meridian illinois member handbookmeridian illinois member handbook

Find a doctor, explore coverage, review documents and much more. Want a paper copy? 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 MeridianComplete at 1-855-323-4578 (TTY users should call 711), 8 a.m to 8 p.m., seven days a week. 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. 0000014634 00000 n Your handbook is full of important information about your health care and Meridian. You are leaving this website to go to a website managed by a contracted company, which provides service on our behalf. For example, we may not approve your providers request for a certain drug. The Member Handbook, along with your enrollment form, serves as Meridian Medicare-Medicaid Plan's (MMP) contract with you. ATENCIN: Si habla espaol, tiene a su disposicin servicios gratuitos de asistencia lingstica. You can also visit the Illinois Client Enrollment Services website. Learn more about how being a Meridian provider benefits you. Su llamada ser devuelta dentro del siguiente da hbil. The handbook will explain your rights, benefits, and responsibilities as a member of MeridianComplete. Please review the various programs below. The call is free. You can make an appeal if you disagree with our verdict. HFS sends paperwork in the mail that you need to renew your Medicaid coverage. 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 <. 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 more information contact the plan or read the Meridian Member Handbook. We are excited to share that MeridianCare, a WellCare company, is changing its name to WellCare, effective January 1, 2020! It explains the medical, dental, vision, and pharmacy services that are covered by your plan. You will need Adobe Reader to open PDFs on this site. For a more comprehensive description of the plan benefits, please refer to your Member Handbook. member.ILmeridian.com. With HealthChoice Illinois, you have a health plan partner to turn to for help. 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. This way, we can connect you with the right care. 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 are now able to view your health information from a third-party app on a mobile device or PC! Monday-Friday, 7:00 a.m. to 5:30 p.m. (TTY: 711) Ser vice area . It explains the medical, dental, vision, and pharmacy services that are covered by your plan. Each link will open a new window and is either a PDF or a website. 0000002074 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. trailer 0000047422 00000 n With added benefitslike supportmakingsmart health choices, personal care coordination, 24-hour nursing help line, and more. If you wish to stay on this website, please click Cancel. 0000006553 00000 n The call is free. Copays for prescription drugs may vary based on the level of Extra Help you receive. It also explains how to find care and how to earn rewards. The Member Handbook, along with your enrollment form, serves as Meridian Medicare-Medicaid Plan's (MMP) contract with you. %%EOF 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. Out-of-network/non-contracted providers are under no obligation to treat MeridianComplete members, except in emergency situations. We want you to be happy with your healthcare services. MeridianComplete is a health plan that contracts with both Medicare and Illinois Medicaid to provide benefits of both programs to enrollees. At the right time and place. The benefit information is a brief summary, not a complete description of benefits. This site contains various Meridian Medicare-Medicaid Plan (MMP) links and resources. Meridian Member Services . window.location.replace("https://mmp.ilmeridian.com/member/benefits-coverage/whats-covered/member-handbook.html"); We will send you a notice before we make a change that affects you. 0000067354 00000 n The Health Library is a free resource exclusively for MeridianComplete members and providers. Each link will open a new window and is either a PDF or a website. 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. Please turn on JavaScript and try again. 0000068208 00000 n 0000021917 00000 n Check out the Interoperability page to learn 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. The benefit information is a brief summary, not a complete description of benefits. Member ID Cards 5. The right care for you. You will need Adobe Reader to open PDFs on this site. Provider Network 6 199 0 obj <>stream If you wish to stay on this website, please click Cancel. Copyright 2023 Meridian All Rights Reserved. Please visit our new website to see up to date information about your plan. It looks like your browser does not have JavaScript enabled. The COC lays out all the details so that you can stay on top of your coverage. A grievance is a complaint about a provider or about the quality of care or services you received. Out-of-network/non-contracted providers are under no obligation to treat Meridian members, except in emergency situations. You are leaving this website to go to a website managed by a contracted company, which provides service on our behalf. We are excited to share that MeridianCare, a WellCare company, is changing its name to WellCare, effective January 1, 2020! Llame al 1-855-580-1689 (los usuarios de TTY deben llamar al 711). 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. h|kPQevkmNRIDrDI-)Vw*DYS7cgcr!349g3. 2022 Provider Manual (PDF) Meridian Provider Manual Errata Sheet (PDF) Documents and Forms Medical Referrals & Authorizations Pharmacy Billing Mandatory Training Attestation Meridian covers all counties in Illinois. Download the Member Handbook(PDF). 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). Each link will open a new window and is either a PDF or a website. Understanding the ins and outs of your health plan can be difficult. 0000080946 00000 n xref 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. 0000000956 00000 n You can also visit the Illinois Client Enrollment Services website. 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 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. If you wish to stay on this website, please click Cancel. We can connect you with support, services, and even rewards. 