meridian illinois member handbook

Copays for prescription drugs may vary based on the level of Extra Help you receive. Each link will open a new window and is either a PDF or a website. Download the Member Handbook(PDF). The call is free. With HealthChoice Illinois, you have a health plan partner to turn to for help. https://www.illinois.gov/hfs/healthchoice/Pages/HealthPlans.aspx, https://www.illinois.gov/hfs/healthchoice/reportcard. 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. We will send you a notice before we make a change that affects you. HealthChoice Illinois is the smart way most Medicaid members get quality care. 0000046386 00000 n 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 <. 0000014634 00000 n This is not a complete list. 0000041585 00000 n For more information contact the plan or read the Meridian Member Handbook. If we fall short, you can file a grievance or appeal. A certificate of coverage (COC) tells you what to expect from your healthcare plan. Visit your Member Portal or call Member Services. The Member Handbook, along with your enrollment form, serves as Meridian Medicare-Medicaid Plan's (MMP) contract with you. An appeal is a way for you to ask for a review of our actions. 0000002131 00000 n 0000046576 00000 n Llame al 1-855-580-1689 (los usuarios de TTY deben llamar al 711). Member ID Cards 5. More information is in your Member Handbook(PDF). 0000040481 00000 n Our Population Health Management Programs are offered to Meridian members and designed to improve your overall health and quality of care. You've got questions and we've got answers. The benefit information is a brief summary, not a complete description of benefits. 0000001774 00000 n For more information contact the plan or read the MeridianComplete Member Handbook. It explains the medical, dental, vision, and pharmacy services that are covered by your plan. With HealthChoice Illinois, you have a health plan partner to turn to for help. 0 It looks like your browser does not have JavaScript enabled. 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. You will need Adobe Reader to open PDFs on this site. Check out the Interoperability page to learn more. All Rights Reserved. If your address changes, let us know. Download the free version of Adobe Reader. It also explains how to find care and how to earn rewards. The handbook will explain your rights, benefits, and responsibilities as a member of Meridian. Click the link below to view or save a copy. Please visit our new website to see up to date information about your plan. Each link will open a new window and is either a PDF or a website. HFS sends paperwork in the mail that you need to renew your Medicaid coverage. window.location.replace("https://mmp.ilmeridian.com/member/benefits-coverage/whats-covered/member-handbook.html"); Looking for your plan home page or interested in becoming a member? You can also visit the Illinois Client Enrollment Services website. You can also file a grievance or appeal on the phone by calling Member Services or in writing via mail or fax. Call Member Services if youd like paper copies of any of these documents. startxref 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. Your Member Handbook is a great resource if you have any questions or just want to learn more about your coverage. 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. Llame al 1-855-580-1689 (los usuarios de TTY deben llamar al 711). Call 1-855-580-1689 (TTY: 711). You will need Adobe Reader to open PDFs on this site. This is not a complete list. The handbook will explain your rights, benefits, and responsibilities as a member of Meridian. It also explains how to find care and how to earn rewards. The call is free. The Member Handbook, along with your enrollment form, serves as Meridian Medicare-Medicaid Plan's (MMP) contract with you. PDF 2021 Member Handbook - Meridian Medicare Medicaid Plan On weekends and on state or federal holidays, you may be asked to leave a message. PDF ILLINOIS MEMBER HANDBOOK - Meridian Illinois Managed Care Plans This site contains various Meridian Medicare-Medicaid Plan (MMP) links and resources. The Health Library is a free resource exclusively for MeridianComplete members and providers. A grievance is a complaint about a provider or about the quality of care or services you received. 0000041209 00000 n Keep in mind that everything you choose to share is confidential. It explains the medical, dental, vision, and pharmacy services that are covered by your plan. The handbook will explain your rights, benefits, and responsibilities as a member of MeridianComplete. 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. 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. ATENCIN: Si habla espaol, tiene a su disposicin servicios gratuitos de asistencia lingstica. Your call will be returned within the next business day. On weekends and on state or federal holidays, you may be asked to leave a message. If your pregnancy is at high risk, we may call 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. PDF here's your member handbook. When you go to file, youll want to write when and where the incident took place, and what happened. Meridian All Rights Reserved. 0000046799 00000 n Call 1-855-580-1689 (TTY: 711). %PDF-1.7 % Don't forget to call your local HFS oce and Meridian Member Services with your new address. Monday-Friday, 8 a.m. to 8 p.m. CST 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. 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. If you have questions, please call MeridianComplete (Medicare-Medicaid Plan) Member Services at 1-855-580-1689 (TTY users should call 711). On weekends and on state or federal holidays, you may be asked to leave a message. You are leaving this website to go to a website managed by a contracted company, which provides service on our behalf. Meridian Member Services . Download the Member Handbook (PDF). 0 This is not a complete list. Your Member Handbook is a great resource if you have any questions or just want to learn more about your coverage. Su llamada ser devuelta dentro del siguiente da hbil. You can join our Start Smart for Your Baby program. For Members | Meridian 866-606-3700 . Out-of-network/non-contracted providers are under no obligation to treat Meridian members, except in emergency situations. It outlines services and benefits that areand are notcovered. 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. If you have any questions, call Meridian Member Services toll-free at 866-606-3700. Starting January 1, 2018, the Illinois Medicaid Managed Care Program is expanding to include all The handbook will explain your rights, benefits, and responsibilities as a member of Meridian. The call is free. Provider Network 6 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. Provider Manual | Meridian Health Plan of Illinois If you wish to stay on this website, please click Cancel. You can get this document for free in other formats, such as large print, braille, or audio. 