If you have questions, please call MeridianComplete (Medicare-Medicaid Plan) Member Services at 1-855-580-1689 (TTY users should call 711). Meridian will work with you to make sure you get all of the care you need, when you need it. 0000002131 00000 n 0000040481 00000 n 0000006553 00000 n The Member Handbook, along with your enrollment form, serves asMeridian Medicare-Medicaid Plan's (MMP) contract with you. We can connect you with support, services, and even rewards. 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.ILmeridian.com. 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. MeridianComplete is a health plan that contracts with both Medicare and Illinois Medicaid to provide benefits of both programs to enrollees. Each link will open a new window and is either a PDF or a website. Our Population Health Management Programs are offered to Meridian members and designed to improve your overall health and quality of care. Documents and Forms - Meridian Medicare Medicaid Plan 0000041668 00000 n Representatives are available Monday-Friday, 8 a.m. to 8 p.m. to assist you. Download the Member Handbook (PDF). This is not a complete list. 0000072727 00000 n 0000067553 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. Out-of-network/non-contracted providers are under no obligation to treat Meridian members, except in emergency situations. ATENCIN: Si habla espaol, tiene a su disposicin servicios gratuitos de asistencia lingstica. 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. Out-of-network/non-contracted providers are under no obligation to treat MeridianComplete members, except in emergency situations. Please review the various programs below. %%EOF JB Pritzker, Governor Theresa Eagleson, Director. Llame al 1-855-580-1689 (los usuarios de TTY deben llamar al 711). Meridian You are now able to view your health information from a third-party app on a mobile device or PC! https://www.illinois.gov/hfs/healthchoice/Pages/HealthPlans.aspx, https://www.illinois.gov/hfs/healthchoice/reportcard. It will also explain our responsibilities to you, as well as outline the following details: For information regarding our Pharmacy Benefit Manager (PBM), MeridianRx, visit the MeridianRx website. You will need Adobe Reader to open PDFs on this site. endstream endobj 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) The Member Handbook, along with your enrollment form, serves as Meridian Medicare-Medicaid Plan's (MMP) contract with you. The List of Covered Drugs and/or pharmacy and provider networks may change throughout the year. It will help you get the care you need. 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. 0000046576 00000 n 2022 Provider Manual (PDF) Meridian Provider Manual Errata Sheet (PDF) Documents and Forms Medical Referrals & Authorizations Pharmacy Billing Mandatory Training Attestation We are excited to share that MeridianCare, a WellCare company, is changing its name to WellCare, effective January 1, 2020! 0000046966 00000 n Complete the Member Notification of Pregnancy(PDF) form in the Member Portal. This way, we can connect you with the right care. // PDF here's your member handbook. 0000002074 00000 n 0 For more information, call MeridianComplete Member Services or read the MeridianComplete Member Handbook. 199 0 obj <>stream v4P+r-k E`:8\TV%F1MeLT=LyMit+GYrUn*mH gp`x Y;EgPCSSphf>op!mOQtkC v^K#x" 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. Open Enrollment 6. 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. Your Member Handbook is a great resource if you have any questions or just want to learn more about your coverage. Material ID:H6080_WEBSITE_2023_Accepted_09282022. Material ID:H6080_WEBSITE_2023_Accepted_09282022. The COC lays out all the details so that you can stay on top of your coverage. Provider Network 6 Member Handbook | Meridian Complete of Illinois Call Member Services if youd like paper copies of any of these documents. trailer Su llamada ser devuelta dentro del siguiente da hbil. Meridian will help make your Medicare and Medicaid benefits work better together and work better for 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 Meridian members, except in emergency situations. Your call will be returned within the next business day. 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. La llamada es gratis. ATTENTION: If you speak a language other than English, language assistance services, free of charge, are available to you. Please contact the plan for more details. 0000025639 00000 n You've got questions and we've got answers. When you go to file, youll want to write when and where the incident took place, and what happened. Copyright 2023 Meridian All Rights Reserved. 2500 0 obj <>stream It outlines services and benefits that areand are notcovered. The handbook will explain your rights, benefits, and responsibilities as a member of Meridian. It explains the medical, dental, vision, and pharmacy services that are covered by your plan. Other pharmacies/physicians/providers are available in our network. providerhelp.IL@mhplan.com, The Interoperability and Patient Access Rule. Visit your Member Portal or call Member Services. Your call will be returned within the next business day. startxref If you wish to stay on this website, please click Cancel. The benefit information is a brief summary, not a complete description of benefits. Making healthcare decisions can be tough--who to see for care, what to ask, when to go. If you experience any problems receiving your mail order prescription, call Member Services at. 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. 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. Call 1-855-580-1689 (TTY: 711). Representatives are available Monday-Friday, 8 a.m. to 8 p.m. to assist you. MeridianHealth is now Meridian! With our Medicare-Medicaid Plan (MMP) youre getting: An assigned care manager to help answer questions and coordinate your care. If you have any questions, call Meridian Member Services toll-free at 866-606-3700. 0000040678 00000 n 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. 0000046386 00000 n Other pharmacies/physicians/providers are available in our network. Want a paper copy? The handbook will explain your rights, benefits, and responsibilities as a member of MeridianComplete. Provider Manual | Meridian Health Plan of Illinois For more information contact the plan or read the Meridian Member Handbook. hbbd``b`R@AH&="> $ $= @+D C[} "Fod(AE+ For more information contact the plan or read the Meridian Member Handbook. It explains the medical, dental, vision, and pharmacy services that are covered by your plan. 167 0 obj <> endobj The handbook will explain your rights, benefits, and responsibilities as a member of Meridian. Your handbook is full of important information about your health care and Meridian. [CDATA[ HealthChoice Illinois is the smart way most Medicaid members get quality care. 0000068680 00000 n Fill out the Member Notification of Pregnancy form(PDF)to let us know if you are pregnant. +t x1Rdt!v8,1{1"sAS*.