Llame al 1-855-580-1689 (los usuarios de TTY deben llamar al 711). 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. 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. 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. With added benefitslike supportmakingsmart health choices, personal care coordination, 24-hour nursing help line, and more. Your handbook is full of important information about your health care and Meridian. 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 benefit information is a brief summary, not a complete description of benefits. +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 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)! If you wish to stay on this website, please click Cancel. %%EOF 1-855-580-1689 (TTY 711) [CDATA[ You are leaving this website to go to a website managed by a contracted company, which provides service on our behalf. 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. Catching a Breath Complex Case Management Flu Outreach Opioids 0000041209 00000 n Member ID Cards 5. 0000010510 00000 n Monday-Friday, 8 a.m. to 8 p.m. CST Its full of tips and resources for pregnant members and new parents. ATENCIN: Si habla espaol, tiene a su disposicin servicios gratuitos de asistencia lingstica. Other pharmacies/physicians/providers are available in our network. xref Each link will open a new window and is either a PDF or a website. The Member Handbook, along with your enrollment form, serves as Meridian Medicare-Medicaid Plan's (MMP) contract with you. startxref Your call will be returned within the next business day. For more information contact the plan or read the Meridian Member Handbook. 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 way, we can connect you with the right care. Su llamada ser devuelta dentro del siguiente da hbil. Open Enrollment 6. This site contains various MeridianComplete (Medicare-Medicaid Plan) links and resources. 0000041668 00000 n Don't forget to call your local HFS oce and Meridian Member Services with your new address. 0 Be sure to read your Meridian Member Handbook and keep it handy. 0000014634 00000 n ATENCIN: Si habla espaol, tiene a su disposicin servicios gratuitos de asistencia lingstica. Call MeridianComplete at 1-855-323-4578 (TTY users should call 711), 8 a.m to 8 p.m., seven days a week. If you have any questions, call Meridian Member Services toll-free at 866-606-3700. The handbook will explain your rights, benefits, and responsibilities as a member of Meridian. We are excited to share that MeridianCare, a WellCare company, is changing its name to WellCare, effective January 1, 2020! Looking for your plan home page or interested in becoming a member? 167 0 obj <> endobj Representatives are available Monday-Friday, 8 a.m. to 8 p.m. to assist you. 2021 Member Handbook Illinois Counties: Cook, DuPage, Kane, Kankakee, Lake, Will . La llamada es gratis. Click the link below to view or save a copy. Want a paper copy? 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. 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. 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. Please turn on JavaScript and try again. 0000002041 00000 n You can get this document for free in other formats, such as large print, braille, or audio. 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. You will need Adobe Reader to open PDFs on this site. 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! 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. 0000006553 00000 n You can also file a grievance or appeal on the phone by calling Member Services or in writing via mail or fax. member.ILmeridian.com. Each link will open a new window and is either a PDF or a website. This is not a complete list. This site contains various Meridian Medicare-Medicaid Plan (MMP) links and resources. The Member Handbook, along with your enrollment form, serves as MeridianCompletes contract with you. For Members | Meridian More information is in your Member Handbook(PDF). 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. Meridian Member Services . The call is free. The Provider Manual has everything you need to know about member benefits, coverage, and provider guidelines. You will need Adobe Reader to open PDFs on this site. Our Population Health Management Programs are offered to Meridian members and designed to improve your overall health and quality of care. Download the free version of Adobe Reader. PDF 2021 Member Handbook - Meridian Medicare Medicaid Plan The right care for you. If you have questions, please call MeridianComplete (Medicare-Medicaid Plan) Member Services at 1-855-580-1689 (TTY users should call 711). 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. Please contact the plan for more details. 0000046966 00000 n 0000040481 00000 n The Personal Wellness Assessment is a short form about you and your health journey. 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. <<0B5A082EC79D7049BD46C1656B63CA22>]/Prev 539953>> With our Medicare-Medicaid Plan (MMP) youre getting: An assigned care manager to help answer questions and coordinate your care. 0000025639 00000 n Your call will be returned within the next business day. If your pregnancy is at high risk, we may call you. Language Assistance & Notice of Nondiscrimination. 0000002131 00000 n It looks like your browser does not have JavaScript enabled. On weekends and on state or federal holidays, you may be asked to leave a message. 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. Download the Member Handbook (PDF). 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. Understanding the ins and outs of your health plan can be difficult. 