meridian illinois member handbook

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. 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! 0000046576 00000 n 0000040481 00000 n La llamada es gratis. See if you qualify, and explore the HealthChoice Illinois advantage. The benefit information is a brief summary, not a complete description of benefits. Download the free version of Adobe Reader. If your pregnancy is at high risk, we may call you. Call 1-855-580-1689 (TTY: 711). 0000041585 00000 n Representatives are available Monday-Friday, 8 a.m. to 8 p.m. to assist you. 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) Monday-Friday, 8 a.m. to 8 p.m. CST If you wish to stay on this website, please click Cancel. Your call will be returned within the next business day. 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 COC lays out all the details so that you can stay on top of your coverage. A grievance is a complaint about a provider or about the quality of care or services you received. The benefit information is a brief summary, not a complete description of benefits. The call is free. If you are using a Meridian provider, you will not have to pay a plan premium, deductible, or copay. With our Medicare-Medicaid Plan (MMP) youre getting: An assigned care manager to help answer questions and coordinate your care. Learn more about how being a Meridian provider benefits you. This is not a complete list. Please turn on JavaScript and try again. Please review the various programs below. Copays for prescription drugs may vary based on the level of Extra Help you receive. You are leaving this website to go to a website managed by a contracted company, which provides service on our behalf. endstream endobj startxref With HealthChoice Illinois, you have a health plan partner to turn to for help. JB Pritzker, Governor Theresa Eagleson, Director. Download the Member Handbook(PDF). The Member Handbook, along with your enrollment form, serves as Meridian Medicare-Medicaid Plan's (MMP) contract with you. You can also visit the Illinois Client Enrollment Services website. 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. You can get this document for free in other formats, such as large print, braille, or audio. Monday-Friday, 8 a.m. to 5 p.m. CST Su llamada ser devuelta dentro del siguiente da hbil. Meridian covers all counties in Illinois. It explains the medical, dental, vision, and pharmacy services that are covered by your plan. It will help you get the care you need. This is not a complete list. Call, Usted puede obtener gratuitamente este documento en espaol o hablar con alguien sobre esta informacin en otros idiomas. You can get this document in Spanish, or speak with someone about this information in other languages for free. 0000021917 00000 n It will also explain our responsibilities to you, as well as outline the following details: Don't forget to call your local HFS oce and Meridian Member Services with your new address. 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. 0 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. 0000041668 00000 n ATTENTION: If you speak a language other than English, language assistance services, free of charge, are available to you. Fill out the Member Notification of Pregnancy form(PDF)to let us know if you are pregnant. 1-855-580-1689 (TTY 711) La llamada es gratis. Looking for your plan home page or interested in becoming a member? Llame al 1-855-580-1689 (los usuarios de TTY deben llamar al 711). This is not a complete list. The handbook will explain your rights, benefits, and responsibilities as a member of MeridianComplete. The Member Handbook, along with your enrollment form, serves as Meridian Medicare-Medicaid Plan's (MMP) contract with you. Your Member Handbook is a great resource if you have any questions or just want to learn more about your coverage. Llame al 1-855-580-1689 (los usuarios de TTY deben llamar al 711). Want a paper copy? 0000068680 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. We are excited to share that MeridianCare, a WellCare company, is changing its name to WellCare, effective January 1, 2020! You are leaving this website to go to a website managed by a contracted company, which provides service on our behalf. We are excited to share that MeridianCare, a WellCare company, is changing its name to WellCare, effective January 1, 2020! It explains the medical, dental, vision, and pharmacy services that are covered by your plan. Each link will open a new window and is either a PDF or a website. Copyright 2023 Meridian All Rights Reserved. For more information contact the plan or read the MeridianComplete Member Handbook. 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 . 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. For a more comprehensive description of the plan benefits, please refer to your Member Handbook which can also be found on this page. All Rights Reserved. 