meridian illinois member handbook

Monday-Friday, 8 a.m. to 5 p.m. CST h|kPQevkmNRIDrDI-)Vw*DYS7cgcr!349g3. For more information contact the plan or read the Meridian Member Handbook. Other pharmacies/physicians/providers are available in our network. Your call will be returned within the next business day. View your Provider Manual, important plan information and more. Your Member Handbook is a great resource if you have any questions or just want to learn more about your coverage. Fill out the Member Notification of Pregnancy form(PDF)to let us know if you are pregnant. Llame al 1-855-580-1689 (los usuarios de TTY deben llamar al 711). ATENCIN: Si habla espaol, tiene a su disposicin servicios gratuitos de asistencia lingstica. For more information contact the plan or read the Meridian Member Handbook. 2023 Meridian will help make your Medicare and Medicaid benefits work better together and work better for you. 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 <. 0000002074 00000 n This site contains various Meridian Medicare-Medicaid Plan (MMP) links and resources. The Provider Manual has everything you need to know about member benefits, coverage, and provider guidelines. 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. %%EOF On weekends and on state or federal holidays, 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 review the various programs below. The Member Handbook, along with your enrollment form, serves as Meridian Medicare-Medicaid Plan's (MMP) contract with you. The call is free. 0000047422 00000 n Each link will open a new window and is either a PDF or a website. You are now able to view your health information from a third-party app on a mobile device or PC! Other pharmacies/physicians/providers are available in our network. 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)! Prior Authorization, Step Therapy and Quantity Limits, Coverage Determinations and Redeterminations for Drugs, Notice of Nondiscrimination & Language Assistance. Your call will be returned within the next business day. 0000046966 00000 n Find a doctor, explore coverage, review documents and much more. Click the link below to view or save a copy. Los representantes estn disponibles para ayudarle de lunes a viernes de 8 a.m. a 8 p.m. Los fines de semana y los das feriados estatales o federales, es posible que se le solicite que deje un mensaje. Your Member Handbook is a great resource if you have any questions or just want to learn more about your coverage. We want you to be happy with your healthcare services. 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. It will also explain our responsibilities to you, as well as outline the following details: 0000000956 00000 n Please contact the plan for more details. 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. 0000002177 00000 n ATENCIN: Si habla espaol, tiene a su disposicin servicios gratuitos de asistencia lingstica. Usually a mail-order pharmacy order will get to you in no more than 5 days. Copays for prescription drugs may vary based on the level of Extra Help you receive. 866-606-3700 . Language Assistance & Notice of Nondiscrimination, What is covered, including health care services, behavioral health coverage, prescription drug coverage, How to get the care you need, including the rules you must follow, Your rights and responsibilities as a member of our plan. The List of Covered Drugs and/or pharmacy and provider networks may change throughout the year. Please visit our new website to see up to date information about your plan. // ^| ! Llame al 1-855-580-1689 (los usuarios de TTY deben llamar al 711). <<0B5A082EC79D7049BD46C1656B63CA22>]/Prev 539953>> Download the Member Handbook(PDF). The call is free. 0 Call Member Services if youd like paper copies of any of these documents. If you have questions, please call MeridianComplete (Medicare-Medicaid Plan) Member Services at 1-855-580-1689 (TTY users should call 711). You can make an appeal if you disagree with our verdict. Call, Usted puede obtener gratuitamente este documento en espaol o hablar con alguien sobre esta informacin en otros idiomas. 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. Youll tell us about any health conditions, recent hospital visits, medications, and more. 0000010510 00000 n The handbook will explain your rights, benefits, and responsibilities as a member of Meridian. Meridian MeridianHealth is now Meridian! Representatives are available Monday-Friday, 8 a.m. to 8 p.m. to assist you. Learn more about how being a Meridian provider benefits you. We are excited to share that MeridianCare, a WellCare company, is changing its name to WellCare, effective January 1, 2020! You can also file a grievance or appeal on the phone by calling Member Services or in writing via mail or fax. This is not a complete list. 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. The Member Handbook, along with your enrollment form, serves as Meridian Medicare-Medicaid Plan's (MMP) contract with you. 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. 0000041209 00000 n Under our plan, you will have one card for your Medicare and Medicaid services, including long-term services and supports and prescriptions. 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. Meridian will work with you to make sure you get all of the care you need, when you need it. 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. 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. 0000002041 00000 n The handbook will explain your rights, benefits, and responsibilities as a member of Meridian. Want a paper copy? It looks like your browser does not have JavaScript enabled. Want a paper copy? 0000041585 00000 n On weekends and on state or federal holidays, you may be asked to leave a message. 