Your call will be returned within the next business day. If you wish to stay on this website, please click Cancel. It also explains how to find care and how to earn rewards. For more information contact the plan or read the Meridian Member Handbook. This is not a complete list. 0000151745 00000 n Provider Network 6 0000002131 00000 n Meridian will work with you to make sure you get all of the care you need, when you need it. 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. 0000067354 00000 n Don't forget to call your local HFS oce and Meridian Member Services with your new address. You will be able to work with one health plan for all of your health insurance needs. The call is free. 2500 0 obj <>stream For more information, or to find out how to get enrolled, please contact Meridian at 888-437-0606. The Health Library is a free resource exclusively for MeridianComplete members and providers. This is not a complete list. 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. Prior Authorization, Step Therapy and Quantity Limits, Coverage Determinations and Redeterminations for Drugs, Notice of Nondiscrimination & Language Assistance. You are leaving this website to go to a website managed by a contracted company, which provides service on our behalf. startxref The COC lays out all the details so that you can stay on top of your coverage. 0000072727 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. Download the free version of Adobe Reader. Download the Member Handbook (PDF). Keep in mind that everything you choose to share is confidential. 0 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. 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)! Limitations, copays, and restrictions may apply. 0000000956 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) <<0B5A082EC79D7049BD46C1656B63CA22>]/Prev 539953>> The Member Handbook, along with your enrollment form, serves asMeridian Medicare-Medicaid Plan's (MMP) contract with you. Report an address update to HFS online. 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. 0000080946 00000 n We will send you a notice before we make a change that affects you. ATENCIN: Si habla espaol, tiene a su disposicin servicios gratuitos de asistencia lingstica. 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! [CDATA[ You can make an appeal if you disagree with our verdict. The benefit information is a brief summary, not a complete description of benefits. If you are using a Meridian provider, you will not have to pay a plan premium, deductible, or copay. This site contains various Meridian Medicare-Medicaid Plan (MMP) links and resources. Copyright 2023 Meridian All Rights Reserved. You will need Adobe Reader to open PDFs on this site. 1-855-580-1689 (TTY 711) The Member Handbook, along with your enrollment form, serves as Meridian Medicare-Medicaid Plan's (MMP) contract with you. If your address changes, let us know. 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. xref hbbd``b`R@AH&="> $ $= @+D C[} "Fod(AE+ The Provider Manual has everything you need to know about member benefits, coverage, and provider guidelines. Meridian Member Services . Each link will open a new window and is either a PDF or a website. 2023 trailer Out-of-network/non-contracted providers are under no obligation to treat Meridian members, except in emergency situations. 0000001708 00000 n You will need Adobe Reader to open PDFs on this site. Monday-Friday, 8 a.m. to 8 p.m. CST Representatives are available Monday-Friday, 8 a.m. to 8 p.m. to assist you. 0000010510 00000 n Su llamada ser devuelta dentro del siguiente da hbil. 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 Llame al. The List of Covered Drugs and/or pharmacy and provider networks may change throughout the year. Member Handbook | Meridian Health Plan of Illinois You will need Adobe Reader to open PDFs on this site. 0000002041 00000 n On weekends and on state or federal holidays, you may be asked to leave a message. It looks like your browser does not have JavaScript enabled. 0000006553 00000 n Providers - MeridianComplete 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. This site contains various MeridianComplete (Medicare-Medicaid Plan) links and resources. 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. Su llamada ser devuelta dentro del siguiente da hbil. On weekends and on state or federal holidays, you may be asked to leave a message. Out-of-network/non-contracted providers are under no obligation to treat Meridian members, except in emergency situations. HFS sends paperwork in the mail that you need to renew your Medicaid coverage. Meridian Llame al 1-855-580-1689 (los usuarios de TTY deben llamar al 711). Material ID:H6080_WEBSITE_2023_Accepted_09282022. All Rights Reserved. ATTENTION: If you speak a language other than English, language assistance services, free of charge, are available to 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. ATENCIN: Si habla espaol, tiene a su disposicin servicios gratuitos de asistencia lingstica. 