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You can make an appeal if you disagree with our verdict. For more information, call MeridianComplete Member Services or read the MeridianComplete Member Handbook. 2023 For more information contact the plan or read the MeridianComplete Member Handbook. 0000041209 00000 n With our Medicare-Medicaid Plan (MMP) youre getting: An assigned care manager to help answer questions and coordinate your care. Material ID:H6080_WEBSITE_2023_Accepted_09282022. It also explains how to find care and how to earn rewards. La llamada es gratis. This site contains various Meridian Medicare-Medicaid Plan (MMP) links and resources. MeridianComplete (Medicare-Medicaid Plan) is a health plan that contracts with both Medicare and Michigan Medicaid to provide benefits of both programs to enrollees. We are excited to share that MeridianCare, a WellCare company, is changing its name to WellCare, effective January 1, 2020! The call is free. Meridian If your address changes, let us know. Making healthcare decisions can be tough--who to see for care, what to ask, when to go. 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. 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. Out-of-network/non-contracted providers are under no obligation to treat Meridian members, except in emergency situations. 0000002177 00000 n This is not a complete list. Making healthcare decisions can be tough--who to see for care, what to ask, when to go. This way, we can connect you with the right care. HealthChoice Illinois is the smart way most Medicaid members get quality care. Material ID:H6080_WEBSITE_2023_Accepted_09282022. 2021 Member Handbook Illinois Counties: Cook, DuPage, Kane, Kankakee, Lake, Will . You can get this document for free in other formats, such as large print, braille, or audio. 2022 Provider Manual (PDF) Meridian Provider Manual Errata Sheet (PDF) Documents and Forms Medical Referrals & Authorizations Pharmacy Billing Mandatory Training Attestation The benefit information is a brief summary, not a complete description of benefits. Provider Network 6 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. 2500 0 obj <>stream window.location.replace("https://mmp.ilmeridian.com/member/benefits-coverage/whats-covered/member-handbook.html"); Prior Authorization, Step Therapy and Quantity Limits, Coverage Determinations and Redeterminations for Drugs, Notice of Nondiscrimination & Language Assistance. You can also visit the Illinois Client Enrollment Services website. Each link will open a new window and is either a PDF or a website. (los usuarios de TTY deben llamar al 711), lunes a domingo, de 8 a.m. a 8 p.m. La llamada es gratuita. Other pharmacies/physicians/providers are available in our network. v4P+r-k E`:8\TV%F1MeLT=LyMit+GYrUn*mH gp`x Y;EgPCSSphf>op!mOQtkC v^K#x" For more information, or to find out how to get enrolled, please contact Meridian at 888-437-0606. More information is in your Member Handbook(PDF). 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. Your call will be returned within the next business day. 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. 0000014634 00000 n 0000041668 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. Report an address update to HFS online. Please contact the plan for more details. Want a paper copy? Meridian hbbd``b`R@AH&="> $ $= @+D C[} "Fod(AE+ The COC lays out all the details so that you can stay on top of your coverage. All Rights Reserved. You can also visit the Illinois Client Enrollment Services website. Call Member Services if youd like paper copies of any of these documents. On weekends and on state or federal holidays, This site contains various MeridianComplete (Medicare-Medicaid Plan) links and resources. Download the Member Handbook(PDF). View our Frequently Asked Questions page. If we fall short, you can file a grievance or appeal. Other pharmacies/physicians/providers are available in our network. This is not a complete list. Learn more about how being a Meridian provider benefits you. 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. Usually a mail-order pharmacy order will get to you in no more than 5 days. You are leaving this website to go to a website managed by a contracted company, which provides service on our behalf. 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. Be sure to read your Meridian Member Handbook and keep it handy. See if you qualify, and explore the HealthChoice Illinois advantage. It looks like your browser does not have JavaScript enabled. 0000080946 00000 n You will need Adobe Reader to open PDFs on this site. 0000046799 00000 n The List of Covered Drugs and/or pharmacy and provider networks may change throughout the year. Your call will be returned within the next business day. Meridian is for people eligible for both Medicaid and Medicare. Su llamada ser devuelta dentro del siguiente da hbil. Call 1-855-580-1689 (TTY: 711). Download the Member Handbook (PDF). Each link will open a new window and is either a PDF or a website. We can connect you with support, services, and even rewards. If you wish to stay on this website, please click Cancel. Other pharmacies/physicians/providers are available in our network. Representatives are available Monday-Friday, 8 a.m. to 8 p.m. to assist you. <<0B5A082EC79D7049BD46C1656B63CA22>]/Prev 539953>> You can get this document for free in other formats, such as large print, braille, or audio. 0000002220 00000 n // ]]>. A certificate of coverage (COC) tells you what to expect from your healthcare plan. A grievance is a complaint about a provider or about the quality of care or services you received. 0000000016 00000 n You can get this document in Spanish, or speak with someone about this information in other languages for 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.mi@mhplan.com. It explains the medical, dental, vision, and pharmacy services that are covered by your plan. 