3. 0000046386 00000 n It will also explain our responsibilities to you, as well as outline the following details: The COC lays out all the details so that you can stay on top of your coverage. Provider Manual | Meridian Health Plan of Illinois 2021 Member Handbook Illinois Counties: Cook, DuPage, Kane, Kankakee, Lake, Will . For more information, call MeridianComplete Member Services or read the MeridianComplete Member Handbook. The call is free. With added benefitslike supportmakingsmart health choices, personal care coordination, 24-hour nursing help line, and more. You are leaving this website to go to a website managed by a contracted company, which provides service on our behalf. It also explains how to find care and how to earn rewards. Monday-Friday, 8 a.m. to 8 p.m. CST trailer startxref 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. If you wish to stay on this website, please click Cancel. It outlines services and benefits that areand are notcovered. 2023 Download the Member Handbook (PDF). The handbook will explain your rights, benefits, and responsibilities as a member of Meridian. HFS sends paperwork in the mail that you need to renew your Medicaid coverage. You will need Adobe Reader to open PDFs on this site. Call MeridianComplete at 1-855-323-4578 (TTY users should call 711), 8 a.m to 8 p.m., seven days a week. %%EOF You can also visit the Illinois Client Enrollment Services website. Download the Member Handbook (PDF). Out-of-network/non-contracted providers are under no obligation to treat Meridian members, except in emergency situations. 0000001708 00000 n 0000002177 00000 n For more information contact the plan or read the Meridian Member Handbook. Please contact the plan for more details. 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. 0000041585 00000 n JB Pritzker, Governor Theresa Eagleson, Director. You can get this document in Spanish, or speak with someone about this information in other languages for free. Want a paper copy? You can also visit the Illinois Client Enrollment Services website. Meridian Member 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. Making healthcare decisions can be tough--who to see for care, what to ask, when to go. Documents and Forms - Meridian Medicare Medicaid 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. 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. 0000046799 00000 n 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. If your address changes, let us know. On weekends and on state or federal holidays, 0000041209 00000 n Other pharmacies/physicians/providers are available in our network. For a more comprehensive description of the plan benefits, please refer to your Member Handbook. Your call will be returned within the next business day. Understanding the ins and outs of your health plan can be difficult. The Member Handbook, along with your enrollment form, serves as MeridianCompletes contract with you. For more information, or to find out how to get enrolled, please contact Meridian at 888-437-0606. Your Member Handbook is a great resource if you have any questions or just want to learn more about your coverage. With our Medicare-Medicaid Plan (MMP) youre getting: An assigned care manager to help answer questions and coordinate your care. A certificate of coverage (COC) tells you what to expect from your healthcare plan. Su llamada ser devuelta dentro del siguiente da hbil. Llame al. PDF ILLINOIS MEMBER HANDBOOK - Meridian Illinois Managed Care Plans All Rights Reserved. The benefit information is a brief summary, not a complete description of benefits. 1-855-580-1689 (TTY 711) For a more comprehensive description of the plan benefits, please refer to your Member Handbook which can also be found on this page. With HealthChoice Illinois, you have a health plan partner to turn to for help. A grievance is a complaint about a provider or about the quality of care or services you received. Meridian Member Handbooks and Forms If you have any questions, call Meridian Member Services toll-free at 866-606-3700. 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. Click the link below to view or save a copy. 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. 0000025639 00000 n 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: The Annual Notice of Changes (ANOC) is a brief summary of benefits and benefit changes that occurred from one year to the next. Representatives are available Monday-Friday, 8 a.m. to 8 p.m. to assist you. ATENCIN: Si habla espaol, tiene a su disposicin servicios gratuitos de asistencia lingstica. This way, we can connect you with the right care. You can get this document for free in other formats, such as large print, braille, or audio. Your call will be returned within the next business day. 0000010510 00000 n Language Assistance & Notice of Nondiscrimination. Providers - MeridianComplete 0000072727 00000 n Usually a mail-order pharmacy order will get to you in no more than 5 days. Su llamada ser devuelta dentro del siguiente da hbil. The right care for you. Representatives are available Monday-Friday, 8 a.m. to 8 p.m. to assist you. Open Enrollment 6. Under our plan, you will have one card for your Medicare and Medicaid services, including long-term services and supports and prescriptions. Visit your Member Portal or call Member Services. 1-855-580-1689 (TTY 711) 0000002220 00000 n 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) 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. h|kPQevkmNRIDrDI-)Vw*DYS7cgcr!349g3. 0 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). Representatives are available Monday-Friday, 8 a.m. to 8 p.m. to assist you. Call Member Services if youd like paper copies of any of these documents. Prior Authorization, Step Therapy and Quantity Limits, Coverage Determinations and Redeterminations for Drugs, Notice of Nondiscrimination & Language Assistance. window.location.replace("https://mmp.ilmeridian.com/member/benefits-coverage/whats-covered/member-handbook.html"); The Member Handbook, along with your enrollment form, serves as Meridian Medicare-Medicaid Plan's (MMP) contract with you. Catching a Breath Complex Case Management Flu Outreach Opioids 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. 