meridian illinois member handbook meridian illinois member handbook

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. Please turn on JavaScript and try again. Your call will be returned within the next business day. 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. Want a paper copy? ATENCIN: Si habla espaol, tiene a su disposicin servicios gratuitos de asistencia lingstica. 1-855-580-1689 (TTY 711) You are leaving this website to go to a website managed by a contracted company, which provides service on our behalf. Llame al 1-855-580-1689 (los usuarios de TTY deben llamar al 711). 0000025980 00000 n For more information contact the plan or read the Meridian Member Handbook. This is not a complete list. Material ID:H6080_WEBSITE_2023_Accepted_09282022. 0000046966 00000 n Open Enrollment 6. 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. 0 Each link will open a new window and is either a PDF or a website. Provider Network 6 Youll tell us about any health conditions, recent hospital visits, medications, and more. For a more comprehensive description of the plan benefits, please refer to your Member Handbook which can also be found on this page. 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. xref 0000006553 00000 n The call is free. For information regarding our Pharmacy Benefit Manager (PBM), MeridianRx, visit the MeridianRx website. Your handbook is full of important information about your health care and Meridian. 0000067553 00000 n 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. Member ID Cards 5. 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! Meridian is for people eligible for both Medicaid and Medicare. This site contains various Meridian Medicare-Medicaid Plan (MMP) links and resources. 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. There are a few ways to complete the form: We want you to have a safe, healthy, and happy pregnancy! Keep in mind that everything you choose to share is confidential. The benefit information is a brief summary, not a complete description of benefits. Out-of-network/non-contracted providers are under no obligation to treat Meridian members, except in emergency situations. 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)! 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. Moving? JB Pritzker, Governor Theresa Eagleson, Director. 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. On weekends and on state or federal holidays, you may be asked to leave a message. The Member Handbook, along with your enrollment form, serves as Meridian Medicare-Medicaid Plan's (MMP) contract with you. 0000014634 00000 n Under our plan, you will have one card for your Medicare and Medicaid services, including long-term services and supports and prescriptions. You are leaving this website to go to a website managed by a contracted company, which provides service on our behalf. A grievance is a complaint about a provider or about the quality of care or services you received. It looks like your browser does not have JavaScript enabled. Su llamada ser devuelta dentro del siguiente da hbil. Your call will be returned within the next business day. h|kPQevkmNRIDrDI-)Vw*DYS7cgcr!349g3. Representatives are available Monday-Friday, 8 a.m. to 8 p.m. to assist you. Your call will be returned within the next business day. MeridianComplete is a health plan that contracts with both Medicare and Illinois Medicaid to provide benefits of both programs to enrollees. 0000067354 00000 n Download the 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. 0000080946 00000 n 0000021917 00000 n It explains the medical, dental, vision, and pharmacy services that are covered by your plan. 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. 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. Other pharmacies/physicians/providers are available in our network. 0000002177 00000 n You can also file a grievance or appeal on the phone by calling Member Services or in writing via mail or fax. Prior Authorization, Step Therapy and Quantity Limits, Coverage Determinations and Redeterminations for Drugs, Notice of Nondiscrimination & Language Assistance. This is not a complete list. You can get this document in Spanish, or speak with someone about this information in other languages for free. The Provider Manual has everything you need to know about member benefits, coverage, and provider guidelines. 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. Representatives are available Monday-Friday, 8 a.m. to 8 p.m. to assist you. 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. More information is in your Member Handbook(PDF). Complete the Member Notification of Pregnancy(PDF) form in the Member Portal. Your call will be returned within the next business day. Download the Member Handbook(PDF). For more information contact the plan or read the MeridianComplete Member Handbook. Our Population Health Management Programs are offered to Meridian members and designed to improve your overall health and quality of care. At the right time and place. You will need Adobe Reader to open PDFs on this site. We need to be able to send you important information in the mail. Other pharmacies/physicians/providers are available in our network. Be sure to read your Meridian Member Handbook and keep it handy. View your Provider Manual, important plan information and more. You will need Adobe Reader to open PDFs on this site. %%EOF It will also explain our responsibilities to you, as well as outline the following details: All Rights Reserved. 