meridian illinois member handbook

Your call will be returned within the next business day. Call 1-855-580-1689 (TTY: 711). Complete the Member Notification of Pregnancy(PDF) form in the Member Portal. Copays for prescription drugs may vary based on the level of Extra Help you receive. Keep in mind that everything you choose to share is confidential. 199 0 obj <>stream The Member Handbook, along with your enrollment form, serves as Meridian Medicare-Medicaid Plan's (MMP) contract with you. Report an address update to HFS online. 1-855-580-1689 (TTY 711) If you wish to stay on this website, please click Cancel. It also explains how to find care and how to earn rewards. 0000080946 00000 n It explains the medical, dental, vision, and pharmacy services that are covered by your plan. 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 We want you to be happy with your healthcare services. 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 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. startxref 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) trailer Its full of tips and resources for pregnant members and new parents. Meridian Member Services . For more information, call MeridianComplete Member Services or read the MeridianComplete Member Handbook. // op!mOQtkC v^K#x" Making healthcare decisions can be tough--who to see for care, what to ask, when to go. If you wish to stay on this website, please click Cancel. Each link will open a new window and is either a PDF or a website. For information regarding our Pharmacy Benefit Manager (PBM), MeridianRx, visit the MeridianRx website. For more information contact the plan or read the MeridianComplete Member Handbook. Member ID Cards 5. 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! ATENCIN: Si habla espaol, tiene a su disposicin servicios gratuitos de asistencia lingstica. 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 you have questions, please call MeridianComplete (Medicare-Medicaid Plan) Member Services at 1-855-580-1689 (TTY users should call 711). The call is free. A certificate of coverage (COC) tells you what to expect from your healthcare plan. The Member Handbook, along with your enrollment form, serves as MeridianCompletes contract with you. Representatives are available Monday-Friday, 8 a.m. to 8 p.m. to assist you. 0000025980 00000 n Each link will open a new window and is either a PDF or a website. 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. 0000067553 00000 n Member Handbook | Meridian Complete of Illinois We can connect you with support, services, and even rewards. Moving? At the right time and place. 0000151745 00000 n Youll tell us about any health conditions, recent hospital visits, medications, and more. 3. 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. On weekends and on state or federal holidays, you may be asked to leave a message. For certain kinds of drugs, you can use the plans network mail-order services. Please visit our new website to see up to date information about your plan. Language Assistance & Notice of Nondiscrimination. 1-855-580-1689 (TTY 711) The handbook will explain your rights, benefits, and responsibilities as a member of MeridianComplete. Out-of-network/non-contracted providers are under no obligation to treat Meridian members, except in emergency situations. Your call will be returned within the next business day. xref You are leaving this website to go to a website managed by a contracted company, which provides service on our behalf. 1-855-580-1689 (TTY 711) 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. Open Enrollment 6. ATENCIN: Si habla espaol, tiene a su disposicin servicios gratuitos de asistencia lingstica. You also need to make sure that the Department of Healthcare & Family Services (HFS) has your new address. 0 0000041209 00000 n You can join our Start Smart for Your Baby program. +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 Looking for your plan home page or interested in becoming a member? 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 <. Providers - MeridianComplete This site contains various Meridian Medicare-Medicaid Plan (MMP) links and resources. It will also explain our responsibilities to you, as well as outline the following details: On weekends and on state or federal holidays, you may be asked to leave a message. Out-of-network/non-contracted providers are under no obligation to treat Meridian members, except in emergency situations. You can also file a grievance or appeal on the phone by calling Member Services or in writing via mail or fax. This is not a complete list. 0000046799 00000 n Check out the Interoperability page to learn more. PDF ILLINOIS MEMBER HANDBOOK - Meridian Illinois Managed Care Plans The COC lays out all the details so that you can stay on top of your coverage. Call 1-855-580-1689 (TTY: 711). You will be able to work with one health plan for all of your health insurance needs. %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. 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. Meridian is for people eligible for both Medicaid and Medicare. 