0000000956 00000 n The benefit information is a brief summary, not a complete description of benefits. Want a paper copy? La llamada es gratis. 0000002220 00000 n Our Population Health Management Programs are offered to Meridian members and designed to improve your overall health and quality of care. Out-of-network/non-contracted providers are under no obligation to treat Meridian members, except in emergency situations. 1-855-580-1689 (TTY 711) 1-855-580-1689 (TTY 711) If theres a question you cant find the answer to on our website, call us at 1-855-323-4578(TTY 711), Monday - Friday from 8 a.m. - 8 p.m. EST. We will send you a notice before we make a change that affects you. This is not a complete list. providerhelp.IL@mhplan.com. Meridian is for people eligible for both Medicaid and Medicare. 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. The call is free. 0000002131 00000 n v4P+r-k E`:8\TV%F1MeLT=LyMit+GYrUn*mH gp`x Y;EgPCSSphf>op!mOQtkC v^K#x" The COC lays out all the details so that you can stay on top of your coverage. This site contains various Meridian Medicare-Medicaid Plan (MMP) links and resources. 0000068208 00000 n Prior Authorization, Step Therapy and Quantity Limits, Coverage Determinations and Redeterminations for Drugs, Notice of Nondiscrimination & Language Assistance. Click the link below to view or save a copy. The Personal Wellness Assessment is a short form about you and your health journey. The handbook will explain your rights, benefits, and responsibilities as a member of Meridian. JB Pritzker, Governor Theresa Eagleson, Director. We want you to be happy with your healthcare services. Catching a Breath Complex Case Management Flu Outreach Opioids 1-855-580-1689 (TTY 711) You can get this document for free in other formats, such as large print, braille, or audio. Monday-Friday, 7:00 a.m. to 5:30 p.m. (TTY: 711) Ser vice area . Meridian covers all counties in Illinois. 0000046576 00000 n Call MeridianComplete at 1-855-323-4578 (TTY users should call 711), 8 a.m to 8 p.m., seven days a week. Copyright 2023 Meridian All Rights Reserved. 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. ATENCIN: Si habla espaol, tiene a su disposicin servicios gratuitos de asistencia lingstica. 0000067354 00000 n If you wish to stay on this website, please click Cancel. For certain kinds of drugs, you can use the plans network mail-order services. 866-606-3700 . If your pregnancy is at high risk, we may call you. The handbook will explain your rights, benefits, and responsibilities as a member of Meridian. Representatives are available Monday-Friday, 8 a.m. to 8 p.m. to assist you. The call is free. Want a paper copy? 0000151745 00000 n If you experience any problems receiving your mail order prescription, call Member Services at. Material ID:H6080_WEBSITE_2023_Accepted_09282022. Su llamada ser devuelta dentro del siguiente da hbil. You can get this document for free in other formats, such as large print, braille, or audio. Visit your Member Portal or call Member Services. Your Member Handbook is a great resource if you have any questions or just want to learn more about your coverage. With HealthChoice Illinois, you have a health plan partner to turn to for help. Out-of-network/non-contracted providers are under no obligation to treat Meridian members, except in emergency situations. At the right time and place. 0000067553 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. The benefit information is a brief summary, not a complete description of benefits. Su llamada ser devuelta dentro del siguiente da hbil. 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. La llamada es gratis. 0000041668 00000 n %PDF-1.7 % An appeal is a way for you to ask for a review of our actions. It also explains how to find care and how to earn rewards. member.ILmeridian.com. 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) Starting January 1, 2018, the Illinois Medicaid Managed Care Program is expanding to include all %PDF-1.4 % With added benefitslike supportmakingsmart health choices, personal care coordination, 24-hour nursing help line, and more. We can connect you with support, services, and even rewards. You are leaving this website to go to a website managed by a contracted company, which provides service on our behalf. Language Assistance & Notice of Nondiscrimination. View your Provider Manual, important plan information and more. h|kPQevkmNRIDrDI-)Vw*DYS7cgcr!349g3. If you wish to stay on this website, please click Cancel. Check out the Interoperability page to learn more. On weekends and on state or federal holidays, you may be asked to leave a message. Just call Member Services with your new address. 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. Download the Member Handbook (PDF). 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. Making healthcare decisions can be tough--who to see for care, what to ask, when to go. You can get this document for free in other formats, such as large print, braille, or audio. 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. 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. On weekends and on state or federal holidays, you may be asked to leave a message. 0 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. We are excited to share that MeridianCare, a WellCare company, is changing its name to WellCare, effective January 1, 2020! 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)! 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. See if you qualify, and explore the HealthChoice Illinois advantage. Your call will be returned within the next business day. It outlines services and benefits that areand are notcovered. On weekends and on state or federal holidays, %%EOF All Rights Reserved. startxref 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 Find a doctor, explore coverage, review documents and much more. When you go to file, youll want to write when and where the incident took place, and what happened. If your address changes, let us know. 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. On weekends and on state or federal holidays, you may be asked to leave a message. You can also file a grievance or appeal on the phone by calling Member Services or in writing via mail or fax. 2021 Member Handbook Illinois Counties: Cook, DuPage, Kane, Kankakee, Lake, Will . [CDATA[ Be sure to read your Meridian Member Handbook and keep it handy. endstream endobj startxref Fill out the Member Notification of Pregnancy form(PDF)to let us know if you are pregnant. The Member Handbook, along with your enrollment form, serves as MeridianCompletes contract with you. Each link will open a new window and is either a PDF or a website. 