meridian illinois member handbook

0000067354 00000 n Please review the various programs below. Llame al 1-855-580-1689 (los usuarios de TTY deben llamar al 711). Representatives are available Monday-Friday, 8 a.m. to 8 p.m. to assist you. You will need Adobe Reader to open PDFs on this site. You are leaving this website to go to a website managed by a contracted company, which provides service on our behalf. On weekends and on state or federal holidays, you may be asked to leave a message. 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)! 0000017969 00000 n [CDATA[ %%EOF Click the link below to view or save a copy. You will need Adobe Reader to open PDFs on this site. 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. On weekends and on state or federal holidays, 2500 0 obj <>stream providerhelp.IL@mhplan.com. 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 Personal Wellness Assessment is a short form about you and your health journey. Making healthcare decisions can be tough--who to see for care, what to ask, when to go. 0000000016 00000 n 0000080946 00000 n 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. Your call will be returned within the next business day. At the right time and place. 0000001708 00000 n We can connect you with support, services, and even rewards. MeridianComplete is a health plan that contracts with both Medicare and Illinois Medicaid to provide benefits of both programs to enrollees. %%EOF 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. 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. Please turn on JavaScript and try again. On weekends and on state or federal holidays, you may be asked to leave a message. It will also explain our responsibilities to you, as well as outline the following details: Meridian is for people eligible for both Medicaid and Medicare. You can get this document in Spanish, or speak with someone about this information in other languages for free. 0000000956 00000 n With HealthChoice Illinois, you have a health plan partner to turn to for help. Other pharmacies/physicians/providers are available in our network. 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. MeridianHealth is now Meridian! The benefit information is a brief summary, not a complete description of benefits. This way, we can connect you with the right care. This is not a complete list. You will need Adobe Reader to open PDFs on this site. Out-of-network/non-contracted providers are under no obligation to treat Meridian members, except in emergency situations. 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. 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. Other pharmacies/physicians/providers are available in our network. More information is in your Member Handbook(PDF). Llame al 1-855-580-1689 (los usuarios de TTY deben llamar al 711). You are leaving this website to go to a website managed by a contracted company, which provides service on our behalf. Llame al. Monday-Friday, 8 a.m. to 5 p.m. CST If your pregnancy is at high risk, we may call you. 0000040678 00000 n %PDF-1.4 % You can get this document for free in other formats, such as large print, braille, or audio. 3. https://www.illinois.gov/hfs/healthchoice/Pages/HealthPlans.aspx, https://www.illinois.gov/hfs/healthchoice/reportcard. Each link will open a new window and is either a PDF or a website. Please contact the plan for more details. Learn more about how being a Meridian provider benefits you. // ^| ! It explains the medical, dental, vision, and pharmacy services that are covered by your plan. Material ID:H6080_WEBSITE_2023_Accepted_09282022. Meridian covers all counties in Illinois. 1-855-580-1689 (TTY 711) Report an address update to HFS online. 0000046966 00000 n v4P+r-k E`:8\TV%F1MeLT=LyMit+GYrUn*mH gp`x Y;EgPCSSphf>op!mOQtkC v^K#x" You will need Adobe Reader to open PDFs on this site. 0000041668 00000 n With our Medicare-Medicaid Plan (MMP) youre getting: An assigned care manager to help answer questions and coordinate your care. <<0B5A082EC79D7049BD46C1656B63CA22>]/Prev 539953>> For more information contact the plan or read the Meridian Member Handbook. Representatives are available Monday-Friday, 8 a.m. to 8 p.m. to assist you. 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. 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. Limitations, copays, and restrictions may apply. For more information, or to find out how to get enrolled, please contact Meridian at 888-437-0606. You are now able to view your health information from a third-party app on a mobile device or PC! Language Assistance & Notice of Nondiscrimination. Check out the Interoperability page to learn more. You are leaving this website to go to a website managed by a contracted company, which provides service on our behalf. You will be able to work with one health plan for all of your health insurance needs. The COC lays out all the details so that you can stay on top of your coverage. 0000002041 00000 n Copays for prescription drugs may vary based on the level of Extra Help you receive. You can get this document for free in other formats, such as large print, braille, or audio. 2023 Prior Authorization, Step Therapy and Quantity Limits, Coverage Determinations and Redeterminations for Drugs, Notice of Nondiscrimination & Language Assistance. View our Frequently Asked Questions page. The Member Handbook, along with your enrollment form, serves as MeridianCompletes contract with you. 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. 866-606-3700 . All Rights Reserved. Be sure to read your Meridian Member Handbook and keep it handy. Complete the Member Notification of Pregnancy(PDF) form in the Member Portal. window.location.replace("https://mmp.ilmeridian.com/member/benefits-coverage/whats-covered/member-handbook.html"); If you are using a Meridian provider, you will not have to pay a plan premium, deductible, or copay. We want you to be happy with the treatment and services you get from Meridian and our providers. 