Meridian covers all counties in Illinois. This is not a complete list. Check out the, Prior Authorization, Step Therapy and Quantity Limits, Coverage Determinations and Redeterminations for Drugs, Illinois Client Enrollment Services website, Language Assistance & Notice of Nondiscrimination. Material ID:H6080_WEBSITE_2023_Accepted_09282022. 0000046799 00000 n The call is free. The benefit information is a brief summary, not a complete description of benefits. 0000025639 00000 n Please visit our new website to see up to date information about your plan. With HealthChoice Illinois, you have a health plan partner to turn to for help. If you wish to stay on this website, please click Cancel. It explains the medical, dental, vision, and pharmacy services that are covered by your plan. You are leaving this website to go to a website managed by a contracted company, which provides service on our behalf. All Rights Reserved. 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. 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. Other pharmacies/physicians/providers are available in our network. You will need Adobe Reader to open PDFs on this site. Meridian is for people eligible for both Medicaid and Medicare. Copays for prescription drugs may vary based on the level of Extra Help you receive. For more information, or to find out how to get enrolled, please contact Meridian at 888-437-0606. Your call will be returned within the next business day. We are excited to share that MeridianCare, a WellCare company, is changing its name to WellCare, effective January 1, 2020! Complete the Member Notification of Pregnancy(PDF) form in the Member Portal. 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. MeridianComplete is a health plan that contracts with both Medicare and Illinois Medicaid to provide benefits of both programs to enrollees. 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. Out-of-network/non-contracted providers are under no obligation to treat Meridian members, except in emergency situations. 0000041668 00000 n On weekends and on state or federal holidays, It also explains how to find care and how to earn rewards. It also explains how to find care and how to earn rewards. 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 is not a complete list. La llamada es gratis. providerhelp.IL@mhplan.com. Open Enrollment 6. xref You can also file a grievance or appeal on the phone by calling Member Services or in writing via mail or fax. Moving? 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. If you have any questions, call Meridian Member Services toll-free at 866-606-3700. Fill out the Member Notification of Pregnancy form(PDF)to let us know if you are pregnant. Su llamada ser devuelta dentro del siguiente da hbil. 0000040481 00000 n HFS sends paperwork in the mail that you need to renew your Medicaid coverage. Want a paper copy? 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. If you have questions, please call MeridianComplete (Medicare-Medicaid Plan) Member Services at 1-855-580-1689 (TTY users should call 711). Language Assistance & Notice of Nondiscrimination. Each link will open a new window and is either a PDF or a website. 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) 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. It explains the medical, dental, vision, and pharmacy services that are covered by your plan. %%EOF 0000025980 00000 n The benefit information is a brief summary, not a complete description of benefits. endstream endobj startxref Your Member Handbook is a great resource if you have any questions or just want to learn more about your coverage. The Personal Wellness Assessment is a short form about you and your health journey. You can also visit the Illinois Client Enrollment Services website. 0000067553 00000 n 0 0000010510 00000 n This is not a complete list. 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. La llamada es gratis. The Member Handbook, along with your enrollment form, serves as Meridian Medicare-Medicaid Plan's (MMP) contract with you. This handbook will help you understand your coverage. %%EOF (los usuarios de TTY deben llamar al 711), lunes a domingo, de 8 a.m. a 8 p.m. La llamada es gratuita. 0000151745 00000 n The Provider Manual has everything you need to know about member benefits, coverage, and provider guidelines. 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 handbook will explain your rights, benefits, and responsibilities as a member of MeridianComplete. See if you qualify, and explore the HealthChoice Illinois advantage. Please turn on JavaScript and try again. The handbook will explain your rights, benefits, and responsibilities as a member of Meridian. You also need to make sure that the Department of Healthcare & Family Services (HFS) has your new address. You will be able to work with one health plan for all of your health insurance needs. For information regarding our Pharmacy Benefit Manager (PBM), MeridianRx, visit the MeridianRx website. 167 33 Visit your Member Portal or call Member Services. 0000000016 00000 n Representatives are available Monday-Friday, 8 a.m. to 8 p.m. to assist you. 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. 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 <. Its full of tips and resources for pregnant members and new parents. 0000041585 00000 n 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. We want you to be happy with the treatment and services you get from Meridian and our providers. Making healthcare decisions can be tough--who to see for care, what to ask, when to go. 