0 Don't forget to call your local HFS oce and Meridian Member Services with your new address. Your call will be returned within the next business day. 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. <<0B5A082EC79D7049BD46C1656B63CA22>]/Prev 539953>> Open Enrollment 6. It explains the medical, dental, vision, and pharmacy services that are covered by your plan. Meridian Member Services . You are leaving this website to go to a website managed by a contracted company, which provides service on our behalf. Monday-Friday, 8 a.m. to 8 p.m. CST Llame al. This site contains various MeridianComplete (Medicare-Medicaid Plan) 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. The Member Handbook, along with your enrollment form, serves as Meridian Medicare-Medicaid Plan's (MMP) contract with you. Out-of-network/non-contracted providers are under no obligation to treat Meridian members, except in emergency situations. We want you to be happy with the treatment and services you get from Meridian and our providers. 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. +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 Looking for your plan home page or interested in becoming a member? Please note that once you have left our website, you may be able to access portions of the contracted company's website that are not related to your plan. If you have any questions, call Meridian Member Services toll-free at 866-606-3700. Copays for prescription drugs may vary based on the level of Extra Help you receive. 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! 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. 0000010510 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. You will be able to work with one health plan for all of your health insurance needs. 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. Keep in mind that everything you choose to share is confidential. // /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 <. Other pharmacies/physicians/providers are available in our network. With HealthChoice Illinois, you have a health plan partner to turn to for help. Call 1-855-580-1689 (TTY: 711). 2369 0 obj <> endobj ATTENTION: If you speak a language other than English, language assistance services, free of charge, are available to you. La llamada es gratis. 0000046966 00000 n 199 0 obj <>stream 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 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. Meridian This way, we can connect you with the right care. Usually a mail-order pharmacy order will get to you in no more than 5 days. Report an address update to HFS online. 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. 0000006553 00000 n Limitations, copays, and restrictions may apply. 0000040481 00000 n You can join our Start Smart for Your Baby program. Monday-Friday, 8 a.m. to 8 p.m. CST Llame al 1-855-580-1689 (los usuarios de TTY deben llamar al 711). Moving? Its full of tips and resources for pregnant members and new parents. Your call will be returned within the next business day. You will need Adobe Reader to open PDFs on this site. 167 0 obj <> endobj Your call will be returned within the next business day. There are a few ways to complete the form: We want you to have a safe, healthy, and happy pregnancy! 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. If you are using a Meridian provider, you will not have to pay a plan premium, deductible, or copay. The call is free. You are now able to view your health information from a third-party app on a mobile device or PC! 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. Other pharmacies/physicians/providers are available in our network. More information is in your Member Handbook(PDF). 0000080946 00000 n Your Member Handbook is a great resource if you have any questions or just want to learn more about your coverage. Meridian will help make your Medicare and Medicaid benefits work better together and work better for you. The Member Handbook, along with your enrollment form, serves asMeridian Medicare-Medicaid Plan's (MMP) contract with you. // ]]>. You can make an appeal if you disagree with our verdict. 3. Representatives are available Monday-Friday, 8 a.m. to 8 p.m. to assist you. 2022 Provider Manual (PDF) Meridian Provider Manual Errata Sheet (PDF) Documents and Forms Medical Referrals & Authorizations Pharmacy Billing Mandatory Training Attestation Call Member Services if youd like paper copies of any of these documents. window.location.replace("https://mmp.ilmeridian.com/member/benefits-coverage/whats-covered/member-handbook.html"); ATENCIN: Si habla espaol, tiene a su disposicin servicios gratuitos de asistencia lingstica. 0000002041 00000 n 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. It looks like your browser does not have JavaScript enabled. Other pharmacies/physicians/providers are available in our network. You will need Adobe Reader to open PDFs on this site. 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. 167 33 hKq?wNe?t!ARk;v6[IqK,h!i2jLnn}>^| ! 0000017969 00000 n This handbook will help you understand your coverage. The handbook will explain your rights, benefits, and responsibilities as a member of Meridian. Your call will be returned within the next business day. 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. A certificate of coverage (COC) tells you what to expect from your healthcare plan. HealthChoice Illinois is the smart way most Medicaid members get quality care. 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. For more information contact the plan or read the MeridianComplete Member Handbook. Meridian View our Frequently Asked Questions page. 0000001774 00000 n This is not a complete list. If you wish to stay on this website, please click Cancel. You will need Adobe Reader to open PDFs on this site. For more information contact the plan or read the Meridian Member Handbook. 0000001708 00000 n Download the Member Handbook (PDF). We are excited to share that MeridianCare, a WellCare company, is changing its name to WellCare, effective January 1, 2020! 