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) It outlines services and benefits that areand are notcovered. It explains the medical, dental, vision, and pharmacy services that are covered by your plan. With added benefitslike supportmakingsmart health choices, personal care coordination, 24-hour nursing help line, and more. member.ILmeridian.com. You can get this document for free in other formats, such as large print, braille, or audio. We need to be able to send you important information in the mail. Looking for your plan home page or interested in becoming a member? If your pregnancy is at high risk, we may call 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. 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. Report an address update to HFS online. Keep in mind that everything you choose to share is confidential. 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. 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. Other pharmacies/physicians/providers are available in our network. Out-of-network/non-contracted providers are under no obligation to treat Meridian members, except in emergency situations. Understanding the ins and outs of your health plan can be difficult. HealthChoice Illinois is the smart way most Medicaid members get quality care. You can get this document for free in other formats, such as large print, braille, or audio. 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. JB Pritzker, Governor Theresa Eagleson, Director. 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. Want a paper copy? xref It explains the medical, dental, vision, and pharmacy services that are covered by your plan. With added benefits like support making smart health choices, personal care coordination, 24-hour nursing help line, and more. It also explains how to find care and how to earn rewards. 2023 The Member Handbook, along with your enrollment form, serves as Meridian Medicare-Medicaid Plan's (MMP) contract with you. Representatives are available Monday-Friday, 8 a.m. to 8 p.m. to assist you. // ]]>. The Health Library is a free resource exclusively for MeridianComplete members and providers. Its full of tips and resources for pregnant members and new parents. 0000001708 00000 n The benefit information is a brief summary, not a complete description of benefits. 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. HFS sends paperwork in the mail that you need to renew your Medicaid coverage. 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 site contains various Meridian Medicare-Medicaid Plan (MMP) links and resources. 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. 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. Language Assistance & Notice of Nondiscrimination. You are leaving this website to go to a website managed by a contracted company, which provides service on our behalf. 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. Monday-Friday, 7:00 a.m. to 5:30 p.m. (TTY: 711) Ser vice area . Important Phone Numbers & Contacts In an Emergency 911 Meridian Member Services 866-606-3700 Starting January 1, 2018, the Illinois Medicaid Managed Care Program is expanding to include all Member ID Cards 5. This site contains various MeridianComplete (Medicare-Medicaid Plan) links and resources. Your call will be returned within the next business day. Open Enrollment 6. MeridianComplete (Medicare-Medicaid Plan) is a health plan that contracts with both Medicare and Michigan Medicaid to provide benefits of both programs to enrollees. 0000002220 00000 n The handbook will explain your rights, benefits, and responsibilities as a member of Meridian. 0000080946 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. [CDATA[ This way, we can connect you with the right care. Your call will be returned within the next business day. 0000072727 00000 n 0000000016 00000 n 0000041668 00000 n https://www.illinois.gov/hfs/healthchoice/Pages/HealthPlans.aspx, https://www.illinois.gov/hfs/healthchoice/reportcard. 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. 1-855-580-1689 (TTY 711) Making healthcare decisions can be tough--who to see for care, what to ask, when to go. 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. For a more comprehensive description of the plan benefits, please refer to your Member Handbook which can also be found on this page. Provider Network 6 2500 0 obj <>stream Call 1-855-580-1689 (TTY: 711). You can get this document in Spanish, or speak with someone about this information in other languages for free. 0000017969 00000 n 0000025980 00000 n Llame al. 2369 0 obj <> endobj A grievance is a complaint about a provider or about the quality of care or services you received. Out-of-network/non-contracted providers are under no obligation to treat Meridian members, except in emergency situations. With our Medicare-Medicaid Plan (MMP) youre getting: An assigned care manager to help answer questions and coordinate your care. Su llamada ser devuelta dentro del siguiente da hbil. At the right time and place. Each link will open a new window and is either a PDF or a website. 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. MeridianComplete is a health plan that contracts with both Medicare and Illinois Medicaid to provide benefits of both programs to enrollees. Your Member Handbook is a great resource if you have any questions or just want to learn more about your coverage. providerhelp.IL@mhplan.com, The Interoperability and Patient Access Rule. The benefit information is a brief summary, not a complete description of benefits. 0000006553 00000 n See if you qualify, and explore the HealthChoice Illinois advantage. The call is free. Your handbook is full of important information about your health care and Meridian. 0000068680 00000 n Don't forget to call your local HFS oce and Meridian Member Services with your new address. The Member Handbook, along with your enrollment form, serves as MeridianCompletes contract with you. If your address changes, let us know. Moving? 0000021917 00000 n It will help you get the care you need. The right care for you. We are excited to share that MeridianCare, a WellCare company, is changing its name to WellCare, effective January 1, 2020! 0 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

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meridian illinois member handbook