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. The Provider Manual has everything you need to know about member benefits, coverage, and provider guidelines. Prior Authorization, Step Therapy and Quantity Limits, Coverage Determinations and Redeterminations for Drugs, Notice of Nondiscrimination & Language Assistance. The call is free. MeridianHealth is now Meridian! 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. This way, we can connect you with the right care. On weekends and on state or federal holidays, you may be asked to leave a message. 0000046799 00000 n You will need Adobe Reader to open PDFs on this site. The Health Library is a free resource exclusively for MeridianComplete members and providers. The right care for you. ATTENTION: If you speak a language other than English, language assistance services, free of charge, are available to you. 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. <<0B5A082EC79D7049BD46C1656B63CA22>]/Prev 539953>> Please review the various programs below. For more information contact the plan or read the Meridian Member Handbook. It outlines services and benefits that areand are notcovered. 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. It will help you get the care you need. 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. 0000002074 00000 n Llame al 1-855-580-1689 (los usuarios de TTY deben llamar al 711). 0000025639 00000 n 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. 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. Visit your Member Portal or call Member Services. Just call Member Services with your new address. There are a few ways to complete the form: We want you to have a safe, healthy, and happy pregnancy! 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 We will send you a notice before we make a change that affects you. Don't forget to call your local HFS oce and Meridian Member Services with your new address. 0000001774 00000 n At the right time and place. 0000021917 00000 n Member ID Cards 5. 0000047422 00000 n The Personal Wellness Assessment is a short form about you and your health journey. You are leaving this website to go to a website managed by a contracted company, which provides service on our behalf. You can get this document for free in other formats, such as large print, braille, or audio. View our Frequently Asked Questions page. Su llamada ser devuelta dentro del siguiente da hbil. It explains the medical, dental, vision, and pharmacy services that are covered by your plan. 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. You can also visit the Illinois Client Enrollment Services website. 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. Moving? Your handbook is full of important information about your health care and Meridian. MeridianComplete is a health plan that contracts with both Medicare and Illinois Medicaid to provide benefits of both programs to enrollees. La llamada es gratis. A certificate of coverage (COC) tells you what to expect from your healthcare plan. // ]]>. Our Population Health Management Programs are offered to Meridian members and designed to improve your overall health and quality of care. 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. 0000046386 00000 n If your address changes, let us know. 1-855-580-1689 (TTY 711) For more information, or to find out how to get enrolled, please contact Meridian at 888-437-0606. You are leaving this website to go to a website managed by a contracted company, which provides service on our behalf. The handbook will explain your rights, benefits, and responsibilities as a member of Meridian. On weekends and on state or federal holidays, you may be asked to leave a message. MeridianComplete (Medicare-Medicaid Plan) is a health plan that contracts with both Medicare and Michigan Medicaid to provide benefits of both programs to enrollees. Be sure to read your Meridian Member Handbook and keep it handy. It explains the medical, dental, vision, and pharmacy services that are covered by your plan. Monday-Friday, 8 a.m. to 5 p.m. CST 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. If we fall short, you can file a grievance or appeal. Please contact the plan for more details. Your call will be returned within the next business day. All Rights Reserved. This handbook will help you understand your coverage. For certain kinds of drugs, you can use the plans network mail-order services. 0000072727 00000 n La llamada es gratis. We want you to be happy with the treatment and services you get from Meridian and our providers. 0000041585 00000 n Click the link below to view or save a copy. 0000025980 00000 n 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)! Out-of-network/non-contracted providers are under no obligation to treat Meridian members, except in emergency situations. We are excited to share that MeridianCare, a WellCare company, is changing its name to WellCare, effective January 1, 2020! Download the Member Handbook(PDF). This site contains various MeridianComplete (Medicare-Medicaid Plan) links and resources. You will need Adobe Reader to open PDFs on this site. Su llamada ser devuelta dentro del siguiente da hbil. For information regarding our Pharmacy Benefit Manager (PBM), MeridianRx, visit the MeridianRx website. The benefit information is a brief summary, not a complete description of benefits. 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). If you wish to stay on this website, please click Cancel. Important Phone Numbers & Contacts In an Emergency 911 Meridian Member Services 866-606-3700 This site contains various Meridian Medicare-Medicaid Plan (MMP) links and resources. 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 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 handbook will explain your rights, benefits, and responsibilities as a member of MeridianComplete. ATENCIN: Si habla espaol, tiene a su disposicin servicios gratuitos de asistencia lingstica. When you go to file, youll want to write when and where the incident took place, and what happened. 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. 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. 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. 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) 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. 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. A grievance is a complaint about a provider or about the quality of care or services you received. Representatives are available Monday-Friday, 8 a.m. to 8 p.m. to assist you. Open Enrollment 6. You can also file a grievance or appeal on the phone by calling Member Services or in writing via mail or fax. 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: The Annual Notice of Changes (ANOC) is a brief summary of benefits and benefit changes that occurred from one year to the next. Your Member Handbook is a great resource if you have any questions or just want to learn more about your coverage. You also need to make sure that the Department of Healthcare & Family Services (HFS) has your new address. With HealthChoice Illinois, you have a health plan partner to turn to for help. The Member Handbook, along with your enrollment form, serves as Meridian Medicare-Medicaid Plan's (MMP) contract with you. 0000046576 00000 n 0 Representatives are available Monday-Friday, 8 a.m. to 8 p.m. to assist you. 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 Meridian Member Handbook. Llame al. 0000067553 00000 n You will need Adobe Reader to open PDFs on this site. v4P+r-k E`:8\TV%F1MeLT=LyMit+GYrUn*mH gp`x Y;EgPCSSphf>op!mOQtkC v^K#x" // endobj On weekends and on state or federal holidays, you may be asked to leave a message. Youll tell us about any health conditions, recent hospital visits, medications, and more. Keep in mind that everything you choose to share is confidential. You will need Adobe Reader to open PDFs on this site. 0000068680 00000 n It also explains how to find care and how to earn rewards. Llame al 1-855-580-1689 (los usuarios de TTY deben llamar al 711). The Member Handbook, along with your enrollment form, serves as Meridian Medicare-Medicaid Plan's (MMP) contract with you. 0000151745 00000 n The call is free. 0000041209 00000 n Llame al 1-855-580-1689 (los usuarios de TTY deben llamar al 711). 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. Material ID:H6080_WEBSITE_2023_Accepted_09282022. For a more comprehensive description of the plan benefits, please refer to your Member Handbook. hKq?wNe?t!ARk;v6[IqK,h!i2jLnn}>^| ! 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. You will be able to work with one health plan for all of your health insurance needs. 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. 2023 Find a doctor, explore coverage, review documents and much more. 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. Making healthcare decisions can be tough--who to see for care, what to ask, when to go. 0000067354 00000 n 2500 0 obj <>stream Meridian will help make your Medicare and Medicaid benefits work better together and work better for you. startxref You can join our Start Smart for Your Baby program. If you wish to stay on this website, please click Cancel. Meridian will work with you to make sure you get all of the care you need, when you need it. 3. Check out the Interoperability page to learn more. Other pharmacies/physicians/providers are available in our network.