meridian illinois member handbook

HealthChoice Illinois | HFS Each link will open a new window and is either a PDF or a website. Catching a Breath Complex Case Management Flu Outreach Opioids PDF 2021 Member Handbook - Meridian Medicare Medicaid Plan Want a paper copy? Click the link below to view or save a copy. 3. For certain kinds of drugs, you can use the plans network mail-order services. Material ID:H6080_WEBSITE_2023_Accepted_09282022. We are excited to share that MeridianCare, a WellCare company, is changing its name to WellCare, effective January 1, 2020! %PDF-1.4 % Providers - MeridianComplete 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 will need Adobe Reader to open PDFs on this site. 1-855-580-1689 (TTY 711) You can get this document for free in other formats, such as large print, braille, or audio. For a more comprehensive description of the plan benefits, please refer to your Member Handbook. Its full of tips and resources for pregnant members and new parents. Our Population Health Management Programs are offered to Meridian members and designed to improve your overall health and quality of care. Youll tell us about any health conditions, recent hospital visits, medications, and more. 2369 0 obj <> endobj The call is free. For a more comprehensive description of the plan benefits, please refer to your Member Handbook which can also be found on this page. Meridian is for people eligible for both Medicaid and Medicare. This is not a complete list. PDF Welcome to MeridianHealth Intro to Plan %PDF-1.7 % If you wish to stay on this website, please click Cancel. View your Provider Manual, important plan information and more. 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. 0000002074 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.il@mhplan.com. The benefit information is a brief summary, not a complete description of benefits. If you experience any problems receiving your mail order prescription, call Member Services at. 0000040481 00000 n 2022 Provider Manual (PDF) Meridian Provider Manual Errata Sheet (PDF) Documents and Forms Medical Referrals & Authorizations Pharmacy Billing Mandatory Training Attestation Limitations, copays, and restrictions may apply. It explains the medical, dental, vision, and pharmacy services that are covered by your plan. 0000041209 00000 n 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. Call, Usted puede obtener gratuitamente este documento en espaol o hablar con alguien sobre esta informacin en otros idiomas. You can also visit the Illinois Client Enrollment Services website. 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)! La llamada es gratis. You will need Adobe Reader to open PDFs on this site. 2021 Member Handbook Illinois Counties: Cook, DuPage, Kane, Kankakee, Lake, Will . 0000010510 00000 n 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 Looking for your plan home page or interested in becoming a member? Each link will open a new window and is either a PDF or a website. It also explains how to find care and how to earn rewards. Call 1-855-580-1689 (TTY: 711). 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. Your Member Handbook is a great resource if you have any questions or just want to learn more about your coverage. 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. HealthChoice Illinois is the smart way most Medicaid members get quality care. 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. 0000000016 00000 n 0000068208 00000 n 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! We are excited to share that MeridianCare, a WellCare company, is changing its name to WellCare, effective January 1, 2020! Open Enrollment 6. You can make an appeal if you disagree with our verdict. 0000001774 00000 n Please review the various programs below. Visit your Member Portal or call Member Services. 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. 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. When you go to file, youll want to write when and where the incident took place, and what happened. The right care for you. 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. It will also explain our responsibilities to you, as well as outline the following details: See if you qualify, and explore the HealthChoice Illinois advantage. (los usuarios de TTY deben llamar al 711), lunes a domingo, de 8 a.m. a 8 p.m. La llamada es gratuita. Llame al 1-855-580-1689 (los usuarios de TTY deben llamar al 711). Your handbook is full of important information about your health care and Meridian. Important Phone Numbers & Contacts In an Emergency 911 Meridian Member Services 866-606-3700 There are a few ways to complete the form: We want you to have a safe, healthy, and happy pregnancy! Just call Member Services with your new address. [CDATA[ Moving? Llame al. You are leaving this website to go to a website managed by a contracted company, which provides service on our behalf. 0000001708 00000 n 1-855-580-1689 (TTY 711) Find a doctor, explore coverage, review documents and much more. Please contact the plan for more details. You will need Adobe Reader to open PDFs on this site. Out-of-network/non-contracted providers are under no obligation to treat Meridian members, except in emergency situations. 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. MeridianComplete is a health plan that contracts with both Medicare and Illinois Medicaid to provide benefits of both programs to enrollees. 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) With HealthChoice Illinois, you have a health plan partner to turn to for help. 0000046799 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. If you wish to stay on this website, please click Cancel. Monday-Friday, 7:00 a.m. to 5:30 p.m. (TTY: 711) Ser vice area . On weekends and on state or federal holidays, you may be asked to leave a message. 