0000041668 00000 n If you experience any problems receiving your mail order prescription, call Member Services at. 0000017969 00000 n La llamada es gratis. Llame al 1-855-580-1689 (los usuarios de TTY deben llamar al 711). On weekends and on state or federal holidays, you may be asked to leave a message. 0000067553 00000 n Call 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. Starting January 1, 2018, the Illinois Medicaid Managed Care Program is expanding to include all 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 call our Member Services number or see your Member Handbook for more information, including the cost-sharing that applies to out-of-network services. 0000002220 00000 n This is not a complete list. ATENCIN: Si habla espaol, tiene a su disposicin servicios gratuitos de asistencia lingstica. 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. You can also file a grievance or appeal on the phone by calling Member Services or in writing via mail or fax. 0000040678 00000 n Llame al 1-855-580-1689 (los usuarios de TTY deben llamar al 711). Material ID:H6080_WEBSITE_2023_Accepted_09282022. 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. Call 1-855-580-1689 (TTY: 711). ATTENTION: If you speak a language other than English, language assistance services, free of charge, are available to you. %PDF-1.7 % You will be able to work with one health plan for all of your health insurance needs. MeridianHealth is now Meridian! Download the free version of Adobe Reader. Making healthcare decisions can be tough--who to see for care, what to ask, when to go. Keep in mind that everything you choose to share is confidential. Other pharmacies/physicians/providers are available in our network. Meridian You will need Adobe Reader to open PDFs on this site. 0000046576 00000 n 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. Su llamada ser devuelta dentro del siguiente da hbil. 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. Be sure to read your Meridian Member Handbook and keep it handy. Youll tell us about any health conditions, recent hospital visits, medications, and more. 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. The Personal Wellness Assessment is a short form about you and your health journey. A certificate of coverage (COC) tells you what to expect from your healthcare plan. You can get this document for free in other formats, such as large print, braille, or audio. // ]/Prev 539953>> An appeal is a way for you to ask for a review of our actions. Su llamada ser devuelta dentro del siguiente da hbil. 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! 0000002131 00000 n 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) 1-855-580-1689 (TTY 711) 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)! The call is free. If you have any questions, call Meridian Member Services toll-free at 866-606-3700. Representatives are available Monday-Friday, 8 a.m. to 8 p.m. to assist you. If your address changes, let us know. You can get this document in Spanish, or speak with someone about this information in other languages for free. Your call will be returned within the next business day. The benefit information is a brief summary, not a complete description of benefits. If you wish to stay on this website, please click Cancel. %%EOF Important Phone Numbers & Contacts In an Emergency 911 Meridian Member Services 866-606-3700 0000010510 00000 n The benefit information is a brief summary, not a complete description of benefits. %PDF-1.4 % Material ID:H6080_WEBSITE_2023_Accepted_09282022. 0000002177 00000 n On weekends and on state or federal holidays, you may be asked to leave a message. You are leaving this website to go to a website managed by a contracted company, which provides service on our behalf. 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. See if you qualify, and explore the HealthChoice Illinois advantage. 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. With added benefits like support making smart health choices, personal care coordination, 24-hour nursing help line, and more. For more information, call MeridianComplete Member Services or read the MeridianComplete Member Handbook. 0000001774 00000 n For more information contact the plan or read the MeridianComplete Member Handbook. 0000046799 00000 n 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. You've got questions and we've got answers. 0000040481 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. Limitations, copays, and restrictions may apply. The Provider Manual has everything you need to know about member benefits, coverage, and provider guidelines. It will also explain our responsibilities to you, as well as outline the following details: [CDATA[ 0000025980 00000 n Download the Member Handbook (PDF). Don't forget to call your local HFS oce and Meridian Member Services with your new address. You are leaving this website to go to a website managed by a contracted company, which provides service on our behalf. Meridian is for people eligible for both Medicaid and Medicare. 0 hbbd``b`R@AH&="> $ $= @+D C[} "Fod(AE+ 0000151745 00000 n 1-855-580-1689 (TTY 711) Your Member Handbook is a great resource if you have any questions or just want to learn more about your coverage. It explains the medical, dental, vision, and pharmacy services that are covered by your plan. Making healthcare decisions can be tough--who to see for care, what to ask, when to go. Download the Member Handbook (PDF). View your Provider Manual, important plan information and more. Open Enrollment 6. Your call will be returned within the next business day. For certain kinds of drugs, you can use the plans network mail-order services. For a more comprehensive description of the plan benefits, please refer to your Member Handbook which can also be found on this page. Your call will be returned within the next business day. Looking for your plan home page or interested in becoming a member? With our Medicare-Medicaid Plan (MMP) youre getting: An assigned care manager to help answer questions and coordinate your care.
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