian Complete of Illinois Out-of-network/non-contracted providers are under no obligation to treat Meridian members, except in emergency situations. The Provider Manual has everything you need to know about member benefits, coverage, and provider guidelines. 0000151745 00000 n 0000014634 00000 n 0000002074 00000 n Report an address update to HFS online. If we fall short, you can file a grievance or appeal. 0000002220 00000 n Youll tell us about any health conditions, recent hospital visits, medications, 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. You are leaving this website to go to a website managed by a contracted company, which provides service on our behalf. If your address changes, let us know. startxref 0000041209 00000 n 167 33 Starting January 1, 2018, the Illinois Medicaid Managed Care Program is expanding to include all 0000041668 00000 n Call, Usted puede obtener gratuitamente este documento en espaol o hablar con alguien sobre esta informacin en otros idiomas. Meridian covers all counties in Illinois. Learn more about how being a Meridian provider benefits you. View our Frequently Asked Questions page. providerhelp.IL@mhplan.com. Out-of-network/non-contracted providers are under no obligation to treat Meridian members, except in emergency situations. 0000010510 00000 n Be sure to read your Meridian Member Handbook and keep it handy. The handbook will explain your rights, benefits, and responsibilities as a member of Meridian. You can also visit the Illinois Client Enrollment Services website. The call is free. %%EOF 0000000956 00000 n This site contains various Meridian Medicare-Medicaid Plan (MMP) links and resources. For more information contact the plan or read the Meridian Member Handbook. Please review the various programs below. // ]]>. 0000046966 00000 n https://www.illinois.gov/hfs/healthchoice/Pages/HealthPlans.aspx, https://www.illinois.gov/hfs/healthchoice/reportcard. 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. Call MeridianComplete at 1-855-323-4578 (TTY users should call 711), 8 a.m to 8 p.m., seven days a week. It will also explain our responsibilities to you, as well as outline the following details: 2022 Provider Manual (PDF) Meridian Provider Manual Errata Sheet (PDF) Documents and Forms Medical Referrals & Authorizations Pharmacy Billing Mandatory Training Attestation 0000046386 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 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. 1-855-580-1689 (TTY 711) 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. This is not a complete list. 0000002041 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. 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. Provider Network 6 For Members | Meridian Call 1-855-580-1689 (TTY: 711). The handbook will explain your rights, benefits, and responsibilities as a member of Meridian. trailer 0000068680 00000 n If you are using a Meridian provider, you will not have to pay a plan premium, deductible, or copay. You will need Adobe Reader to open PDFs on this site. 2023 // ]/Prev 539953>> You will need Adobe Reader to open PDFs on this site. The benefit information is a brief summary, not a complete description of benefits. Representatives are available Monday-Friday, 8 a.m. to 8 p.m. to assist you. Understanding the ins and outs of your health plan can be difficult. This way, we can connect you with the right care. 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. Please visit our new website to see up to date information about your plan. Keep in mind that everything you choose to share is confidential. 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. Each link will open a new window and is either a PDF or a website. It explains the medical, dental, vision, and pharmacy services that are covered by your plan. hbbd``b`R@AH&="> $ $= @+D C[} "Fod(AE+ 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. providerhelp.IL@mhplan.com, The Interoperability and Patient Access Rule. You can get this document in Spanish, or speak with someone about this information in other languages for free. If you wish to stay on this website, please click Cancel. 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. 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. [CDATA[ An appeal is a way for you to ask for a review of our actions. 0000068208 00000 n MeridianComplete is a health plan that contracts with both Medicare and Illinois Medicaid to provide benefits of both programs to enrollees. With added benefits like support making smart health choices, personal care coordination, 24-hour nursing help line, and more. 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. Don't forget to call your local HFS oce and Meridian Member Services with your new address. Material ID:H6080_WEBSITE_2023_Accepted_09282022. You can also visit the Illinois Client Enrollment Services website. 0 The handbook will explain your rights, benefits, and responsibilities as a member of Meridian. 167 0 obj <> endobj La llamada es gratis. Other pharmacies/physicians/providers are available in our network. On weekends and on state or federal holidays, 0000040678 00000 n You are leaving this website to go to a website managed by a contracted company, which provides service on our behalf. This is not a complete list. For more information, call MeridianComplete Member Services or read the MeridianComplete Member Handbook. Our Population Health Management Programs are offered to Meridian members and designed to improve your overall health and quality of care. Fill out the Member Notification of Pregnancy form(PDF)to let us know if you are pregnant. Llame al. The Member Handbook, along with your enrollment form, serves as Meridian Medicare-Medicaid Plan's (MMP) contract with you. PDF 2021 Member Handbook - Meridian Medicare Medicaid Plan Su llamada ser devuelta dentro del siguiente da hbil. If you have questions, please call MeridianComplete (Medicare-Medicaid Plan) Member Services at 1-855-580-1689 (TTY users should call 711). Each link will open a new window and is either a PDF or a website. PDF Welcome to MeridianHealth Intro to Plan Download the Member Handbook(PDF). 0000017969 00000 n Material ID:H6080_WEBSITE_2023_Accepted_09282022. Each link will open a new window and is either a PDF or a website. 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. Your call will be returned within the next business day. For more information contact the plan or read the MeridianComplete Member Handbook. The call is free. With HealthChoice Illinois, you have a health plan partner to turn to for help. Meridian You are leaving this website to go to a website managed by a contracted company, which provides service on our behalf. The List of Covered Drugs and/or pharmacy and provider networks may change throughout the year. For a more comprehensive description of the plan benefits, please refer to your Member Handbook which can also be found on this page. 0000006553 00000 n hKq?wNe?t!ARk;v6[IqK,h!i2jLnn}>^| ! MeridianComplete (Medicare-Medicaid Plan) is a health plan that contracts with both Medicare and Michigan Medicaid to provide benefits of both programs to enrollees. Provider Manual | Meridian Health Plan of Illinois PDF here's your member handbook. 