0000040481 00000 n ATENCIN: Si habla espaol, tiene a su disposicin servicios gratuitos de asistencia lingstica. 0000040678 00000 n The handbook will explain your rights, benefits, and responsibilities as a member of Meridian. 866-606-3700 . 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. When you go to file, youll want to write when and where the incident took place, and what happened. 0000002131 00000 n Fill out the Member Notification of Pregnancy form(PDF)to let us know if you are pregnant. 199 0 obj <>stream 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. 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. ATENCIN: Si habla espaol, tiene a su disposicin servicios gratuitos de asistencia lingstica. 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. // ]]>. For Members | Meridian endstream endobj startxref The Member Handbook, along with your enrollment form, serves as Meridian Medicare-Medicaid Plan's (MMP) contract with you. 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. Report an address update to HFS online. Find a doctor, explore coverage, review documents and much more. You will need Adobe Reader to open PDFs on this site. You can get this document for free in other formats, such as large print, braille, or audio. 0000014634 00000 n Don't forget to call your local HFS oce and Meridian Member Services with your new address. 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. We are excited to share that MeridianCare, a WellCare company, is changing its name to WellCare, effective January 1, 2020! 2023 If you have questions, please call MeridianComplete (Medicare-Medicaid Plan) Member Services at 1-855-580-1689 (TTY users should call 711). For information regarding our Pharmacy Benefit Manager (PBM), MeridianRx, visit the MeridianRx website. With HealthChoice Illinois, you have a health plan partner to turn to for help. Each link will open a new window and is either a PDF or a website. If you wish to stay on this website, please click Cancel. It also explains how to find care and how to earn rewards. Each link will open a new window and is either a PDF or a website. 0000002074 00000 n 2369 0 obj <> endobj Member Handbook | Meridian Complete of Illinois 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. This handbook will help you understand your coverage. Your handbook is full of important information about your health care and Meridian. Other pharmacies/physicians/providers are available in our network. 0000000956 00000 n Meridian will help make your Medicare and Medicaid benefits work better together and work better for you. hbbd``b`R@AH&="> $ $= @+D C[} "Fod(AE+ It explains the medical, dental, vision, and pharmacy services that are covered by your plan. We can connect you with support, services, and even rewards. 0000000016 00000 n It explains the medical, dental, vision, and pharmacy services that are covered by your plan. Youll tell us about any health conditions, recent hospital visits, medications, and more. Want a paper copy? Provider Network 6 providerhelp.IL@mhplan.com, The Interoperability and Patient Access Rule. If your pregnancy is at high risk, we may call you. Other pharmacies/physicians/providers are available in our network. Looking for your plan home page or interested in becoming a member? Your call will be returned within the next business day. The benefit information is a brief summary, not a complete description of benefits. [CDATA[ If you wish to stay on this website, please click Cancel. MeridianComplete is a health plan that contracts with both Medicare and Illinois Medicaid to provide benefits of both programs to enrollees. (los usuarios de TTY deben llamar al 711), lunes a domingo, de 8 a.m. a 8 p.m. La llamada es gratuita. 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. 167 0 obj <> endobj 0000067553 00000 n 0000067354 00000 n This site contains various Meridian Medicare-Medicaid Plan (MMP) links and resources. %%EOF It looks like your browser does not have JavaScript enabled. Meridian is for people eligible for both Medicaid and Medicare. xref PDF <DATE> Program called HealthChoice Illinois . We have been working hard %PDF-1.7 % We want you to be happy with the treatment and services you get from Meridian and our providers. View your Provider Manual, important plan information and more. The benefit information is a brief summary, not a complete description of benefits. Learn more about how being a Meridian provider benefits you. 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. The Provider Manual has everything you need to know about member benefits, coverage, and provider guidelines. The benefit information is a brief summary, not a complete description of benefits. 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)! 0000025980 00000 n This site contains various MeridianComplete (Medicare-Medicaid Plan) links and resources. 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 can also file a grievance or appeal on the phone by calling Member Services or in writing via mail or fax. The call is free. This is not a complete list. 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. Llame al 1-855-580-1689 (los usuarios de TTY deben llamar al 711). Meridian covers all counties in Illinois. // 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. Member Handbook - Meridian Medicare Medicaid Plan We want you to be happy with your healthcare services. There are a few ways to complete the form: We want you to have a safe, healthy, and happy pregnancy! On weekends and on state or federal holidays, you may be asked to leave a message. It also explains how to find care and how to earn rewards. 0000068208 00000 n Other pharmacies/physicians/providers are available in our network. 