If you wish to stay on this website, please click Cancel. If your pregnancy is at high risk, we may call you. The call is free. See if you qualify, and explore the HealthChoice Illinois advantage. trailer Meridian // PDF here's your 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. ATENCIN: Si habla espaol, tiene a su disposicin servicios gratuitos de asistencia lingstica. The Provider Manual has everything you need to know about member benefits, coverage, and provider guidelines. You can get this document in Spanish, or speak with someone about this information in other languages for free. Other pharmacies/physicians/providers are available in our network. hKq?wNe?t!ARk;v6[IqK,h!i2jLnn}>^| ! At the right time and place. 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. For example, we may not approve your providers request for a certain drug. 0000002177 00000 n 0000047422 00000 n Want a paper copy? 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. 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. View our Frequently Asked Questions page. The benefit information is a brief summary, not a complete description of benefits. 0000025980 00000 n You will need Adobe Reader to open PDFs on this site. 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. On weekends and on state or federal holidays, you may be asked to leave a message. The List of Covered Drugs and/or pharmacy and provider networks may change throughout the year. The call is free. Su llamada ser devuelta dentro del siguiente da hbil. MeridianComplete (Medicare-Medicaid Plan) is a health plan that contracts with both Medicare and Michigan Medicaid to provide benefits of both programs to enrollees. Llame al 1-855-580-1689 (los usuarios de TTY deben llamar al 711). La llamada es gratis. The Member Handbook, along with your enrollment form, serves asMeridian Medicare-Medicaid Plan's (MMP) contract with you. With HealthChoice Illinois, you have a health plan partner to turn to for help. You are leaving this website to go to a website managed by a contracted company, which provides service on our behalf. On weekends and on state or federal holidays, We are excited to share that MeridianCare, a WellCare company, is changing its name to WellCare, effective January 1, 2020! +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 Provider Manual | Meridian Health Plan of Illinois 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. You will be able to work with one health plan for all of your health insurance needs. Documents and Forms - Meridian Medicare Medicaid Plan With HealthChoice Illinois, you have a health plan partner to turn to for help. 2500 0 obj <>stream MeridianHealth is now Meridian! Want a paper copy? Providers - MeridianComplete MeridianComplete is a health plan that contracts with both Medicare and Illinois Medicaid to provide benefits of both programs to enrollees. 0000002131 00000 n 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 Meridian Medicare-Medicaid Plan's (MMP) contract with you. If you wish to stay on this website, please click Cancel. Member Handbook - Meridian Medicare Medicaid Plan [CDATA[ You will need Adobe Reader to open PDFs on this site. Representatives are available Monday-Friday, 8 a.m. to 8 p.m. to assist you. 0000017969 00000 n Download the free version of Adobe Reader. 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 The call is free. With added benefitslike supportmakingsmart health choices, personal care coordination, 24-hour nursing help line, and more. Member ID Cards 5. On weekends and on state or federal holidays, you may be asked to leave a message. https://www.illinois.gov/hfs/healthchoice/Pages/HealthPlans.aspx, https://www.illinois.gov/hfs/healthchoice/reportcard. Its full of tips and resources for pregnant members and new parents. PDF 2021 Member Handbook - Meridian Medicare Medicaid Plan window.location.replace("https://mmp.ilmeridian.com/member/benefits-coverage/whats-covered/member-handbook.html"); PDF Welcome to MeridianHealth Intro to Plan 0000067553 00000 n hbbd``b`R@AH&="> $ $= @+D C[} "Fod(AE+ 167 0 obj <> endobj 0000040678 00000 n Other pharmacies/physicians/providers are available in our network. This is not a complete list. For more information contact the plan or read the Meridian Member Handbook. The COC lays out all the details so that you can stay on top of your coverage. 1-855-580-1689 (TTY 711) It will help you get the care you need. The call is free. Usually a mail-order pharmacy order will get to you in no more than 5 days. Meridian 0000000956 00000 n 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. This site contains various MeridianComplete (Medicare-Medicaid Plan) links and resources. If you wish to stay on this website, please click Cancel. You are leaving this website to go to a website managed by a contracted company, which provides service on our behalf. ATTENTION: If you speak a language other than English, language assistance services, free of charge, are available to you. <<0B5A082EC79D7049BD46C1656B63CA22>]/Prev 539953>> Monday-Friday, 7:00 a.m. to 5:30 p.m. (TTY: 711) Ser vice area . Our Population Health Management Programs are offered to Meridian members and designed to improve your overall health and quality of care. h|kPQevkmNRIDrDI-)Vw*DYS7cgcr!349g3. La llamada es gratis. Meridian covers all counties in Illinois. v4P+r-k E`:8\TV%F1MeLT=LyMit+GYrUn*mH gp`x Y;EgPCSSphf>op!mOQtkC v^K#x" If you experience any problems receiving your mail order prescription, call Member Services at. 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 have any questions, call Meridian Member Services toll-free at 866-606-3700. Please review the various programs below. For a more comprehensive description of the plan benefits, please refer to your Member Handbook. Out-of-network/non-contracted providers are under no obligation to treat MeridianComplete members, except in emergency situations. Each link will open a new window and is either a PDF or a website. 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. Llame al. The call is free. There are a few ways to complete the form: We want you to have a safe, healthy, and happy pregnancy! Representatives are available Monday-Friday, 8 a.m. to 8 p.m. to assist you. HealthChoice Illinois | HFS Just call Member Services with your new address. 0000041585 00000 n Please turn on JavaScript and try again. Visit your Member Portal or call Member Services. Learn more about how being a Meridian provider benefits you. For more information, or to find out how to get enrolled, please contact Meridian at 888-437-0606. // ]]>. Don't forget to call your local HFS oce and Meridian Member Services with your new address. Complete the Member Notification of Pregnancy(PDF) form in the Member Portal. 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. You will need Adobe Reader to open PDFs on this site. Call Member Services if youd like paper copies of any of these documents. Meridian will help make your Medicare and Medicaid benefits work better together and work better for you. 0000001774 00000 n 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. PDF ILLINOIS MEMBER HANDBOOK - Meridian Illinois Managed Care Plans Call 1-855-580-1689 (TTY: 711). 