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. The handbook will explain your rights, benefits, and responsibilities as a member of MeridianComplete. Each link will open a new window and is either a PDF or a website. 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. On weekends and on state or federal holidays, you may be asked to leave a message. +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 If you wish to stay on this website, please click Cancel. 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. La llamada es gratis. Meridian will help make your Medicare and Medicaid benefits work better together and work better for you. Its full of tips and resources for pregnant members and new parents. Download the Member Handbook (PDF). 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. 0000017969 00000 n It explains the medical, dental, vision, and pharmacy services that are covered by your plan. Language Assistance & Notice of Nondiscrimination. This is not a complete list. %PDF-1.4 % 199 0 obj <>stream The handbook will explain your rights, benefits, and responsibilities as a member of Meridian. ATTENTION: If you speak a language other than English, language assistance services, free of charge, are available to you. For example, we may not approve your providers request for a certain drug. It outlines services and benefits that areand are notcovered. 0000046576 00000 n When you go to file, youll want to write when and where the incident took place, and what happened. 167 0 obj <> endobj If you wish to stay on this website, please click Cancel. If you experience any problems receiving your mail order prescription, call Member Services at. Just call Member Services with your new address. Catching a Breath Complex Case Management Flu Outreach Opioids Llame al 1-855-580-1689 (los usuarios de TTY deben llamar al 711). Looking for your plan home page or interested in becoming a member? We are excited to share that MeridianCare, a WellCare company, is changing its name to WellCare, effective January 1, 2020! 1-855-580-1689 (TTY 711) Meridian covers all counties in Illinois. providerhelp.IL@mhplan.com. Your call will be returned within the next business day. La llamada es gratis. 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. For more information contact the plan or read the Meridian Member Handbook. Your handbook is full of important information about your health care and Meridian. You will be able to work with one health plan for all of your health insurance needs. Monday-Friday, 8 a.m. to 5 p.m. CST 0000010510 00000 n Fill out the Member Notification of Pregnancy form(PDF)to let us know if you are pregnant. We want you to be happy with the treatment and services you get from Meridian and our providers. JB Pritzker, Governor Theresa Eagleson, Director. The Provider Manual has everything you need to know about member benefits, coverage, and provider guidelines. If your pregnancy is at high risk, we may call you. 0000067354 00000 n It explains the medical, dental, vision, and pharmacy services that are covered by your plan. 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. 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. 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. MeridianHealth is now Meridian! Call MeridianComplete at 1-855-323-4578 (TTY users should call 711), 8 a.m to 8 p.m., seven days a week. With added benefitslike supportmakingsmart health choices, personal care coordination, 24-hour nursing help line, and more. 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) 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. 0000025980 00000 n Call 1-855-580-1689 (TTY: 711). 0000040678 00000 n 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. 0000067553 00000 n providerhelp.IL@mhplan.com, The Interoperability and Patient Access Rule. xref 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. Representatives are available Monday-Friday, 8 a.m. to 8 p.m. to assist you. 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. Your Member Handbook is a great resource if you have any questions or just want to learn more about your coverage. 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. Moving? Meridian will work with you to make sure you get all of the care you need, when you need it. Call, Usted puede obtener gratuitamente este documento en espaol o hablar con alguien sobre esta informacin en otros idiomas. Monday-Friday, 8 a.m. to 8 p.m. CST 0000046386 00000 n startxref 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. It also explains how to find care and how to earn rewards. Su llamada ser devuelta dentro del siguiente da hbil. 167 33 With added benefits like support making smart health choices, personal care coordination, 24-hour nursing help line, and more. h|kPQevkmNRIDrDI-)Vw*DYS7cgcr!349g3. Click the link below to view or save a copy. We will send you a notice before we make a change that affects you. 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. You can also file a grievance or appeal on the phone by calling Member Services or in writing via mail or fax. Representatives are available Monday-Friday, 8 a.m. to 8 p.m. to assist you. Our Population Health Management Programs are offered to Meridian members and designed to improve your overall health and quality of care. Check out the Interoperability page to learn more. 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. 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 any questions, call Meridian Member Services toll-free at 866-606-3700. With HealthChoice Illinois, you have a health plan partner to turn to for help. 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.