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 we fall short, you can file a grievance or appeal. 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 benefit information is a brief summary, not a complete description of benefits. This is not a complete list. Download the Member Handbook (PDF). 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. It also explains how to find care and how to earn rewards. Provider Network 6 We want you to be happy with the treatment and services you get from Meridian and our providers. You are now able to view your health information from a third-party app on a mobile device or PC! The call is free. 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. 0000002177 00000 n For more information, call MeridianComplete Member Services or read the MeridianComplete Member Handbook. window.location.replace("https://mmp.ilmeridian.com/member/benefits-coverage/whats-covered/member-handbook.html"); hKq?wNe?t!ARk;v6[IqK,h!i2jLnn}>^| ! It will help you get the care you need. member.ILmeridian.com. Material ID:H6080_WEBSITE_2023_Accepted_09282022. Meridian will work with you to make sure you get all of the care you need, when you need it. La llamada es gratis. %%EOF The Member Handbook, along with your enrollment form, serves as Meridian Medicare-Medicaid Plan's (MMP) contract with you. For more information contact the plan or read the Meridian Member Handbook. endstream endobj startxref Call 1-855-580-1689 (TTY: 711). At the right time and place. On weekends and on state or federal holidays, you may be asked to leave a message. The call is free. Out-of-network/non-contracted providers are under no obligation to treat MeridianComplete members, except in emergency situations. If your address changes, let us know. Member Handbook - Meridian Medicare Medicaid Plan <<0B5A082EC79D7049BD46C1656B63CA22>]/Prev 539953>> 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 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. 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 List of Covered Drugs and/or pharmacy and provider networks may change throughout the year. 1-855-580-1689 (TTY 711) Representatives are available Monday-Friday, 8 a.m. to 8 p.m. to assist you. The call is free. On weekends and on state or federal holidays, you may be asked to leave a message. The handbook will explain your rights, benefits, and responsibilities as a member of Meridian. Su llamada ser devuelta dentro del siguiente da hbil. You've got questions and we've got answers. 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. Meridian will help make your Medicare and Medicaid benefits work better together and work better for you. Each link will open a new window and is either a PDF or a website. You will need Adobe Reader to open PDFs on this site. PDF <DATE> Program called HealthChoice Illinois . We have been working hard Report an address update to HFS online. This is not a complete list. Other pharmacies/physicians/providers are available in our network. 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. View our Frequently Asked Questions 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. ATENCIN: Si habla espaol, tiene a su disposicin servicios gratuitos de asistencia lingstica. On weekends and on state or federal holidays, you may be asked to leave a message. Your Member Handbook is a great resource if you have any questions or just want to learn more about your coverage. We will send you a notice before we make a change that affects you. This is not a complete list. 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. This site contains various Meridian Medicare-Medicaid Plan (MMP) links and resources. 0000002041 00000 n 0000067354 00000 n It looks like your browser does not have JavaScript enabled. 0000041585 00000 n trailer It will also explain our responsibilities to you, as well as outline the following details: An appeal is a way for you to ask for a review of our actions. If you wish to stay on this website, please click Cancel. Don't forget to call your local HFS oce and Meridian Member Services with your new address. 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. Making healthcare decisions can be tough--who to see for care, what to ask, when to go. If you wish to stay on this website, please click Cancel. 0000025639 00000 n 0000046966 00000 n We want you to be happy with your healthcare services. 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. It explains the medical, dental, vision, and pharmacy services that are covered by your plan. https://www.illinois.gov/hfs/healthchoice/Pages/HealthPlans.aspx, https://www.illinois.gov/hfs/healthchoice/reportcard. MeridianComplete (Medicare-Medicaid Plan) is a health plan that contracts with both Medicare and Michigan Medicaid to provide benefits of both programs to enrollees. Want a paper copy? 0000047422 00000 n 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. Check out the Interoperability page to learn more. h|kPQevkmNRIDrDI-)Vw*DYS7cgcr!349g3. You also need to make sure that the Department of Healthcare & Family Services (HFS) has your new address. 