meridian illinois member handbook11 Mar meridian illinois member handbook
Your handbook is full of important information about your health care and Meridian. It will help you get the care you need. 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. 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. La llamada es gratis. Making healthcare decisions can be tough--who to see for care, what to ask, when to go. Download the Member Handbook (PDF). 0000002220 00000 n Please review the various programs below. 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 more information, call MeridianComplete Member Services or read the MeridianComplete Member Handbook. Each link will open a new window and is either a PDF or a website. Material ID:H6080_WEBSITE_2023_Accepted_09282022. %%EOF 0000041209 00000 n Your Member Handbook is a great resource if you have any questions or just want to learn more about your coverage. HFS sends paperwork in the mail that you need to renew your Medicaid coverage. 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. You are leaving this website to go to a website managed by a contracted company, which provides service on our behalf. https://www.illinois.gov/hfs/healthchoice/Pages/HealthPlans.aspx, https://www.illinois.gov/hfs/healthchoice/reportcard. For a more comprehensive description of the plan benefits, please refer to your Member Handbook which can also be found on this page. Making healthcare decisions can be tough--who to see for care, what to ask, when to go. The benefit information is a brief summary, not a complete description of benefits. Please turn on JavaScript and try again. On weekends and on state or federal holidays, you may be asked to leave a message. 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. 0000151745 00000 n The Member Handbook, along with your enrollment form, serves as MeridianCompletes contract with you. Su llamada ser devuelta dentro del siguiente da hbil. 0000046799 00000 n Starting January 1, 2018, the Illinois Medicaid Managed Care Program is expanding to include all 199 0 obj <>stream member.ILmeridian.com. 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. Monday-Friday, 8 a.m. to 8 p.m. CST 1-855-580-1689 (TTY 711) Download the free version of Adobe Reader. The handbook will explain your rights, benefits, and responsibilities as a member of Meridian. For more information contact the plan or read the Meridian Member Handbook. The Member Handbook, along with your enrollment form, serves as Meridian Medicare-Medicaid Plan's (MMP) contract with you. With HealthChoice Illinois, you have a health plan partner to turn to for help. JB Pritzker, Governor Theresa Eagleson, Director. Meridian Member Services . startxref You are leaving this website to go to a website managed by a contracted company, which provides service on our behalf. View your Provider Manual, important plan information and more. 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. View our Frequently Asked Questions page. Meridian will help make your Medicare and Medicaid benefits work better together and work better for you. 0000068680 00000 n More information is in your Member Handbook(PDF). 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. 0000017969 00000 n 0000002131 00000 n 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. MeridianComplete (Medicare-Medicaid Plan) is a health plan that contracts with both Medicare and Michigan Medicaid to provide benefits of both programs to enrollees. Call 1-855-580-1689 (TTY: 711). Monday-Friday, 8 a.m. to 5 p.m. CST Limitations, copays, and restrictions may apply. You can join our Start Smart for Your Baby program. Important Phone Numbers & Contacts In an Emergency 911 Meridian Member Services 866-606-3700 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. You are leaving this website to go to a website managed by a contracted company, which provides service on our behalf. 0000072727 00000 n 0000025980 00000 n 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 You also need to make sure that the Department of Healthcare & Family Services (HFS) has your new address. Moving? If your address changes, let us know. If you have any questions, call Meridian Member Services toll-free at 866-606-3700. 0000046576 00000 n You can also visit the Illinois Client Enrollment Services website. The handbook will explain your rights, benefits, and responsibilities as a member of Meridian. 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. With our Medicare-Medicaid Plan (MMP) youre getting: An assigned care manager to help answer questions and coordinate your care. Please call our Member Services number or see your Member Handbook for more information, including the cost-sharing that applies to out-of-network services. 0000040481 00000 n The call is free. Monday-Friday, 7:00 a.m. to 5:30 p.m. (TTY: 711) Ser vice area . You can get this document for free in other formats, such as large print, braille, or audio. 0000021917 00000 n 0000001774 00000 n Meridian will work with you to make sure you get all of the care you need, when you need it. 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. 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. // ]]>. 0000001708 00000 n The call is free. 0000014634 00000 n 167 0 obj <> endobj The handbook will explain your rights, benefits, and responsibilities as a member of Meridian. 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 will need Adobe Reader to open PDFs on this site. It looks like your browser does not have JavaScript enabled. Keep in mind that everything you choose to share is confidential. Check out the Interoperability page to learn more. v4P+r-k E`:8\TV%F1MeLT=LyMit+GYrUn*mH gp`x Y;EgPCSSphf>op!mOQtkC v^K#x" +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 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) Member ID Cards 5. For more information contact the plan or read the Meridian Member Handbook. %PDF-1.4 % Each link will open a new window and is either a PDF or a website. The benefit information is a brief summary, not a complete description of benefits. You can get this document in Spanish, or speak with someone about this information in other languages for free. Call, Usted puede obtener gratuitamente este documento en espaol o hablar con alguien sobre esta informacin en otros idiomas. The call is free. 0000067354 00000 n If we fall short, you can file a grievance or appeal. providerhelp.IL@mhplan.com. Representatives are available Monday-Friday, 8 a.m. to 8 p.m. to assist you. The right care for you. Your call will be returned within the next business day. Please visit our new website to see up to date information about your plan. On weekends and on state or federal holidays, you may be asked to leave a message. We will send you a notice before we make a change that affects you. Meridian We need to be able to send you important information in the mail. This is not a complete list. We want you to be happy with your healthcare services. xref 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. 