0000068208 00000 n We want you to be happy with your healthcare services. startxref All Rights Reserved. Monday-Friday, 8 a.m. to 8 p.m. CST We want you to be happy with the treatment and services you get from Meridian and our providers. The Member Handbook, along with your enrollment form, serves as Meridian Medicare-Medicaid Plan's (MMP) contract with you. Monday-Friday, 8 a.m. to 5 p.m. CST 0000010510 00000 n 2023 For a more comprehensive description of the plan benefits, please refer to your Member Handbook which can also be found on this page. Starting January 1, 2018, the Illinois Medicaid Managed Care Program is expanding to include all %%EOF The Member Handbook, along with your enrollment form, serves as MeridianCompletes contract with you. The handbook will explain your rights, benefits, and responsibilities as a member of Meridian. 199 0 obj <>stream 0000068680 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. The benefit information is a brief summary, not a complete description of benefits. It outlines services and benefits that areand are notcovered. You can also visit the Illinois Client Enrollment Services website. Meridian will work with you to make sure you get all of the care you need, when you need it. 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. 2021 Member Handbook Illinois Counties: Cook, DuPage, Kane, Kankakee, Lake, Will . We are excited to share that MeridianCare, a WellCare company, is changing its name to WellCare, effective January 1, 2020! This is not a complete list. Youll tell us about any health conditions, recent hospital visits, medications, and more. 0000067354 00000 n Looking for your plan home page or interested in becoming a member? 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. Want a paper copy? Copyright 2023 Meridian All Rights Reserved. The handbook will explain your rights, benefits, and responsibilities as a member of Meridian. Your Member Handbook is a great resource if you have any questions or just want to learn more about your coverage. %PDF-1.7 % Keep in mind that everything you choose to share is confidential. For more information contact the plan or read the Meridian Member Handbook. Copays for prescription drugs may vary based on the level of Extra Help you receive. Call 1-855-580-1689 (TTY: 711). For more information contact the plan or read the MeridianComplete Member Handbook. Out-of-network/non-contracted providers are under no obligation to treat Meridian members, except in emergency situations. If your address changes, let us know. Be sure to read your Meridian Member Handbook and keep it handy. 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. 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 <. 0000025639 00000 n The handbook will explain your rights, benefits, and responsibilities as a member of MeridianComplete. This is not a complete list. It will also explain our responsibilities to you, as well as outline the following details: 0000000016 00000 n The Health Library is a free resource exclusively for MeridianComplete members and providers. 0000040481 00000 n 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. You will need Adobe Reader to open PDFs on this site. 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. An appeal is a way for you to ask for a review of our actions. ATENCIN: Si habla espaol, tiene a su disposicin servicios gratuitos de asistencia lingstica. The Personal Wellness Assessment is a short form about you and your health journey. %PDF-1.4 % providerhelp.IL@mhplan.com, The Interoperability and Patient Access Rule. Your Member Handbook is a great resource if you have any questions or just want to learn more about your coverage. 0000046966 00000 n HFS sends paperwork in the mail that you need to renew your Medicaid coverage. It explains the medical, dental, vision, and pharmacy services that are covered by your plan. Call, Usted puede obtener gratuitamente este documento en espaol o hablar con alguien sobre esta informacin en otros idiomas. 2369 0 obj <> endobj Member Handbook | Meridian Health Plan of Illinois 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: 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. Check out the Interoperability page to learn more. Report an address update to HFS online. Limitations, copays, and restrictions may apply. For information regarding our Pharmacy Benefit Manager (PBM), MeridianRx, visit the MeridianRx website. 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. 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. Su llamada ser devuelta dentro del siguiente da hbil. You are leaving this website to go to a website managed by a contracted company, which provides service on our behalf. On weekends and on state or federal holidays, you may be asked to leave a message. The right care for you. Your call will be returned within the next business day. endstream endobj startxref Monday-Friday, 8 a.m. to 8 p.m. CST 2022 Provider Manual (PDF) Meridian Provider Manual Errata Sheet (PDF) Documents and Forms Medical Referrals & Authorizations Pharmacy Billing Mandatory Training Attestation All Rights Reserved. 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. Your call will be returned within the next business day. 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. Catching a Breath Complex Case Management Flu Outreach Opioids 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. It also explains how to find care and how to earn rewards. 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). 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 call our Member Services number or see your Member Handbook for more information, including the cost-sharing that applies to out-of-network services. 0 The handbook will explain your rights, benefits, and responsibilities as a member of Meridian. 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. Please visit our new website to see up to date information about your plan. 0000006553 00000 n For more information, call MeridianComplete Member Services or read the MeridianComplete Member Handbook. Language Assistance & Notice of Nondiscrimination. providerhelp.IL@mhplan.com. Representatives are available Monday-Friday, 8 a.m. to 8 p.m. to assist you. It explains the medical, dental, vision, and pharmacy services that are covered by your plan. 0000002074 00000 n 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. Your Member Handbook is a great resource if you have any questions or just want to learn more about your coverage. 0000046386 00000 n This handbook will help you understand your coverage. Making healthcare decisions can be tough--who to see for care, what to ask, when to go. 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. 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.