0000002131 00000 n If you have any questions, call Meridian Member Services toll-free at 866-606-3700. For more information, or to find out how to get enrolled, please contact Meridian at 888-437-0606. HFS sends paperwork in the mail that you need to renew your Medicaid coverage. 2369 0 obj <> endobj The COC lays out all the details so that you can stay on top of your coverage. Other pharmacies/physicians/providers are available in our network. %PDF-1.4 % 0000067553 00000 n We are excited to share that MeridianCare, a WellCare company, is changing its name to WellCare, effective January 1, 2020! On weekends and on state or federal holidays, you may be asked to leave a message. 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. Llame al 1-855-580-1689 (los usuarios de TTY deben llamar al 711). 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. Copyright 2023 Meridian All Rights Reserved. Copays for prescription drugs may vary based on the level of Extra Help you receive. 2021 Member Handbook Illinois Counties: Cook, DuPage, Kane, Kankakee, Lake, Will . Want a paper copy? Call 1-855-580-1689 (TTY: 711). View your Provider Manual, important plan information and more. The call is free. 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)! Other pharmacies/physicians/providers are available in our network. You will be able to work with one health plan for all of your health insurance needs. v4P+r-k E`:8\TV%F1MeLT=LyMit+GYrUn*mH gp`x Y;EgPCSSphf>op!mOQtkC v^K#x" %PDF-1.7 % 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. With added benefitslike supportmakingsmart health choices, personal care coordination, 24-hour nursing help line, and more. 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. 2023 You can get this document for free in other formats, such as large print, braille, or audio. Member Handbooks and Forms We want you to be happy with the treatment and services you get from Meridian and our providers. 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. 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. member.ILmeridian.com. You can also file a grievance or appeal on the phone by calling Member Services or in writing via mail or fax. MeridianHealth is now Meridian! For more information contact the plan or read the Meridian Member Handbook. Documents and Forms - Meridian Medicare Medicaid Plan Llame al 1-855-580-1689 (los usuarios de TTY deben llamar al 711). A grievance is a complaint about a provider or about the quality of care or services you received. 0000001774 00000 n Call 1-855-580-1689 (TTY: 711). For example, we may not approve your providers request for a certain drug. This site contains various MeridianComplete (Medicare-Medicaid Plan) links and resources. The call is free. Important Phone Numbers & Contacts In an Emergency 911 Meridian Member Services 866-606-3700 Your call will be returned within the next business day. Download the Member Handbook (PDF). 2500 0 obj <>stream You are leaving this website to go to a website managed by a contracted company, which provides service on our behalf. Your Member Handbook is a great resource if you have any questions or just want to learn more about your coverage. 0000067354 00000 n 866-606-3700 . We can connect you with support, services, and even rewards. 0000047422 00000 n For certain kinds of drugs, you can use the plans network mail-order services. Su llamada ser devuelta dentro del siguiente da hbil. It explains the medical, dental, vision, and pharmacy services that are covered by your plan. Please turn on JavaScript and try again. HealthChoice Illinois | HFS Check out the Interoperability page to learn more. 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. 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. If you wish to stay on this website, please click Cancel. If you wish to stay on this website, please click Cancel. Limitations, copays, and restrictions may apply. Llame al 1-855-580-1689 (los usuarios de TTY deben llamar al 711). Click the link below to view or save a copy. 0000080946 00000 n 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. All Rights Reserved. Making healthcare decisions can be tough--who to see for care, what to ask, when to go. The Health Library is a free resource exclusively for MeridianComplete members and providers. 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've got questions and we've got answers. 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 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. Please contact the plan for more details. Want a paper copy? Other pharmacies/physicians/providers are available in our network. Representatives are available Monday-Friday, 8 a.m. to 8 p.m. to assist you. 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. Su llamada ser devuelta dentro del siguiente da hbil. Your call will be returned within the next business day. 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 <. Your handbook is full of important information about your health care and Meridian. At the right time and place. 0000021917 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. For information regarding our Pharmacy Benefit Manager (PBM), MeridianRx, visit the MeridianRx website. Out-of-network/non-contracted providers are under no obligation to treat MeridianComplete members, except in emergency situations. The right care for you. 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. Monday-Friday, 7:00 a.m. to 5:30 p.m. (TTY: 711) Ser vice area . 0000046799 00000 n PDF <DATE> Program called HealthChoice Illinois . We have been working hard 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. The Member Handbook, along with your enrollment form, serves as Meridian Medicare-Medicaid Plan's (MMP) contract with you. Looking for your plan home page or interested in becoming a member? Call Member Services if youd like paper copies of any of these documents. You can make an appeal if you disagree with our verdict. You can get this document for free in other formats, such as large print, braille, or audio. The Personal Wellness Assessment is a short form about you and your health journey. PDF ILLINOIS MEMBER HANDBOOK - Meridian Illinois Managed Care Plans ATTENTION: If you speak a language other than English, language assistance services, free of charge, are available to you. ATENCIN: Si habla espaol, tiene a su disposicin servicios gratuitos de asistencia lingstica. You can get this document for free in other formats, such as large print, braille, or audio. You will need Adobe Reader to open PDFs on this site. La llamada es gratis. With HealthChoice Illinois, you have a health plan partner to turn to for help.