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. Call 1-855-580-1689 (TTY: 711). Click the link below to view or save a copy. 3. The call is free. 0000072727 00000 n This is not a complete list. // ^| ! If you wish to stay on this website, please click Cancel. Each link will open a new window and is either a PDF or a website. The List of Covered Drugs and/or pharmacy and provider networks may change throughout the year. Material ID:H6080_WEBSITE_2023_Accepted_09282022. For certain kinds of drugs, you can use the plans network mail-order services. 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. Call 1-855-580-1689 (TTY: 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. View our Frequently Asked Questions page. // ]]>. member.ILmeridian.com. The handbook will explain your rights, benefits, and responsibilities as a member of MeridianComplete. providerhelp.IL@mhplan.com. 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. The COC lays out all the details so that you can stay on top of your coverage. Making healthcare decisions can be tough--who to see for care, what to ask, when to go. It explains the medical, dental, vision, and pharmacy services that are covered by your plan. It also explains how to find care and how to earn rewards. If you wish to stay on this website, please click Cancel. Llame al. With our Medicare-Medicaid Plan (MMP) youre getting: An assigned care manager to help answer questions and coordinate your care. You will be able to work with one health plan for all of your health insurance needs. 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. 167 0 obj <> endobj 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: This site contains various Meridian Medicare-Medicaid Plan (MMP) links and resources. Each link will open a new window and is either a PDF or a website. Meridian covers all counties in Illinois. 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. 0000000956 00000 n You can get this document for free in other formats, such as large print, braille, or audio. Understanding the ins and outs of your health plan can be difficult. Su llamada ser devuelta dentro del siguiente da hbil. %%EOF The Member Handbook, along with your enrollment form, serves as MeridianCompletes contract with you. Starting January 1, 2018, the Illinois Medicaid Managed Care Program is expanding to include all On weekends and on state or federal holidays, 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. You will need Adobe Reader to open PDFs on this site. All Rights Reserved. ATENCIN: Si habla espaol, tiene a su disposicin servicios gratuitos de asistencia lingstica. Llame al 1-855-580-1689 (los usuarios de TTY deben llamar al 711). Out-of-network/non-contracted providers are under no obligation to treat MeridianComplete members, except in emergency situations. Call 1-855-580-1689 (TTY: 711). 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 will need Adobe Reader to open PDFs on this site. The handbook will explain your rights, benefits, and responsibilities as a member of Meridian. With added benefits like support making smart health choices, personal care coordination, 24-hour nursing help line, and more. With HealthChoice Illinois, you have a health plan partner to turn to for help. The right care for you. <<0B5A082EC79D7049BD46C1656B63CA22>]/Prev 539953>> A certificate of coverage (COC) tells you what to expect from your healthcare plan. The benefit information is a brief summary, not a complete description of benefits. 199 0 obj <>stream Catching a Breath Complex Case Management Flu Outreach Opioids Copays for prescription drugs may vary based on the level of Extra Help you receive. It will help you get the care you need. Out-of-network/non-contracted providers are under no obligation to treat Meridian members, except in emergency situations. The call is free. This handbook will help you understand your coverage. 0000001708 00000 n We are excited to share that MeridianCare, a WellCare company, is changing its name to WellCare, effective January 1, 2020! If your address changes, let us know. When you go to file, youll want to write when and where the incident took place, and what happened. You've got questions and we've got answers. 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. Usually a mail-order pharmacy order will get to you in no more than 5 days. For a more comprehensive description of the plan benefits, please refer to your Member Handbook. It outlines services and benefits that areand are notcovered. If you wish to stay on this website, please click Cancel. If you wish to stay on this website, please click Cancel. We can connect you with support, services, and even rewards. 0000010510 00000 n 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) 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. Call MeridianComplete at 1-855-323-4578 (TTY users should call 711), 8 a.m to 8 p.m., seven days a week. 0000002220 00000 n On weekends and on state or federal holidays, you may be asked to leave a message. Find a doctor, explore coverage, review documents and much more. 0000068208 00000 n startxref HealthChoice Illinois is the smart way most Medicaid members get quality care. 2500 0 obj <>stream Monday-Friday, 7:00 a.m. to 5:30 p.m. (TTY: 711) Ser vice area . 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.