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. 2021 Member Handbook Illinois Counties: Cook, DuPage, Kane, Kankakee, Lake, Will . 0000068208 00000 n Fill out the Member Notification of Pregnancy form(PDF)to let us know if you are pregnant. Meridian Member Services . You can also file a grievance or appeal on the phone by calling Member Services or in writing via mail or fax. 199 0 obj <>stream 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. Meridian We want you to be happy with your healthcare services. 0000067553 00000 n La llamada es gratis. Su llamada ser devuelta dentro del siguiente da hbil. The right care for you. Your Member Handbook is a great resource if you have any questions or just want to learn more about your coverage. Download the Member Handbook (PDF). Member ID Cards 5. If you wish to stay on this website, please click Cancel. Its full of tips and resources for pregnant members and new parents. 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! Want a paper copy? member.ILmeridian.com. 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. Your call will be returned within the next business day. With HealthChoice Illinois, you have a health plan partner to turn to for help. 0000046386 00000 n 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. 0000151745 00000 n Each link will open a new window and is either a PDF or a website. Each link will open a new window and is either a PDF or a website. The call is free. The call is free. If you wish to stay on this website, please click Cancel. Copyright 2023 Meridian All Rights Reserved. Starting January 1, 2018, the Illinois Medicaid Managed Care Program is expanding to include all Material ID:H6080_WEBSITE_2023_Accepted_09282022. Meridian 1-855-580-1689 (TTY 711) Open Enrollment 6. See if you qualify, and explore the HealthChoice Illinois advantage. Call 1-855-580-1689 (TTY: 711). The call is free. This is not a complete list. You can also visit the Illinois Client Enrollment Services website. If you have any questions, call Meridian Member Services toll-free at 866-606-3700. 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! 0000002131 00000 n For a more comprehensive description of the plan benefits, please refer to your Member Handbook which can also be found on this page. Just call Member Services with your new address. It outlines services and benefits that areand are notcovered. h|kPQevkmNRIDrDI-)Vw*DYS7cgcr!349g3. You are leaving this website to go to a website managed by a contracted company, which provides service on our behalf. A certificate of coverage (COC) tells you what to expect from your healthcare plan. Su llamada ser devuelta dentro del siguiente da hbil. ATTENTION: If you speak a language other than English, language assistance services, free of charge, are available to you. Your call will be returned within the next business day. Our Population Health Management Programs are offered to Meridian members and designed to improve your overall health and quality of care. If you have questions, please call MeridianComplete (Medicare-Medicaid Plan) Member Services at 1-855-580-1689 (TTY users should call 711). The benefit information is a brief summary, not a complete description of benefits. 167 0 obj <> endobj For more information contact the plan or read the Meridian Member Handbook. 0000072727 00000 n 0000021917 00000 n 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. // ]]>. There are a few ways to complete the form: We want you to have a safe, healthy, and happy pregnancy! ATENCIN: Si habla espaol, tiene a su disposicin servicios gratuitos de asistencia lingstica. The Provider Manual has everything you need to know about member benefits, coverage, and provider guidelines. If you wish to stay on this website, please click Cancel. 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. The handbook will explain your rights, benefits, and responsibilities as a member of Meridian. startxref It also explains how to find care and how to earn rewards. HFS sends paperwork in the mail that you need to renew your Medicaid coverage. Call Member Services if youd like paper copies of any of these documents. 0000046799 00000 n 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. This handbook will help you understand your coverage. Please visit our new website to see up to date information about your plan. 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. For certain kinds of drugs, you can use the plans network mail-order services. For more information contact the plan or read the MeridianComplete Member Handbook. Download the Member Handbook (PDF). This site contains various Meridian Medicare-Medicaid Plan (MMP) links and resources. 2022 Provider Manual (PDF) Meridian Provider Manual Errata Sheet (PDF) Documents and Forms Medical Referrals & Authorizations Pharmacy Billing Mandatory Training Attestation trailer You can join our Start Smart for Your Baby program. Want a paper copy? Don't forget to call your local HFS oce and Meridian Member Services with your new address. Looking for your plan home page or interested in becoming a member? MeridianComplete (Medicare-Medicaid Plan) is a health plan that contracts with both Medicare and Michigan Medicaid to provide benefits of both programs to enrollees. If we fall short, you can file a grievance or appeal. 0000040481 00000 n Download the free version of Adobe Reader. It also explains how to find care and how to earn rewards. Out-of-network/non-contracted providers are under no obligation to treat Meridian members, except in emergency situations. Each link will open a new window and is either a PDF or a website. 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: 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. 