1-855-580-1689 (TTY 711) Download the Member Handbook(PDF). PDF ILLINOIS MEMBER HANDBOOK - Meridian Illinois Managed Care Plans Usually a mail-order pharmacy order will get to you in no more than 5 days. It will also explain our responsibilities to you, as well as outline the following details: Call 1-855-580-1689 (TTY: 711). 199 0 obj <>stream On weekends and on state or federal holidays, you may be asked to leave a message. Meridian will help make your Medicare and Medicaid benefits work better together and work better for you. For example, we may not approve your providers request for a certain drug. We can connect you with support, services, and even rewards. Fill out the Member Notification of Pregnancy form(PDF)to let us know if you are pregnant. On weekends and on state or federal holidays, you may be asked to leave a message. Meridian Other pharmacies/physicians/providers are available in our network. 2022 Provider Manual (PDF) Meridian Provider Manual Errata Sheet (PDF) Documents and Forms Medical Referrals & Authorizations Pharmacy Billing Mandatory Training Attestation PDF <DATE> Program called HealthChoice Illinois . We have been working hard 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. Representatives are available Monday-Friday, 8 a.m. to 8 p.m. to assist you. You can join our Start Smart for Your Baby program. providerhelp.IL@mhplan.com. We need to be able to send you important information in the mail. 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. 0000025980 00000 n Out-of-network/non-contracted providers are under no obligation to treat Meridian members, except in emergency situations. Call 1-855-580-1689 (TTY: 711). // ]]>. window.location.replace("https://mmp.ilmeridian.com/member/benefits-coverage/whats-covered/member-handbook.html"); Other pharmacies/physicians/providers are available in our network. Each link will open a new window and is either a PDF or a website. 0000002220 00000 n It outlines services and benefits that areand are notcovered. The Member Handbook, along with your enrollment form, serves as Meridian Medicare-Medicaid Plan's (MMP) contract with you. 0000041585 00000 n You can make an appeal if you disagree with our verdict. Member Handbook - Meridian Medicare Medicaid Plan Meridian Copays for prescription drugs may vary based on the level of Extra Help you receive. For a more comprehensive description of the plan benefits, please refer to your Member Handbook which can also be found on this page. For more information, or to find out how to get enrolled, please contact Meridian at 888-437-0606. For more information contact the plan or read the MeridianComplete Member Handbook. A certificate of coverage (COC) tells you what to expect from your healthcare plan. Visit your Member Portal or call Member Services. 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) This is not a complete list. For a more comprehensive description of the plan benefits, please refer to your Member Handbook. 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 . This is not a complete list. It also explains how to find care and how to earn rewards. 0000046386 00000 n You will need Adobe Reader to open PDFs on this site. If you wish to stay on this website, please click Cancel. The COC lays out all the details so that you can stay on top of your coverage. If you would like a Provider/Pharmacy Directory mailed to you, you may call the number above, request one at the website link provided above, or email memberservices.mi@mhplan.com. Important Phone Numbers & Contacts In an Emergency 911 Meridian Member Services 866-606-3700 Your Member Handbook is a great resource if you have any questions or just want to learn more about your coverage. hKq?wNe?t!ARk;v6[IqK,h!i2jLnn}>^| ! 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 also visit the Illinois Client Enrollment Services website. 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. Your call will be returned within the next business day. Check out the Interoperability page to learn more. It also explains how to find care and how to earn rewards. Just call Member Services with your new address. Making healthcare decisions can be tough--who to see for care, what to ask, when to go. 866-606-3700 . trailer The Health Library is a free resource exclusively for MeridianComplete members and providers. Keep in mind that everything you choose to share is confidential. You are now able to view your health information from a third-party app on a mobile device or PC! Youll tell us about any health conditions, recent hospital visits, medications, and more. Su llamada ser devuelta dentro del siguiente da hbil. 2023 This handbook will help you understand your coverage. Your Member Handbook is a great resource if you have any questions or just want to learn more about your coverage. The Member Handbook, along with your enrollment form, serves as Meridian Medicare-Medicaid Plan's (MMP) contract with you. Call, Usted puede obtener gratuitamente este documento en espaol o hablar con alguien sobre esta informacin en otros idiomas. MeridianComplete is a health plan that contracts with both Medicare and Illinois Medicaid to provide benefits of both programs to enrollees. All Rights Reserved. If you wish to stay on this website, please click Cancel. Meridian covers all counties in Illinois. Other pharmacies/physicians/providers are available in our network. Find a doctor, explore coverage, review documents and much more. You will need Adobe Reader to open PDFs on this site. Want a paper copy? ATENCIN: Si habla espaol, tiene a su disposicin servicios gratuitos de asistencia lingstica. Call Member Services if youd like paper copies of any of these documents. Please review the various programs below. An appeal is a way for you to ask for a review of our actions. On weekends and on state or federal holidays, you may be asked to leave a message. providerhelp.IL@mhplan.com, The Interoperability and Patient Access Rule. You are leaving this website to go to a website managed by a contracted company, which provides service on our behalf. 