0000000016 00000 n 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 as Meridian Medicare-Medicaid Plan's (MMP) contract with you. This is not a complete list. Please visit our new website to see up to date information about your plan. 0000072727 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. This is not a complete list. Please review the various programs below. For a more comprehensive description of the plan benefits, please refer to your Member Handbook. All Rights Reserved. It also explains how to find care and how to earn rewards. You can also visit the Illinois Client Enrollment Services website. Your handbook is full of important information about your health care and Meridian. 0000002177 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. 0000025980 00000 n xref If we fall short, you can file a grievance or appeal. 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. We need to be able to send you important information in the mail. 0000025639 00000 n 2500 0 obj <>stream 2023 Your Member Handbook is a great resource if you have any questions or just want to learn more about your coverage. Benefits, List of Covered Drugs, pharmacy and provider networks and/or copayments may change from time to time throughout the year and on January 1 of each year. Important Phone Numbers & Contacts In an Emergency 911 Meridian Member Services 866-606-3700 You can get this document in Spanish, or speak with someone about this information in other languages for free. The benefit information is a brief summary, not a complete description of benefits. (los usuarios de TTY deben llamar al 711), lunes a domingo, de 8 a.m. a 8 p.m. La llamada es gratuita. Material ID:H6080_WEBSITE_2023_Accepted_09282022. Out-of-network/non-contracted providers are under no obligation to treat MeridianComplete members, except in emergency situations. You also need to make sure that the Department of Healthcare & Family Services (HFS) has your new address. 0000014634 00000 n 0000046386 00000 n Youll tell us about any health conditions, recent hospital visits, medications, and more. With added benefits like support making smart health choices, personal care coordination, 24-hour nursing help line, and more. Each link will open a new window and is either a PDF or a website. For information regarding our Pharmacy Benefit Manager (PBM), MeridianRx, visit the MeridianRx website. It will also explain our responsibilities to you, as well as outline the following details: MeridianHealth is now Meridian! Learn more about how being a Meridian provider benefits you. With our Medicare-Medicaid Plan (MMP) youre getting: An assigned care manager to help answer questions and coordinate your care. ATENCIN: Si habla espaol, tiene a su disposicin servicios gratuitos de asistencia lingstica. Understanding the ins and outs of your health plan can be difficult. For example, we may not approve your providers request for a certain drug. Your call will be returned within the next business day. 0000046799 00000 n The Health Library is a free resource exclusively for MeridianComplete members and providers. 0000040678 00000 n 0000047422 00000 n You've got questions and we've got answers. 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. The handbook will explain your rights, benefits, and responsibilities as a member of Meridian. https://www.illinois.gov/hfs/healthchoice/Pages/HealthPlans.aspx, https://www.illinois.gov/hfs/healthchoice/reportcard. 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. For more information contact the plan or read the Meridian Member Handbook. 0000021917 00000 n Su llamada ser devuelta dentro del siguiente da hbil. Making healthcare decisions can be tough--who to see for care, what to ask, when to go. You are leaving this website to go to a website managed by a contracted company, which provides service on our behalf. The call is free. Under our plan, you will have one card for your Medicare and Medicaid services, including long-term services and supports and prescriptions. The Member Handbook, along with your enrollment form, serves as Meridian Medicare-Medicaid Plan's (MMP) contract with you. Please turn on JavaScript and try again. For more information contact the plan or read the Meridian Member Handbook. Call 1-855-580-1689 (TTY: 711). The benefit information is a brief summary, not a complete description of benefits. Monday-Friday, 8 a.m. to 5 p.m. CST The call is free. Representatives are available Monday-Friday, 8 a.m. to 8 p.m. to assist you. It will also explain our responsibilities to you, as well as outline the following details: Please note that once you have left our website, you may be able to access portions of the contracted company's website that are not related to your plan. If you 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. HFS sends paperwork in the mail that you need to renew your Medicaid coverage. Provider Network 6 This site contains various Meridian Medicare-Medicaid Plan (MMP) links and resources. If you have questions, please call MeridianComplete (Medicare-Medicaid Plan) Member Services at 1-855-580-1689 (TTY users should call 711). You can also visit the Illinois Client Enrollment Services website. It will help you get the care you need. It explains the medical, dental, vision, and pharmacy services that are covered by your plan. 0000068680 00000 n providerhelp.IL@mhplan.com, The Interoperability and Patient Access Rule. The right care for you. 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. For more information, or to find out how to get enrolled, please contact Meridian at 888-437-0606. Member ID Cards 5. On weekends and on state or federal holidays, you may be asked to leave a message. Want a paper copy? On weekends and on state or federal holidays, you may be asked to leave a message. trailer 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 Provider Manual has everything you need to know about member benefits, coverage, and provider guidelines. 0000041585 00000 n %%EOF It also explains how to find care and how to earn rewards. Call, Usted puede obtener gratuitamente este documento en espaol o hablar con alguien sobre esta informacin en otros idiomas. Complete the Member Notification of Pregnancy(PDF) form in the Member Portal. 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. Download the Member Handbook(PDF). A grievance is a complaint about a provider or about the quality of care or services you received. 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.