0000000956 00000 n Learn more about how being a Meridian provider benefits you. More information is in your Member Handbook(PDF). Documents and Forms - Meridian Medicare Medicaid Plan Llame al 1-855-580-1689 (los usuarios de TTY deben llamar al 711). The Member Handbook, along with your enrollment form, serves asMeridian Medicare-Medicaid Plan's (MMP) contract with 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. Su llamada ser devuelta dentro del siguiente da hbil. Representatives are available Monday-Friday, 8 a.m. to 8 p.m. to assist you. Call MeridianComplete at 1-855-323-4578 (TTY users should call 711), 8 a.m to 8 p.m., seven days a week. Keep in mind that everything you choose to share is confidential. The Provider Manual has everything you need to know about member benefits, coverage, and provider guidelines. 0000041668 00000 n The handbook will explain your rights, benefits, and responsibilities as a member of Meridian. Language Assistance & Notice of Nondiscrimination. The Member Handbook, along with your enrollment form, serves as Meridian Medicare-Medicaid Plan's (MMP) contract with you. With our Medicare-Medicaid Plan (MMP) youre getting: An assigned care manager to help answer questions and coordinate your care. MeridianHealth is now Meridian! 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. HFS sends paperwork in the mail that you need to renew your Medicaid coverage. 0000002220 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. Download the Member Handbook (PDF). 2500 0 obj <>stream For more information contact the plan or read the Meridian Member Handbook. 0000014634 00000 n Monday-Friday, 8 a.m. to 5 p.m. CST For example, we may not approve your providers request for a certain drug. 0000002131 00000 n Your call will be returned within the next business day. Member Handbook | Meridian Complete of Illinois Provider Manual | Meridian Health Plan of Illinois A grievance is a complaint about a provider or about the quality of care or services you received. With HealthChoice Illinois, you have a health plan partner to turn to for help. Please visit our new website to see up to date information about your plan. 0000017969 00000 n For Members | Meridian 2023 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. Making healthcare decisions can be tough--who to see for care, what to ask, when to go. You can also file a grievance or appeal on the phone by calling Member Services or in writing via mail or fax. On weekends and on state or federal holidays, you may be asked to leave a message. Meridian Medicare Medicaid Plan A certificate of coverage (COC) tells you what to expect from your healthcare 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. 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. Under our plan, you will have one card for your Medicare and Medicaid services, including long-term services and supports and prescriptions. 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 <. You are leaving this website to go to a website managed by a contracted company, which provides service on our behalf. Want a paper copy? Your call will be returned within the next business day. La llamada es gratis. hbbd``b`R@AH&="> $ $= @+D C[} "Fod(AE+ 167 33 Fill out the Member Notification of Pregnancy form(PDF)to let us know if you are pregnant. You can get this document in Spanish, or speak with someone about this information in other languages for free. Download the free version of Adobe Reader. providerhelp.IL@mhplan.com. Your call will be returned within the next business day. 866-606-3700 . v4P+r-k E`:8\TV%F1MeLT=LyMit+GYrUn*mH gp`x Y;EgPCSSphf>op!mOQtkC v^K#x" xref We can connect you with support, services, and even rewards. The call is free. The Health Library is a free resource exclusively for MeridianComplete members and providers. It outlines services and benefits that areand are notcovered. 0000046576 00000 n // ]]>. 0 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. 199 0 obj <>stream ATENCIN: Si habla espaol, tiene a su disposicin servicios gratuitos de asistencia lingstica. 0000025980 00000 n Call 1-855-580-1689 (TTY: 711). Member ID Cards 5. For more information contact the plan or read the MeridianComplete Member Handbook. Meridian Member Services . 0000068680 00000 n For information regarding our Pharmacy Benefit Manager (PBM), MeridianRx, visit the MeridianRx website. If your pregnancy is at high risk, we may call you. 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. 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. You will need Adobe Reader to open PDFs on this site. %%EOF Out-of-network/non-contracted providers are under no obligation to treat Meridian members, except in emergency situations. +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 You can get this document for free in other formats, such as large print, braille, or audio. 2023 Representatives are available Monday-Friday, 8 a.m. to 8 p.m. to assist you. // Usually a mail-order pharmacy order will get to you in no more than 5 days. If you have any questions, call Meridian Member Services toll-free at 866-606-3700. The benefit information is a brief summary, not a complete description of benefits. You are leaving this website to go to a website managed by a contracted company, which provides service on our behalf. 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. This way, we can connect you with the right care. The handbook will explain your rights, benefits, and responsibilities as a member of Meridian. Other pharmacies/physicians/providers are available in our network. On weekends and on state or federal holidays, Copyright 2023 Meridian All Rights Reserved. 0 With added benefits like support making smart health choices, personal care coordination, 24-hour nursing help line, and more. PDF here's your member handbook. 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. 167 0 obj <> endobj 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.

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