0000000016 00000 n You can get this document for free in other formats, such as large print, braille, or audio. 0000046799 00000 n You can also visit the Illinois Client Enrollment Services website. We are excited to share that MeridianCare, a WellCare company, is changing its name to WellCare, effective January 1, 2020! If you are using a Meridian provider, you will not have to pay a plan premium, deductible, or copay. 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 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 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. 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 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. 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. Check out the Interoperability page to learn more. 0000017969 00000 n You will need Adobe Reader to open PDFs on this site. The call is free. All Rights Reserved. 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. Want a paper copy? Meridian This is not a complete list. You also need to make sure that the Department of Healthcare & Family Services (HFS) has your new address. On weekends and on state or federal holidays, you may be asked to leave a message. 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. Call 1-855-580-1689 (TTY: 711). Llame al 1-855-580-1689 (los usuarios de TTY deben llamar al 711). Report an address update to HFS online. 0000080946 00000 n This site contains various Meridian Medicare-Medicaid Plan (MMP) links and resources. %PDF-1.4 % (los usuarios de TTY deben llamar al 711), lunes a domingo, de 8 a.m. a 8 p.m. La llamada es gratuita. 3. It explains the medical, dental, vision, and pharmacy services that are covered by your plan. You've got questions and we've got answers. trailer If we fall short, you can file a grievance or appeal. You can get this document for free in other formats, such as large print, braille, or audio. Llame al. Keep in mind that everything you choose to share is confidential. 0000014634 00000 n 1-855-580-1689 (TTY 711) The handbook will explain your rights, benefits, and responsibilities as a member of MeridianComplete. The List of Covered Drugs and/or pharmacy and provider networks may change throughout the year. A certificate of coverage (COC) tells you what to expect from your healthcare plan. For example, we may not approve your providers request for a certain drug. Meridian will work with you to make sure you get all of the care you need, when you need it. You are leaving this website to go to a website managed by a contracted company, which provides service on our behalf. Each link will open a new window and is either a PDF or a website. 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. Please contact the plan for more details. 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) The call is free. Copyright 2023 Meridian All Rights Reserved. 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 <. At the right time and place. 0000041209 00000 n On weekends and on state or federal holidays, 167 0 obj <> endobj 2023 HealthChoice Illinois is the smart way most Medicaid members get quality care. 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 your address changes, let us know. Download the free version of Adobe Reader. This site contains various MeridianComplete (Medicare-Medicaid Plan) links and resources. Monday-Friday, 7:00 a.m. to 5:30 p.m. (TTY: 711) Ser vice area . Monday-Friday, 8 a.m. to 8 p.m. CST This site contains various Meridian Medicare-Medicaid Plan (MMP) links and resources. ATENCIN: Si habla espaol, tiene a su disposicin servicios gratuitos de asistencia lingstica. Meridian It also explains how to find care and how to earn rewards. You can also visit the Illinois Client Enrollment Services website. 1-855-580-1689 (TTY 711) Learn more about how being a Meridian provider benefits you. This is not a complete list. 0000021917 00000 n Your Member Handbook is a great resource if you have any questions or just want to learn more about your coverage. <<0B5A082EC79D7049BD46C1656B63CA22>]/Prev 539953>> La llamada es gratis. 0000002041 00000 n This is not a complete list. Call 1-855-580-1689 (TTY: 711). Monday-Friday, 8 a.m. to 8 p.m. CST For more information, or to find out how to get enrolled, please contact Meridian at 888-437-0606. 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 You will need Adobe Reader to open PDFs on this site. Call Member Services if youd like paper copies of any of these documents. Your Member Handbook is a great resource if you have any questions or just want to learn more about your coverage. Under our plan, you will have one card for your Medicare and Medicaid services, including long-term services and supports and prescriptions. 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. We are excited to share that MeridianCare, a WellCare company, is changing its name to WellCare, effective January 1, 2020! 0000068208 00000 n h|kPQevkmNRIDrDI-)Vw*DYS7cgcr!349g3. For certain kinds of drugs, you can use the plans network mail-order services. It also explains how to find care and how to earn rewards. 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 call is free. 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. Prior Authorization, Step Therapy and Quantity Limits, Coverage Determinations and Redeterminations for Drugs, Notice of Nondiscrimination & Language Assistance. Llame al 1-855-580-1689 (los usuarios de TTY deben llamar al 711). MeridianComplete (Medicare-Medicaid Plan) is a health plan that contracts with both Medicare and Michigan Medicaid to provide benefits of both programs to enrollees. Other pharmacies/physicians/providers are available in our network. Representatives are available Monday-Friday, 8 a.m. to 8 p.m. to assist you. 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. 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. 