~Y|U:d\e6qXaI1,JSh\0y7x'zz|:nY\bnLM H\Bd ;,|Xt$Au*5Ndt:|_bLR[QcO?#VJ2VH n6 (_`/}^v}~/ OZ1?.9H Pl;-wrZi}wSzpibGlU}~/r B5[AuJL~2P1W^ j}Y@5( ?d We will send you a notice before we make a change that affects you. 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. Llame al. xref The call is free. On weekends and on state or federal holidays, you may be asked to leave a message. 2369 0 obj <> endobj 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! 0000002220 00000 n HFS sends paperwork in the mail that you need to renew your Medicaid coverage. 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. PDF <DATE> Program called HealthChoice Illinois . We have been working hard It also explains how to find care and how to earn rewards. La llamada es gratis. HealthChoice Illinois | HFS If you wish to stay on this website, please click Cancel. Limitations, copays, and restrictions may apply. Be sure to read your Meridian Member Handbook and keep it handy. Starting January 1, 2018, the Illinois Medicaid Managed Care Program is expanding to include all More information is in your Member Handbook(PDF). Your call will be returned within the next business day. 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. You can also visit the Illinois Client Enrollment Services website. // ]]>. %%EOF If your pregnancy is at high risk, we may call you. (los usuarios de TTY deben llamar al 711), lunes a domingo, de 8 a.m. a 8 p.m. La llamada es gratuita. This site contains various MeridianComplete (Medicare-Medicaid Plan) links and resources. 167 33 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. 0000014634 00000 n This site contains various Meridian Medicare-Medicaid Plan (MMP) links and resources. Catching a Breath Complex Case Management Flu Outreach Opioids For a more comprehensive description of the plan benefits, please refer to your Member Handbook which can also be found on this page. Member Handbook - Meridian Medicare Medicaid Plan 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. Representatives are available Monday-Friday, 8 a.m. to 8 p.m. to assist you. We are excited to share that MeridianCare, a WellCare company, is changing its name to WellCare, effective January 1, 2020! View your Provider Manual, important plan information and more. This is not a complete list. 2023 1-855-580-1689 (TTY 711) 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. Your Member Handbook is a great resource if you have any questions or just want to learn more about your coverage. The handbook will explain your rights, benefits, and responsibilities as a member of Meridian. Check out the Interoperability page to learn more. The Personal Wellness Assessment is a short form about you and your health journey. 0000002177 00000 n See if you qualify, and explore the HealthChoice Illinois advantage. 0000067354 00000 n The benefit information is a brief summary, not a complete description of benefits. For Members | Meridian MeridianComplete (Medicare-Medicaid Plan) is a health plan that contracts with both Medicare and Michigan Medicaid to provide benefits of both programs to enrollees. Youll tell us about any health conditions, recent hospital visits, medications, and more. On weekends and on state or federal holidays, you may be asked to leave a message. With added benefits like support making smart health choices, personal care coordination, 24-hour nursing help line, and more. 0000041209 00000 n 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. On weekends and on state or federal holidays, 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. If you wish to stay on this website, please click Cancel. 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 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. For example, we may not approve your providers request for a certain drug. It explains the medical, dental, vision, and pharmacy services that are covered by your plan. Member Handbooks and Forms 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. You also need to make sure that the Department of Healthcare & Family Services (HFS) has your new address. The Member Handbook, along with your enrollment form, serves as Meridian Medicare-Medicaid Plan's (MMP) contract with you. You will be able to work with one health plan for all of your health insurance needs. La llamada es gratis. Out-of-network/non-contracted providers are under no obligation to treat Meridian members, except in emergency situations. 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. %PDF-1.4 % 0000017969 00000 n Want a paper copy? 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 You can get this document in Spanish, or speak with someone about this information in other languages for free. If you are using a Meridian provider, you will not have to pay a plan premium, deductible, or copay. 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. On weekends and on state or federal holidays, you may be asked to leave a message. Each link will open a new window and is either a PDF or a website. You can join our Start Smart for Your Baby program. 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. 0000041585 00000 n You can make an appeal if you disagree with our verdict. 0 Prior Authorization, Step Therapy and Quantity Limits, Coverage Determinations and Redeterminations for Drugs, Notice of Nondiscrimination & Language Assistance. An appeal is a way for you to ask for a review of our actions. With HealthChoice Illinois, you have a health plan partner to turn to for help. You can also file a grievance or appeal on the phone by calling Member Services or in writing via mail or fax. If your address changes, let us know. We need to be able to send you important information in the mail. Under our plan, you will have one card for your Medicare and Medicaid services, including long-term services and supports and prescriptions. %PDF-1.7 % 1-855-580-1689 (TTY 711) 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. Important Phone Numbers & Contacts In an Emergency 911 Meridian Member Services 866-606-3700
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