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 a more comprehensive description of the plan benefits, please refer to your Member Handbook. It also explains how to find care and how to earn rewards. You are now able to view your health information from a third-party app on a mobile device or PC! 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. MeridianHealth is now Meridian! Out-of-network/non-contracted providers are under no obligation to treat Meridian members, except in emergency situations. 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. More information is in your Member Handbook(PDF). Youll tell us about any health conditions, recent hospital visits, medications, and more. For a more comprehensive description of the plan benefits, please refer to your Member Handbook which can also be found on this page. You will need Adobe Reader to open PDFs on this site. 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. On weekends and on state or federal holidays, you may be asked to leave a message. Understanding the ins and outs of your health plan can be difficult. Be sure to read your Meridian Member Handbook and keep it handy. If you wish to stay on this website, please click Cancel. 0000041209 00000 n 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. Learn more about how being a Meridian provider benefits you. 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. 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. v4P+r-k E`:8\TV%F1MeLT=LyMit+GYrUn*mH gp`x Y;EgPCSSphf>op!mOQtkC v^K#x" You are leaving this website to go to a website managed by a contracted company, which provides service on our behalf. hbbd``b`R@AH&="> $ $= @+D C[} "Fod(AE+ Call 1-855-580-1689 (TTY: 711). Monday-Friday, 8 a.m. to 5 p.m. CST 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)! 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. At the right time and place. Keep in mind that everything you choose to share is confidential. 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. If we fall short, you can file a grievance or appeal. Out-of-network/non-contracted providers are under no obligation to treat MeridianComplete members, except in emergency situations. Su llamada ser devuelta dentro del siguiente da hbil. Usually a mail-order pharmacy order will get to you in no more than 5 days. Want a paper copy? Limitations, copays, and restrictions may apply. Looking for your plan home page or interested in becoming a member? For more information contact the plan or read the Meridian Member Handbook. You can get this document for free in other formats, such as large print, braille, or audio. 0000046386 00000 n On weekends and on state or federal holidays, you may be asked to leave a message. 0000046576 00000 n 0000002041 00000 n If you wish to stay on this website, please click Cancel. A certificate of coverage (COC) tells you what to expect from your healthcare plan. 0000040678 00000 n 1-855-580-1689 (TTY 711) The handbook will explain your rights, benefits, and responsibilities as a member of Meridian. You are leaving this website to go to a website managed by a contracted company, which provides service on our behalf. 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. 2023 167 0 obj <> endobj We need to be able to send you important information in the mail. Monday-Friday, 7:00 a.m. to 5:30 p.m. (TTY: 711) Ser vice area . The call is free. Your call will be returned within the next business day. 0000002074 00000 n The Member Handbook, along with your enrollment form, serves as Meridian Medicare-Medicaid Plan's (MMP) contract with you. Meridian With HealthChoice Illinois, you have a health plan partner to turn to for help. Meridian 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. La llamada es gratis. 0000014634 00000 n Llame al 1-855-580-1689 (los usuarios de TTY deben llamar al 711). With added benefitslike supportmakingsmart health choices, personal care coordination, 24-hour nursing help line, and more. Find a doctor, explore coverage, review documents and much more. Download the Member Handbook(PDF). Your Member Handbook is a great resource if you have any questions or just want to learn more about your coverage. 1-855-580-1689 (TTY 711) The Health Library is a free resource exclusively for MeridianComplete members and providers. There are a few ways to complete the form: We want you to have a safe, healthy, and happy pregnancy! With added benefits like support making smart health choices, personal care coordination, 24-hour nursing help line, and more. Monday-Friday, 8 a.m. to 8 p.m. CST 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. %PDF-1.7 % 0000047422 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. View your Provider Manual, important plan information and more. The benefit information is a brief summary, not a complete description of benefits. For more information contact the plan or read the MeridianComplete Member Handbook. startxref Meridian will work with you to make sure you get all of the care you need, when you need it. If you wish to stay on this website, please click Cancel. <<0B5A082EC79D7049BD46C1656B63CA22>]/Prev 539953>> 2500 0 obj <>stream 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. 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! Our Population Health Management Programs are offered to Meridian members and designed to improve your overall health and quality of care. 0000067354 00000 n The COC lays out all the details so that you can stay on top of your coverage. If your pregnancy is at high risk, we may call you. Your call will be returned within the next business day. Su llamada ser devuelta dentro del siguiente da hbil. 