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. It explains the medical, dental, vision, and pharmacy services that are covered by your plan. On weekends and on state or federal holidays, you may be asked to leave a message. You can get this document for free in other formats, such as large print, braille, or audio. 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. For more information, call MeridianComplete Member Services or read the MeridianComplete Member Handbook. 0000006553 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. On weekends and on state or federal holidays, you may be asked to leave a message. 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. xref Download the Member Handbook(PDF). 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) 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. 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. This is not a complete list. The handbook will explain your rights, benefits, and responsibilities as a member of MeridianComplete. The Member Handbook, along with your enrollment form, serves as Meridian Medicare-Medicaid Plan's (MMP) contract with you. JB Pritzker, Governor Theresa Eagleson, Director. You've got questions and we've got answers. 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. Your handbook is full of important information about your health care and Meridian. 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. For more information contact the plan or read the Meridian Member Handbook. 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. Your call will be returned within the next business day. (los usuarios de TTY deben llamar al 711), lunes a domingo, de 8 a.m. a 8 p.m. La llamada es gratuita. 2369 0 obj <> endobj 0000025639 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. It will help you get the care you need. For a more comprehensive description of the plan benefits, please refer to your Member Handbook. Usually a mail-order pharmacy order will get to you in no more than 5 days. 0000025980 00000 n 0000014634 00000 n La llamada es gratis. 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 HealthChoice Illinois is the smart way most Medicaid members get quality care. Your call will be returned within the next business day. Call, Usted puede obtener gratuitamente este documento en espaol o hablar con alguien sobre esta informacin en otros idiomas. All Rights Reserved. 167 33 The List of Covered Drugs and/or pharmacy and provider networks may change throughout the year. You will need Adobe Reader to open PDFs on this site. The benefit information is a brief summary, not a complete description of benefits. Understanding the ins and outs of your health plan can be difficult. 0000010510 00000 n View your Provider Manual, important plan information and more. It explains the medical, dental, vision, and pharmacy services that are covered by your plan. The Member Handbook, along with your enrollment form, serves asMeridian Medicare-Medicaid Plan's (MMP) contract with you. hbbd``b`R@AH&="> $ $= @+D C[} "Fod(AE+ La llamada es gratis. Visit your Member Portal or call Member Services. 0000002177 00000 n 0000046576 00000 n providerhelp.IL@mhplan.com, The Interoperability and Patient Access Rule. 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 <. When you go to file, youll want to write when and where the incident took place, and what happened. The Health Library is a free resource exclusively for MeridianComplete members and providers. This is not a complete list. Call 1-855-580-1689 (TTY: 711). Meridian will work with you to make sure you get all of the care you need, when you need it. The call is free. 0 Out-of-network/non-contracted providers are under no obligation to treat MeridianComplete members, except in emergency situations. 0000068680 00000 n We will send you a notice before we make a change that affects you. Keep in mind that everything you choose to share is confidential. Your Member Handbook is a great resource if you have any questions or just want to learn more about your coverage. Representatives are available Monday-Friday, 8 a.m. to 8 p.m. to assist you. 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. 0000002220 00000 n 0000041585 00000 n Out-of-network/non-contracted providers are under no obligation to treat Meridian members, except in emergency situations. If your address changes, let us know. 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. 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. The call is free. endstream endobj startxref Under our plan, you will have one card for your Medicare and Medicaid services, including long-term services and supports and prescriptions. Important Phone Numbers & Contacts In an Emergency 911 Meridian Member Services 866-606-3700 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. 0000001774 00000 n 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. 0 The handbook will explain your rights, benefits, and responsibilities as a member of Meridian. Monday-Friday, 7:00 a.m. to 5:30 p.m. (TTY: 711) Ser vice area . 2023 Youll tell us about any health conditions, recent hospital visits, medications, and more. We are excited to share that MeridianCare, a WellCare company, is changing its name to WellCare, effective January 1, 2020! It looks like your browser does not have JavaScript enabled. This site contains various MeridianComplete (Medicare-Medicaid Plan) links and resources. 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 make an appeal if you disagree with our verdict. This site contains various Meridian Medicare-Medicaid Plan (MMP) links and resources. Find a doctor, explore coverage, review documents and much more. Call 1-855-580-1689 (TTY: 711). 1-855-580-1689 (TTY 711) 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. A grievance is a complaint about a provider or about the quality of care or services you received. You can also visit the Illinois Client Enrollment Services website.