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. Our Population Health Management Programs are offered to Meridian members and designed to improve your overall health and quality of care. For example, we may not approve your providers request for a certain drug. We are excited to share that MeridianCare, a WellCare company, is changing its name to WellCare, effective January 1, 2020! hKq?wNe?t!ARk;v6[IqK,h!i2jLnn}>^| ! The call is free. Meridian will work with you to make sure you get all of the care you need, when you need it. The call is free. 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. La llamada es gratis. providerhelp.IL@mhplan.com. Your Member Handbook is a great resource if you have any questions or just want to learn more about your coverage. Monday-Friday, 7:00 a.m. to 5:30 p.m. (TTY: 711) Ser vice area . 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. 0000046966 00000 n With added benefits like support making smart health choices, personal care coordination, 24-hour nursing help line, and more. PDF Welcome to MeridianHealth Intro to Plan Meridian Medicare Medicaid Plan Want a paper copy? On weekends and on state or federal holidays, you may be asked to leave a message. HealthChoice Illinois | HFS The Member Handbook, along with your enrollment form, serves as Meridian Medicare-Medicaid Plan's (MMP) contract with you. Important Phone Numbers & Contacts In an Emergency 911 Meridian Member Services 866-606-3700 It explains the medical, dental, vision, and pharmacy services that are covered by your plan. You will be able to work with one health plan for all of your health insurance needs. 2022 Provider Manual (PDF) Meridian Provider Manual Errata Sheet (PDF) Documents and Forms Medical Referrals & Authorizations Pharmacy Billing Mandatory Training Attestation The Personal Wellness Assessment is a short form about you and your health journey. Copyright 2023 Meridian All Rights Reserved. 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) 0000151745 00000 n See if you qualify, and explore the HealthChoice Illinois advantage. PDF here's your member handbook. Moving? 0000041668 00000 n HealthChoice Illinois is the smart way most Medicaid members get quality care. 0 We need to be able to send you important information in the mail. 0000017969 00000 n Call, Usted puede obtener gratuitamente este documento en espaol o hablar con alguien sobre esta informacin en otros idiomas. +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 Llame al 1-855-580-1689 (los usuarios de TTY deben llamar al 711). La llamada es gratis. Please turn on JavaScript and try again. For more information contact the plan or read the MeridianComplete Member Handbook. Material ID:H6080_WEBSITE_2023_Accepted_09282022. Please visit our new website to see up to date information about your plan. v4P+r-k E`:8\TV%F1MeLT=LyMit+GYrUn*mH gp`x Y;EgPCSSphf>op!mOQtkC v^K#x" At the right time and place. Monday-Friday, 8 a.m. to 8 p.m. CST 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. 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. 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. 167 33 You also need to make sure that the Department of Healthcare & Family Services (HFS) has your new address. Monday-Friday, 8 a.m. to 5 p.m. CST The List of Covered Drugs and/or pharmacy and provider networks may change throughout the year. The Member Handbook, along with your enrollment form, serves asMeridian Medicare-Medicaid Plan's (MMP) contract with you. The handbook will explain your rights, benefits, and responsibilities as a member of MeridianComplete. 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. Member ID Cards 5. On weekends and on state or federal holidays, you may be asked to leave a message. If you experience any problems receiving your mail order prescription, call Member Services at. All Rights Reserved. 0000046576 00000 n It will also explain our responsibilities to you, as well as outline the following details: 0000002041 00000 n Complete the Member Notification of Pregnancy(PDF) form in the Member Portal. Out-of-network/non-contracted providers are under no obligation to treat Meridian members, except in emergency situations. Copays for prescription drugs may vary based on the level of Extra Help you receive. This is not a complete list. The call is free. La llamada es gratis. Representatives are available Monday-Friday, 8 a.m. to 8 p.m. to assist you. 2500 0 obj <>stream On weekends and on state or federal holidays, you may be asked to leave a message. Starting January 1, 2018, the Illinois Medicaid Managed Care Program is expanding to include all 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. 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. On weekends and on state or federal holidays, you may be asked to leave a message. Call 1-855-580-1689 (TTY: 711). This site contains various Meridian Medicare-Medicaid Plan (MMP) links and resources. You are leaving this website to go to a website managed by a contracted company, which provides service on our behalf. 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. ATTENTION: If you speak a language other than English, language assistance services, free of charge, are available to you. 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. Your call will be returned within the next business day. The handbook will explain your rights, benefits, and responsibilities as a member of Meridian. member.ILmeridian.com. 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 can join our Start Smart for Your Baby program. MeridianHealth is now Meridian! Each link will open a new window and is either a PDF or a website. Llame al 1-855-580-1689 (los usuarios de TTY deben llamar al 711). You are now able to view your health information from a third-party app on a mobile device or PC! Your call will be returned within the next business day. <<0B5A082EC79D7049BD46C1656B63CA22>]/Prev 539953>> 0000068680 00000 n This is not a complete list. 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. Just call Member Services with your new address. An appeal is a way for you to ask for a review of our actions.