0000021917 00000 n If you wish to stay on this website, please click Cancel. 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. 0000000956 00000 n Meridian Medicare Medicaid Plan hKq?wNe?t!ARk;v6[IqK,h!i2jLnn}>^| ! 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. 0000001774 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. Want a paper copy? Meridian covers all counties in Illinois. Member Handbook - Meridian Medicare Medicaid Plan 0000068680 00000 n On weekends and on state or federal holidays, you may be asked to leave a message. 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. Fill out the Member Notification of Pregnancy form(PDF)to let us know if you are pregnant. 0000000016 00000 n 0 Copyright 2023 Meridian All Rights Reserved. For a more comprehensive description of the plan benefits, please refer to your Member Handbook which can also be found on this page. 0000046576 00000 n This is not a complete list. You can also visit the Illinois Client Enrollment Services website. 866-606-3700 . 0000002177 00000 n On weekends and on state or federal holidays, you may be asked to leave a message. Click the link below to view or save a copy. It explains the medical, dental, vision, and pharmacy services that are covered by your plan. Download the free version of Adobe Reader. All Rights Reserved. The Provider Manual has everything you need to know about member benefits, coverage, and provider guidelines. You will need Adobe Reader to open PDFs on this site. Other pharmacies/physicians/providers are available in our network. The benefit information is a brief summary, not a complete description of benefits. Llame al. This is not a complete list. Please contact the plan for more details. 0000046966 00000 n La llamada es gratis. On weekends and on state or federal holidays, 0000002131 00000 n With HealthChoice Illinois, you have a health plan partner to turn to for help. The call is free. 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. Be sure to read your Meridian Member Handbook and keep it handy. 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. The handbook will explain your rights, benefits, and responsibilities as a member of Meridian. 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 your address changes, let us know. 0000002041 00000 n For example, we may not approve your providers request for a certain drug. 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)! MeridianHealth is now Meridian! 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. Monday-Friday, 8 a.m. to 8 p.m. CST For more information, or to find out how to get enrolled, please contact Meridian at 888-437-0606. It explains the medical, dental, vision, and pharmacy services that are covered by your plan. The handbook will explain your rights, benefits, and responsibilities as a member of Meridian. ATENCIN: Si habla espaol, tiene a su disposicin servicios gratuitos de asistencia lingstica. 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. Meridian 0000006553 00000 n Our Population Health Management Programs are offered to Meridian members and designed to improve your overall health and quality of care. When you go to file, youll want to write when and where the incident took place, and what happened. You are now able to view your health information from a third-party app on a mobile device or PC! 0000001708 00000 n Monday-Friday, 8 a.m. to 5 p.m. CST Want a paper copy? We are excited to share that MeridianCare, a WellCare company, is changing its name to WellCare, effective January 1, 2020! 167 0 obj <> endobj Understanding the ins and outs of your health plan can be difficult. It outlines services and benefits that areand are notcovered. Making healthcare decisions can be tough--who to see for care, what to ask, when to go. HealthChoice Illinois is the smart way most Medicaid members get quality care. Just call Member Services with your new address. 2369 0 obj <> endobj The benefit information is a brief summary, not a complete description of benefits. Call, Usted puede obtener gratuitamente este documento en espaol o hablar con alguien sobre esta informacin en otros idiomas. Member Handbook | Meridian Health Plan of Illinois Monday-Friday, 8 a.m. to 8 p.m. CST 167 33 You will need Adobe Reader to open PDFs on this site. With our Medicare-Medicaid Plan (MMP) youre getting: An assigned care manager to help answer questions and coordinate your care. There are a few ways to complete the form: We want you to have a safe, healthy, and happy pregnancy! 2023 JB Pritzker, Governor Theresa Eagleson, Director. Representatives are available Monday-Friday, 8 a.m. to 8 p.m. to assist you. This way, we can connect you with the right care. 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. Your handbook is full of important information about your health care and 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. 0000072727 00000 n Representatives are available Monday-Friday, 8 a.m. to 8 p.m. to assist you. Each link will open a new window and is either a PDF or a website. 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.