199 0 obj <>stream Monday-Friday, 8 a.m. to 8 p.m. CST Please visit our new website to see up to date information about your plan. Representatives are available Monday-Friday, 8 a.m. to 8 p.m. to assist you. (los usuarios de TTY deben llamar al 711), lunes a domingo, de 8 a.m. a 8 p.m. La llamada es gratuita. providerhelp.IL@mhplan.com. A grievance is a complaint about a provider or about the quality of care or services you received. Member Handbook | Meridian Complete of Illinois Member Handbook - Meridian Medicare Medicaid Plan It outlines services and benefits that areand are notcovered. Catching a Breath Complex Case Management Flu Outreach Opioids We want you to be happy with your healthcare services. 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. Your call will be returned within the next business day. PDF Welcome to MeridianHealth Intro to Plan 0000001774 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. If you have questions, please call MeridianComplete (Medicare-Medicaid Plan) Member Services at 1-855-580-1689 (TTY users should call 711). An appeal is a way for you to ask for a review of our actions. The right care for you. Member Handbooks and Forms Your Member Handbook is a great resource if you have any questions or just want to learn more about your coverage. La llamada es gratis. Your handbook is full of important information about your health care and Meridian. Want a paper copy? The call is free. You are leaving this website to go to a website managed by a contracted company, which provides service on our behalf. For more information contact the plan or read the Meridian Member Handbook. It also explains how to find care and how to earn rewards. Download the Member Handbook(PDF). 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. 1-855-580-1689 (TTY 711) You can join our Start Smart for Your Baby program. 0000041209 00000 n The Member Handbook, along with your enrollment form, serves as Meridian Medicare-Medicaid Plan's (MMP) contract with you. Please review the various programs below. v4P+r-k E`:8\TV%F1MeLT=LyMit+GYrUn*mH gp`x Y;EgPCSSphf>op!mOQtkC v^K#x" If you wish to stay on this website, please click Cancel. 0000040481 00000 n Fill out the Member Notification of Pregnancy form(PDF)to let us know if you are pregnant. 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. Call, Usted puede obtener gratuitamente este documento en espaol o hablar con alguien sobre esta informacin en otros idiomas. Other pharmacies/physicians/providers are available in our network. 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. window.location.replace("https://mmp.ilmeridian.com/member/benefits-coverage/whats-covered/member-handbook.html"); 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. 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. La llamada es gratis. For a more comprehensive description of the plan benefits, please refer to your Member Handbook which can also be found on this page. 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. 2369 0 obj <> endobj It also explains how to find care and how to earn rewards. It will also explain our responsibilities to you, as well as outline the following details: For more information contact the plan or read the Meridian Member Handbook. If you have any questions, call Meridian Member Services toll-free at 866-606-3700. You are leaving this website to go to a website managed by a contracted company, which provides service on our behalf. It will also explain our responsibilities to you, as well as outline the following details: It explains the medical, dental, vision, and pharmacy services that are covered by your plan. PDF here's your member handbook. Your call will be returned within the next business day. Call Member Services if youd like paper copies of any of these documents. Monday-Friday, 7:00 a.m. to 5:30 p.m. (TTY: 711) Ser vice area . Each link will open a new window and is either a PDF or a website. %%EOF More information is in your Member Handbook(PDF). If your pregnancy is at high risk, we may call you. We need to be able to send you important information in the mail. https://www.illinois.gov/hfs/healthchoice/Pages/HealthPlans.aspx, https://www.illinois.gov/hfs/healthchoice/reportcard. Making healthcare decisions can be tough--who to see for care, what to ask, when to go. %PDF-1.7 % 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. You will need Adobe Reader to open PDFs on this site. 167 0 obj <> endobj Find a doctor, explore coverage, review documents and much more. MeridianComplete (Medicare-Medicaid Plan) is a health plan that contracts with both Medicare and Michigan Medicaid to provide benefits of both programs to enrollees. Open Enrollment 6. 