0000025980 00000 n It also explains how to find care and how to earn rewards. 0000067354 00000 n You are leaving this website to go to a website managed by a contracted company, which provides service on our behalf. 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. 0000151745 00000 n You will be able to work with one health plan for all of your health insurance needs. Your call will be returned within the next business day. Su llamada ser devuelta dentro del siguiente da hbil. 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. It explains the medical, dental, vision, and pharmacy services that are covered by your plan. Your call will be returned within the next business day. 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. For example, we may not approve your providers request for a certain drug. You are leaving this website to go to a website managed by a contracted company, which provides service on our behalf. 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) hKq?wNe?t!ARk;v6[IqK,h!i2jLnn}>^| ! 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. You also need to make sure that the Department of Healthcare & Family Services (HFS) has your new address. %PDF-1.4 % 2021 Member Handbook Illinois Counties: Cook, DuPage, Kane, Kankakee, Lake, Will . Meridian Medicare Medicaid Plan You can make an appeal if you disagree with our verdict. %%EOF xref 2023 Be sure to read your Meridian Member Handbook and keep it handy. We are excited to share that MeridianCare, a WellCare company, is changing its name to WellCare, effective January 1, 2020! You can get this document in Spanish, or speak with someone about this information in other languages for free. Your call will be returned within the next business day. Representatives are available Monday-Friday, 8 a.m. to 8 p.m. to assist 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. 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 Understanding the ins and outs of your health plan can be difficult. 0000002074 00000 n ATTENTION: If you speak a language other than English, language assistance services, free of charge, are available to you. Monday-Friday, 8 a.m. to 5 p.m. CST The Member Handbook, along with your enrollment form, serves as Meridian Medicare-Medicaid Plan's (MMP) contract with you. 0000025639 00000 n If you wish to stay on this website, please click Cancel. 3. 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. The Member Handbook, along with your enrollment form, serves asMeridian Medicare-Medicaid Plan's (MMP) contract with you. 0000068680 00000 n Want a paper copy? If you are using a Meridian provider, you will not have to pay a plan premium, deductible, or copay. Material ID:H6080_WEBSITE_2023_Accepted_09282022. For more information, or to find out how to get enrolled, please contact Meridian at 888-437-0606. The Provider Manual has everything you need to know about member benefits, coverage, and provider guidelines. 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. Want a paper copy? Member Handbooks and Forms providerhelp.IL@mhplan.com, The Interoperability and Patient Access Rule. Su llamada ser devuelta dentro del siguiente da hbil. The right care for you. Just call Member Services with your new address. Documents and Forms - Meridian Medicare Medicaid Plan 199 0 obj <>stream Member Handbook | Meridian Health Plan of Illinois 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. 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. Report an address update to HFS online. 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. Making healthcare decisions can be tough--who to see for care, what to ask, when to go. 2022 Provider Manual (PDF) Meridian Provider Manual Errata Sheet (PDF) Documents and Forms Medical Referrals & Authorizations Pharmacy Billing Mandatory Training Attestation 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. 0000021917 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. La llamada es gratis. PDF Welcome to MeridianHealth Intro to Plan On weekends and on state or federal holidays, Call 1-855-580-1689 (TTY: 711). For a more comprehensive description of the plan benefits, please refer to your Member Handbook. On weekends and on state or federal holidays, you may be asked to leave a message. Under our plan, you will have one card for your Medicare and Medicaid services, including long-term services and supports and prescriptions. trailer Member Handbook - Meridian Medicare Medicaid Plan 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. 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). Find a doctor, explore coverage, review documents and much more. Moving? You are now able to view your health information from a third-party app on a mobile device or PC! MeridianHealth is now Meridian! JB Pritzker, Governor Theresa Eagleson, Director. Meridian is for people eligible for both Medicaid and Medicare. 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. 0000002041 00000 n Please turn on JavaScript and try again. There are a few ways to complete the form: We want you to have a safe, healthy, and happy pregnancy! You will need Adobe Reader to open PDFs on this site. MeridianComplete (Medicare-Medicaid Plan) is a health plan that contracts with both Medicare and Michigan 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. 0000068208 00000 n 0000002177 00000 n Representatives are available Monday-Friday, 8 a.m. to 8 p.m. to assist you. 0000040678 00000 n It will also explain our responsibilities to you, as well as outline the following details: Limitations, copays, and restrictions may apply. 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. Each link will open a new window and is either a PDF or a website. hbbd``b`R@AH&="> $ $= @+D C[} "Fod(AE+ 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. Meridian will work with you to make sure you get all of the care you need, when you need it. Meridian covers all counties in Illinois. h|kPQevkmNRIDrDI-)Vw*DYS7cgcr!349g3. The call is free. 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. 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. Complete the Member Notification of Pregnancy(PDF) form in the Member Portal. The benefit information is a brief summary, not a complete description of benefits. Usually a mail-order pharmacy order will get to you in no more than 5 days. providerhelp.IL@mhplan.com. Representatives are available Monday-Friday, 8 a.m. to 8 p.m. to assist you. v4P+r-k E`:8\TV%F1MeLT=LyMit+GYrUn*mH gp`x Y;EgPCSSphf>op!mOQtkC v^K#x"