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. It explains the medical, dental, vision, and pharmacy services that are covered by your plan. This way, we can connect you with the right care. Provider Network 6 If we fall short, you can file a grievance or appeal. If you have any questions, call Meridian Member Services toll-free at 866-606-3700. On weekends and on state or federal holidays, you may be asked to leave a message. 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. With added benefits like support making smart health choices, personal care coordination, 24-hour nursing help line, and more. 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. 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. // ]]>. Limitations, copays, and restrictions may apply. 0000002131 00000 n If you have questions, please call MeridianComplete (Medicare-Medicaid Plan) Member Services at 1-855-580-1689 (TTY users should call 711). Meridian will help make your Medicare and Medicaid benefits work better together and work better for you. 0000002177 00000 n ATENCIN: Si habla espaol, tiene a su disposicin servicios gratuitos de asistencia lingstica. For example, we may not approve your providers request for a certain drug. 2023 You are leaving this website to go to a website managed by a contracted company, which provides service on our behalf. Other pharmacies/physicians/providers are available in our network. You can also visit the Illinois Client Enrollment Services website. 0000000016 00000 n Out-of-network/non-contracted providers are under no obligation to treat Meridian members, except in emergency situations. If you wish to stay on this website, please click Cancel. You will need Adobe Reader to open PDFs on this site. startxref It also explains how to find care and how to earn rewards. The Member Handbook, along with your enrollment form, serves as Meridian Medicare-Medicaid Plan's (MMP) contract with you. The Member Handbook, along with your enrollment form, serves asMeridian Medicare-Medicaid Plan's (MMP) contract with you. The benefit information is a brief summary, not a complete description of benefits. xref 0000046966 00000 n 0000025639 00000 n The call is free. Meridian is for people eligible for both Medicaid and Medicare. 1-855-580-1689 (TTY 711) 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. 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. La llamada es gratis. Want a paper copy? You can get this document for free in other formats, such as large print, braille, or audio. trailer 0000002220 00000 n <<0B5A082EC79D7049BD46C1656B63CA22>]/Prev 539953>> For more information, call MeridianComplete Member Services or read the MeridianComplete Member Handbook. View our Frequently Asked Questions page. 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. This handbook will help you understand your coverage. An appeal is a way for you to ask for a review of our actions. Su llamada ser devuelta dentro del siguiente da hbil. HFS sends paperwork in the mail that you need to renew your Medicaid coverage. 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. Each link will open a new window and is either a PDF or a website. 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. 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. Language Assistance & Notice of Nondiscrimination. https://www.illinois.gov/hfs/healthchoice/Pages/HealthPlans.aspx, https://www.illinois.gov/hfs/healthchoice/reportcard. 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. On weekends and on state or federal holidays, %PDF-1.4 % Report an address update to HFS online. Making healthcare decisions can be tough--who to see for care, what to ask, when to go. 167 33 MeridianHealth is now Meridian! You will need Adobe Reader to open PDFs on this site. We will send you a notice before we make a change that affects you. 199 0 obj <>stream Usually a mail-order pharmacy order will get to you in no more than 5 days. 0000067553 00000 n providerhelp.IL@mhplan.com. You can make an appeal if you disagree with our verdict. On weekends and on state or federal holidays, you may be asked to leave a message. 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. A certificate of coverage (COC) tells you what to expect from your healthcare plan. The handbook will explain your rights, benefits, and responsibilities as a member of Meridian. 0000001774 00000 n You are leaving this website to go to a website managed by a contracted company, which provides service on our behalf. View your Provider Manual, important plan information and more. 2023 The Health Library is a free resource exclusively for MeridianComplete members and providers. There are a few ways to complete the form: We want you to have a safe, healthy, and happy pregnancy! Llame al 1-855-580-1689 (los usuarios de TTY deben llamar al 711). The Member Handbook, along with your enrollment form, serves as MeridianCompletes contract with you. 0000014634 00000 n 0000067354 00000 n You've got questions and we've got answers. Please contact the plan for more details. MeridianComplete is a health plan that contracts with both Medicare and Illinois Medicaid to provide benefits of both programs to enrollees.

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meridian illinois member handbook