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 handbook will explain your rights, benefits, and responsibilities as a member of MeridianComplete. +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 On weekends and on state or federal holidays, you may be asked to leave a message. hKq?wNe?t!ARk;v6[IqK,h!i2jLnn}>^| ! 0000025980 00000 n A certificate of coverage (COC) tells you what to expect from your healthcare plan. 2021 Member Handbook Illinois Counties: Cook, DuPage, Kane, Kankakee, Lake, Will . It explains the medical, dental, vision, and pharmacy services that are covered by your plan. La llamada es gratis. Just call Member Services with your new address. Representatives are available Monday-Friday, 8 a.m. to 8 p.m. to assist you. You can get this document for free in other formats, such as large print, braille, or audio. You are leaving this website to go to a website managed by a contracted company, which provides service on our behalf. // For Members | Meridian On weekends and on state or federal holidays, you may be asked to leave a message. Llame al 1-855-580-1689 (los usuarios de TTY deben llamar al 711). We want you to be happy with the treatment and services you get from Meridian and our providers. Meridian will help make your Medicare and Medicaid benefits work better together and work better for you. If we fall short, you can file a grievance or appeal. // ]]>. JB Pritzker, Governor Theresa Eagleson, Director. For example, we may not approve your providers request for a certain drug. Download the Member Handbook (PDF). Documents and Forms - Meridian Medicare Medicaid 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. For information regarding our Pharmacy Benefit Manager (PBM), MeridianRx, visit the MeridianRx website. Call 1-855-580-1689 (TTY: 711). Member ID Cards 5. 0000014634 00000 n Llame al 1-855-580-1689 (los usuarios de TTY deben llamar al 711). You can also visit the Illinois Client Enrollment Services website. Meridian covers all counties in Illinois. endstream endobj startxref 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. This is not a complete list. Under our plan, you will have one card for your Medicare and Medicaid services, including long-term services and supports and prescriptions. It explains the medical, dental, vision, and pharmacy services that are covered by your plan. When you go to file, youll want to write when and where the incident took place, and what happened. 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. Your Member Handbook is a great resource if you have any questions or just want to learn more about your coverage. ATENCIN: Si habla espaol, tiene a su disposicin servicios gratuitos de asistencia lingstica. 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. 0000025639 00000 n 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. 0000021917 00000 n The Member Handbook, along with your enrollment form, serves as MeridianCompletes contract with you. Understanding the ins and outs of your health plan can be difficult. 866-606-3700 . This handbook will help you understand your coverage. Each link will open a new window and is either a PDF or a website. Your call will be returned within the next business day. 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. Its full of tips and resources for pregnant members and new parents. We can connect you with support, services, and even rewards. With our Medicare-Medicaid Plan (MMP) youre getting: An assigned care manager to help answer questions and coordinate your care. Making healthcare decisions can be tough--who to see for care, what to ask, when to go. It will help you get the care you need. PDF <DATE> Program called HealthChoice Illinois . We have been working hard For a more comprehensive description of the plan benefits, please refer to your Member Handbook. 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. Want a paper copy? HealthChoice Illinois is the smart way most Medicaid members get quality care. Your Member Handbook is a great resource if you have any questions or just want to learn more about your coverage. At the right time and place. 0000068208 00000 n 0000002220 00000 n Copays for prescription drugs may vary based on the level of Extra Help you receive. PDF 2021 Member Handbook - Meridian Medicare Medicaid Plan You can get this document for free in other formats, such as large print, braille, or audio. providerhelp.IL@mhplan.com, The Interoperability and Patient Access Rule. This way, we can connect you with the right care. You can also file a grievance or appeal on the phone by calling Member Services or in writing via mail or fax. h|kPQevkmNRIDrDI-)Vw*DYS7cgcr!349g3. With HealthChoice Illinois, you have a health plan partner to turn to for help. 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.