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, You are now able to view your health information from a third-party app on a mobile device or PC! 0000006553 00000 n The benefit information is a brief summary, not a complete description of benefits. The call is free. Provider Network 6 This is not a complete list. With added benefitslike supportmakingsmart health choices, personal care coordination, 24-hour nursing help line, and more. 0000025639 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. 0000000956 00000 n For a more comprehensive description of the plan benefits, please refer to your Member Handbook. 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. Call, Usted puede obtener gratuitamente este documento en espaol o hablar con alguien sobre esta informacin en otros idiomas. Please review the various programs below. Download the Member Handbook (PDF). %PDF-1.7 % Want a paper copy? You can join our Start Smart for Your Baby program. It explains the medical, dental, vision, and pharmacy services that are covered by your plan. 2369 0 obj <> endobj The benefit information is a brief summary, not a complete description of benefits. Representatives are available Monday-Friday, 8 a.m. to 8 p.m. to assist you. It also explains how to find care and how to earn rewards. Material ID:H6080_WEBSITE_2023_Accepted_09282022. 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. Youll tell us about any health conditions, recent hospital visits, medications, and more. 0000046966 00000 n An appeal is a way for you to ask for a review of our actions. Representatives are available Monday-Friday, 8 a.m. to 8 p.m. to assist you. 0000041668 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)! Call MeridianComplete at 1-855-323-4578 (TTY users should call 711), 8 a.m to 8 p.m., seven days a week. It will help you get the care you need. 0000002220 00000 n Open Enrollment 6. 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. If you wish to stay on this website, please click Cancel. Out-of-network/non-contracted providers are under no obligation to treat Meridian members, except in emergency situations. Its full of tips and resources for pregnant members and new parents. 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. Download the Member Handbook(PDF). providerhelp.IL@mhplan.com. 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. Su llamada ser devuelta dentro del siguiente da hbil. The call is free. Su llamada ser devuelta dentro del siguiente da hbil. https://www.illinois.gov/hfs/healthchoice/Pages/HealthPlans.aspx, https://www.illinois.gov/hfs/healthchoice/reportcard. Member ID Cards 5. We will send you a notice before we make a change that affects you. If you wish to stay on this website, please click Cancel. 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. member.ILmeridian.com. 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. La llamada es gratis. 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 Member Handbook, along with your enrollment form, serves as MeridianCompletes contract with you. We can connect you with support, services, and even rewards. Usually a mail-order pharmacy order will get to you in no more than 5 days. A grievance is a complaint about a provider or about the quality of care or services you received. Making healthcare decisions can be tough--who to see for care, what to ask, when to go. 0000001774 00000 n [CDATA[ This handbook will help you understand your coverage. Copays for prescription drugs may vary based on the level of Extra Help you receive. If you have any questions, call Meridian Member Services toll-free at 866-606-3700. On weekends and on state or federal holidays, you may be asked to leave a message. More information is in your Member Handbook(PDF). If you have questions, please call MeridianComplete (Medicare-Medicaid Plan) Member Services at 1-855-580-1689 (TTY users should call 711). You are leaving this website to go to a website managed by a contracted company, which provides service on our behalf. 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. Don't forget to call your local HFS oce and Meridian Member Services with your new address. Out-of-network/non-contracted providers are under no obligation to treat MeridianComplete members, except in emergency situations. // ]]>. Out-of-network/non-contracted providers are under no obligation to treat Meridian members, except in emergency situations. 0000047422 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 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. // op!mOQtkC v^K#x" It will also explain our responsibilities to you, as well as outline the following details: ATENCIN: Si habla espaol, tiene a su disposicin servicios gratuitos de asistencia lingstica. 2023 View your Provider Manual, important plan information and more. 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 It will also explain our responsibilities to you, as well as outline the following details: Call 1-855-580-1689 (TTY: 711). Making healthcare decisions can be tough--who to see for care, what to ask, when to go. With added benefits like support making smart health choices, personal care coordination, 24-hour nursing help line, and more. You are leaving this website to go to a website managed by a contracted company, which provides service on our behalf. 0000002131 00000 n 0000002177 00000 n 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. Complete the Member Notification of Pregnancy(PDF) form in the Member Portal. 167 33 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. For more information contact the plan or read the Meridian Member Handbook. Find a doctor, explore coverage, review documents and much more. Meridian will help make your Medicare and Medicaid benefits work better together and work better for you. Meridian is for people eligible for both Medicaid and Medicare. For more information, call MeridianComplete Member Services or read the MeridianComplete Member Handbook. With HealthChoice Illinois, you have a health plan partner to turn to for help. You will need Adobe Reader to open PDFs on this site. 0000072727 00000 n Your Member Handbook is a great resource if you have any questions or just want to learn more about your coverage. 