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. 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. Want a paper copy? Language Assistance & Notice of Nondiscrimination. The Health Library is a free resource exclusively for MeridianComplete members and providers. If you need help finding a network provider and/or pharmacy, please call 1-855-323-4578 (TTY 711) or visit mmp.mimeridian.com to access our online searchable directory. If you wish to stay on this website, please click Cancel. Catching a Breath Complex Case Management Flu Outreach Opioids On weekends and on state or federal holidays, you may be asked to leave a message. If you have questions, please call MeridianComplete (Medicare-Medicaid Plan) Member Services at 1-855-580-1689 (TTY users should call 711). Copays for prescription drugs may vary based on the level of Extra Help you receive. 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 usuarios de TTY deben llamar al 711), lunes a domingo, de 8 a.m. a 8 p.m. La llamada es gratuita. 0000000016 00000 n Provider Network 6 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. If you experience any problems receiving your mail order prescription, call Member Services at. Other pharmacies/physicians/providers are available in our network. ATENCIN: Si habla espaol, tiene a su disposicin servicios gratuitos de asistencia lingstica. 2022 Provider Manual (PDF) Meridian Provider Manual Errata Sheet (PDF) Documents and Forms Medical Referrals & Authorizations Pharmacy Billing Mandatory Training Attestation 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. Download the Member Handbook(PDF). The handbook will explain your rights, benefits, and responsibilities as a member of MeridianComplete. Llame al 1-855-580-1689 (los usuarios de TTY deben llamar al 711). Your call will be returned within the next business day. Want a paper copy? 0000041668 00000 n 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. 0000006553 00000 n You've got questions and we've got answers. The Member Handbook, along with your enrollment form, serves asMeridian Medicare-Medicaid Plan's (MMP) contract with you. It explains the medical, dental, vision, and pharmacy services that are covered by your plan. You will need Adobe Reader to open PDFs on this site. 2369 0 obj <> endobj %PDF-1.7 % HealthChoice Illinois is the smart way most Medicaid members get quality care. 0000080946 00000 n See if you qualify, and explore the HealthChoice Illinois advantage. 0000040678 00000 n It explains the medical, dental, vision, and pharmacy services that are covered by your plan. The COC lays out all the details so that you can stay on top of your coverage. trailer 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. We can connect you with support, services, and even rewards. It also explains how to find care and how to earn rewards. Call 1-855-580-1689 (TTY: 711). With added benefitslike supportmakingsmart health choices, personal care coordination, 24-hour nursing help line, and more. 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. 2500 0 obj <>stream We are excited to share that MeridianCare, a WellCare company, is changing its name to WellCare, effective January 1, 2020! 0000067553 00000 n You will need Adobe Reader to open PDFs on this site. Learn more about how being a Meridian provider benefits you. You will be able to work with one health plan for all of your health insurance needs. This site contains various Meridian Medicare-Medicaid Plan (MMP) links and resources. The List of Covered Drugs and/or pharmacy and provider networks may change throughout the year. 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. <<0B5A082EC79D7049BD46C1656B63CA22>]/Prev 539953>> Out-of-network/non-contracted providers are under no obligation to treat Meridian members, except in emergency situations. ATENCIN: Si habla espaol, tiene a su disposicin servicios gratuitos de asistencia lingstica. 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)! 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. 1-855-580-1689 (TTY 711) Out-of-network/non-contracted providers are under no obligation to treat MeridianComplete members, except in emergency situations. This site contains various MeridianComplete (Medicare-Medicaid Plan) links and resources. You can make an appeal if you disagree with our verdict. All Rights Reserved. 167 33 // $ $= @+D C[} "Fod(AE+ 0000025639 00000 n Other pharmacies/physicians/providers are available in our network. Our Population Health Management Programs are offered to Meridian members and designed to improve your overall health and quality of care. 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. For example, we may not approve your providers request for a certain drug. La llamada es gratis. For more information contact the plan or read the Meridian Member Handbook. Out-of-network/non-contracted providers are under no obligation to treat Meridian members, except in emergency situations. If your pregnancy is at high risk, we may call you. 0000002177 00000 n If you wish to stay on this website, please click Cancel. On weekends and on state or federal holidays, you may be asked to leave a message. Report an address update to HFS online. You are now able to view your health information from a third-party app on a mobile device or PC! 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 <. If you wish to stay on this website, please click Cancel. 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 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 Provider Manual has everything you need to know about member benefits, coverage, and provider guidelines. h|kPQevkmNRIDrDI-)Vw*DYS7cgcr!349g3. The handbook will explain your rights, benefits, and responsibilities as a member of Meridian. 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. endstream endobj startxref Youll tell us about any health conditions, recent hospital visits, medications, and more. Your call will be returned within the next business day. This handbook will help you understand your coverage. This is not a complete list. Each link will open a new window and is either a PDF or a website. It will also explain our responsibilities to you, as well as outline the following details: This is not a complete list. Copyright 2023 Meridian All Rights Reserved. Llame al 1-855-580-1689 (los usuarios de TTY deben llamar al 711). Meridian covers all counties in Illinois. Monday-Friday, 8 a.m. to 8 p.m. CST 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). You will need Adobe Reader to open PDFs on this site. La llamada es gratis. Other pharmacies/physicians/providers are available in our network. Open Enrollment 6. A grievance is a complaint about a provider or about the quality of care or services you received.
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