0000072727 00000 n The handbook will explain your rights, benefits, and responsibilities as a member of MeridianComplete. The call is free. 0000001774 00000 n 0 When you go to file, youll want to write when and where the incident took place, and what happened. Out-of-network/non-contracted providers are under no obligation to treat Meridian members, except in emergency situations. We will send you a notice before we make a change that affects you. Monday-Friday, 8 a.m. to 5 p.m. CST 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 benefit information is a brief summary, not a complete description of benefits. Documents and Forms - Meridian Medicare Medicaid Plan 0000080946 00000 n PDF here's your member handbook. The handbook will explain your rights, benefits, and responsibilities as a member of Meridian. JB Pritzker, Governor Theresa Eagleson, Director. If you are using a Meridian provider, you will not have to pay a plan premium, deductible, or copay. 0000047422 00000 n PDF Welcome to MeridianHealth Intro to Plan You've got questions and we've got answers. 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. %PDF-1.4 % The call is free. Member Handbooks and Forms Moving? Your Member Handbook is a great resource if you have any questions or just want to learn more about your 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. Your call will be returned within the next business day. Meridian is for people eligible for both Medicaid and Medicare. The call is free. The List of Covered Drugs and/or pharmacy and provider networks may change throughout the year. HealthChoice Illinois | HFS Copyright 2023 Meridian All Rights Reserved. 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. 0000017969 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. You also need to make sure that the Department of Healthcare & Family Services (HFS) has your new address. The benefit information is a brief summary, not a complete description of benefits. The handbook will explain your rights, benefits, and responsibilities as a member of Meridian. Complete the Member Notification of Pregnancy(PDF) form in the Member Portal. 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. 0000002074 00000 n 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. You will need Adobe Reader to open PDFs on this site. The benefit information is a brief summary, not a complete description of benefits. With HealthChoice Illinois, you have a health plan partner to turn to for help. 2369 0 obj <> endobj It explains the medical, dental, vision, and pharmacy services that are covered by your plan. 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. If you experience any problems receiving your mail order prescription, call Member Services at. Out-of-network/non-contracted providers are under no obligation to treat Meridian members, except in emergency situations. Want a paper copy? Call 1-855-580-1689 (TTY: 711). Prior Authorization, Step Therapy and Quantity Limits, Coverage Determinations and Redeterminations for Drugs, Notice of Nondiscrimination & Language Assistance. 1-855-580-1689 (TTY 711) Please visit our new website to see up to date information about your plan. MeridianComplete (Medicare-Medicaid Plan) is a health plan that contracts with both Medicare and Michigan Medicaid to provide benefits of both programs to enrollees. %%EOF Report an address update to HFS online. Member Handbook | Meridian Complete of Illinois View our Frequently Asked Questions page. Llame al. 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. It explains the medical, dental, vision, and pharmacy services that are covered by your plan. Monday-Friday, 8 a.m. to 8 p.m. CST Meridian Medicare Medicaid Plan 0000046799 00000 n 0000046576 00000 n The call is free. For certain kinds of drugs, you can use the plans network mail-order services. Your call will be returned within the next business day. 0000021917 00000 n It will also explain our responsibilities to you, as well as outline the following details: For information regarding our Pharmacy Benefit Manager (PBM), MeridianRx, visit the MeridianRx website. (los usuarios de TTY deben llamar al 711), lunes a domingo, de 8 a.m. a 8 p.m. La llamada es gratuita. La llamada es gratis. 167 33 At the right time and place. h|kPQevkmNRIDrDI-)Vw*DYS7cgcr!349g3. We want you to be happy with your healthcare services. 0000001708 00000 n Llame al 1-855-580-1689 (los usuarios de TTY deben llamar al 711). ATTENTION: If you speak a language other than English, language assistance services, free of charge, are available to you. We want you to be happy with the treatment and services you get from Meridian and our providers. For more information, call MeridianComplete Member Services or read the MeridianComplete Member Handbook. There are a few ways to complete the form: We want you to have a safe, healthy, and happy pregnancy! 0000068680 00000 n Provider Network 6 Limitations, copays, and restrictions may apply. You can get this document for free in other formats, such as large print, braille, or audio.
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