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 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. 0000001708 00000 n 0000002074 00000 n Important Phone Numbers & Contacts In an Emergency 911 Meridian Member Services 866-606-3700 Language Assistance & Notice of Nondiscrimination. Visit your Member Portal or call Member Services. HFS sends paperwork in the mail that you need to renew your Medicaid coverage. Moving? On weekends and on state or federal holidays, you may be asked to leave a message. 0000067553 00000 n The handbook will explain your rights, benefits, and responsibilities as a member of Meridian. We want you to be happy with the treatment and services you get from Meridian and our providers. 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. You are now able to view your health information from a third-party app on a mobile device or PC! Download the Member Handbook (PDF). 2500 0 obj <>stream 2021 Member Handbook Illinois Counties: Cook, DuPage, Kane, Kankakee, Lake, Will . 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. 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 want you to be happy with your healthcare services. If you experience any problems receiving your mail order prescription, call Member Services at. You can make an appeal if you disagree with our verdict. 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 asMeridian Medicare-Medicaid Plan's (MMP) contract with you. Your call will be returned within the next business day. For more information contact the plan or read the Meridian Member Handbook. You will need Adobe Reader to open PDFs on this site. The handbook will explain your rights, benefits, and responsibilities as a member of Meridian. Be sure to read your Meridian Member Handbook and keep it handy. startxref 0000041585 00000 n 0000046386 00000 n 866-606-3700 . The Member Handbook, along with your enrollment form, serves as Meridian Medicare-Medicaid Plan's (MMP) contract with you. Limitations, copays, and restrictions may apply. 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! Your call will be returned within the next business day. 1-855-580-1689 (TTY 711) If you wish to stay on this website, please click Cancel. Want a paper copy? 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 With HealthChoice Illinois, you have a health plan partner to turn to for help. hbbd``b`R@AH&="> $ $= @+D C[} "Fod(AE+ For more information contact the plan or read the Meridian Member Handbook. 0000067354 00000 n You will be able to work with one health plan for all of your health insurance needs. See if you qualify, and explore the HealthChoice Illinois advantage. All Rights Reserved. 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. Looking for your plan home page or interested in becoming a member? Other pharmacies/physicians/providers are available in our network. The Health Library is a free resource exclusively for MeridianComplete members and providers. When you go to file, youll want to write when and where the incident took place, and what happened. Each link will open a new window and is either a PDF or a website. Our Population Health Management Programs are offered to Meridian members and designed to improve your overall health and quality of care. 0000040481 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. It outlines services and benefits that areand are notcovered. window.location.replace("https://mmp.ilmeridian.com/member/benefits-coverage/whats-covered/member-handbook.html"); MeridianComplete is a health plan that contracts with both Medicare and Illinois Medicaid to provide benefits of both programs to enrollees. The handbook will explain your rights, benefits, and responsibilities as a member of Meridian. Your call will be returned within the next business day. endstream endobj startxref 0000068680 00000 n You can also file a grievance or appeal on the phone by calling Member Services or in writing via mail or fax. The call is free. Your call will be returned within the next business day. The right care for you. Your call will be returned within the next business day. You can get this document for free in other formats, such as large print, braille, or audio. MeridianHealth is now Meridian! If your pregnancy is at high risk, we may call you. On weekends and on state or federal holidays, you may be asked to leave a message. hKq?wNe?t!ARk;v6[IqK,h!i2jLnn}>^| ! 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. For information regarding our Pharmacy Benefit Manager (PBM), MeridianRx, visit the MeridianRx website. It looks like your browser does not have JavaScript enabled. Your call will be returned within the next business day. Monday-Friday, 8 a.m. to 5 p.m. CST ATTENTION: If you speak a language other than English, language assistance services, free of charge, are available to you. Understanding the ins and outs of your health plan can be difficult. %%EOF Other pharmacies/physicians/providers are available in our network. You will need Adobe Reader to open PDFs on this site. xref +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 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. 0000025980 00000 n 0000046576 00000 n 0000040678 00000 n 199 0 obj <>stream Each link will open a new window and is either a PDF or a website. For more information contact the plan or read the MeridianComplete Member Handbook. Please visit our new website to see up to date information about your plan. You are leaving this website to go to a website managed by a contracted company, which provides service on our behalf. 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. Starting January 1, 2018, the Illinois Medicaid Managed Care Program is expanding to include all Out-of-network/non-contracted providers are under no obligation to treat Meridian members, except in emergency situations. Su llamada ser devuelta dentro del siguiente da hbil. providerhelp.IL@mhplan.com, The Interoperability and Patient Access Rule. We need to be able to send you important information in the mail. 0000151745 00000 n
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