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. 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. https://www.illinois.gov/hfs/healthchoice/Pages/HealthPlans.aspx, https://www.illinois.gov/hfs/healthchoice/reportcard. Starting January 1, 2018, the Illinois Medicaid Managed Care Program is expanding to include all +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 Your Member Handbook is a great resource if you have any questions or just want to learn more about your coverage. Your call will be returned within the next business day. The handbook will explain your rights, benefits, and responsibilities as a member of Meridian. 199 0 obj <>stream You can get this document for free in other formats, such as large print, braille, or audio. 2022 Provider Manual (PDF) Meridian Provider Manual Errata Sheet (PDF) Documents and Forms Medical Referrals & Authorizations Pharmacy Billing Mandatory Training Attestation %PDF-1.4 % Meridian Member Services . Don't forget to call your local HFS oce and Meridian Member Services with your new address. Important Phone Numbers & Contacts In an Emergency 911 Meridian Member Services 866-606-3700 The call is free. 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 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. ATENCIN: Si habla espaol, tiene a su disposicin servicios gratuitos de asistencia lingstica. With our Medicare-Medicaid Plan (MMP) youre getting: An assigned care manager to help answer questions and coordinate your care. Your handbook is full of important information about your health care and Meridian. Meridian will help make your Medicare and Medicaid benefits work better together and work better for you. On weekends and on state or federal holidays, you may be asked to leave a message. You can get this document in Spanish, or speak with someone about this information in other languages for free. Copyright 2023 Meridian All Rights Reserved. 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. providerhelp.IL@mhplan.com, The Interoperability and Patient Access Rule. 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 On weekends and on state or federal holidays, you may be asked to leave a message. Representatives are available Monday-Friday, 8 a.m. to 8 p.m. to assist you. 866-606-3700 . ATENCIN: Si habla espaol, tiene a su disposicin servicios gratuitos de asistencia lingstica. 0000080946 00000 n Prior Authorization, Step Therapy and Quantity Limits, Coverage Determinations and Redeterminations for Drugs, Notice of Nondiscrimination & Language Assistance. If you are using a Meridian provider, you will not have to pay a plan premium, deductible, or copay. You can make an appeal if you disagree with our verdict. An appeal is a way for you to ask for a review of our actions. 2021 Member Handbook Illinois Counties: Cook, DuPage, Kane, Kankakee, Lake, Will . You can also visit the Illinois Client Enrollment Services website. For more information, call MeridianComplete Member Services or read the MeridianComplete Member Handbook. 0000017969 00000 n Representatives are available Monday-Friday, 8 a.m. to 8 p.m. to assist you. All Rights Reserved. 0000072727 00000 n Download the Member Handbook (PDF). 0000002177 00000 n Just call Member Services with your new address. It explains the medical, dental, vision, and pharmacy services that are covered by your plan. 3. The call is free. 2023 Catching a Breath Complex Case Management Flu Outreach Opioids If you experience any problems receiving your mail order prescription, call Member Services at. trailer Each link will open a new window and is either a PDF or a website. Out-of-network/non-contracted providers are under no obligation to treat Meridian members, except in emergency situations. When you go to file, youll want to write when and where the incident took place, and what happened. View our Frequently Asked Questions page. 0000046966 00000 n It will help you get the care you need. 2369 0 obj <> endobj The call is free. member.ILmeridian.com. Llame al 1-855-580-1689 (los usuarios de TTY deben llamar al 711). We are excited to share that MeridianCare, a WellCare company, is changing its name to WellCare, effective January 1, 2020! 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. 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. HealthChoice Illinois is the smart way most Medicaid members get quality care. 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. It looks like your browser does not have JavaScript enabled. You will need Adobe Reader to open PDFs on this site. [CDATA[ // ]]>. Call 1-855-580-1689 (TTY: 711). 0000021917 00000 n 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: 0000002220 00000 n This way, we can connect you with the right care. Llame al. Under our plan, you will have one card for your Medicare and Medicaid services, including long-term services and supports and prescriptions. Material ID:H6080_WEBSITE_2023_Accepted_09282022. 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. Report an address update to HFS online. JB Pritzker, Governor Theresa Eagleson, Director. For more information contact the plan or read the Meridian Member Handbook. Each link will open a new window and is either a PDF or a website. 0000001774 00000 n You can join our Start Smart for Your Baby program. Making healthcare decisions can be tough--who to see for care, what to ask, when to go. ATTENTION: If you speak a language other than English, language assistance services, free of charge, are available to you.