It will also explain our responsibilities to you, as well as outline the following details: The call is free. 2500 0 obj <>stream We will send you a notice before we make a change that affects you. We need to be able to send you important information in the mail. The COC lays out all the details so that you can stay on top of your coverage. We are excited to share that MeridianCare, a WellCare company, is changing its name to WellCare, effective January 1, 2020! 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. Su llamada ser devuelta dentro del siguiente da hbil. The handbook will explain your rights, benefits, and responsibilities as a member of Meridian. Just call Member Services with your new address. If you wish to stay on this website, please click Cancel. Download the Member Handbook(PDF). View your Provider Manual, important plan information and more. You can also visit the Illinois Client Enrollment Services website. If your pregnancy is at high risk, we may call you. Out-of-network/non-contracted providers are under no obligation to treat MeridianComplete members, except in emergency situations. For a more comprehensive description of the plan benefits, please refer to your Member Handbook which can also be found on this page. 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. Llame al 1-855-580-1689 (los usuarios de TTY deben llamar al 711). PDF here's your member handbook. Out-of-network/non-contracted providers are under no obligation to treat Meridian members, except in emergency situations. 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. If you have questions, please call MeridianComplete (Medicare-Medicaid Plan) Member Services at 1-855-580-1689 (TTY users should call 711). You can also file a grievance or appeal on the phone by calling Member Services or in writing via mail or fax. If you wish to stay on this website, please click Cancel. 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. Out-of-network/non-contracted providers are under no obligation to treat Meridian members, except in emergency situations. The Member Handbook, along with your enrollment form, serves asMeridian Medicare-Medicaid Plan's (MMP) contract with you. Llame al 1-855-580-1689 (los usuarios de TTY deben llamar al 711). 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. 0000041668 00000 n Open Enrollment 6. 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. hKq?wNe?t!ARk;v6[IqK,h!i2jLnn}>^| ! On weekends and on state or federal holidays, you may be asked to leave a message. 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. Your call will be returned within the next business day. Meridian will help make your Medicare and Medicaid benefits work better together and work better for you. This is not a complete list. 0000002177 00000 n Be sure to read your Meridian Member Handbook and keep it handy. View our Frequently Asked Questions page. With added benefits like support making smart health choices, personal care coordination, 24-hour nursing help line, and more. 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. Call 1-855-580-1689 (TTY: 711). Catching a Breath Complex Case Management Flu Outreach Opioids 0000040678 00000 n member.ILmeridian.com. startxref Your call will be returned within the next business day. The call is free. Making healthcare decisions can be tough--who to see for care, what to ask, when to go. [CDATA[ Your call will be returned within the next business day. Call MeridianComplete at 1-855-323-4578 (TTY users should call 711), 8 a.m to 8 p.m., seven days a week. Representatives are available Monday-Friday, 8 a.m. to 8 p.m. to assist you. 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. Check out the Interoperability page to learn more. 2023 1-855-580-1689 (TTY 711) Material ID:H6080_WEBSITE_2023_Accepted_09282022. It looks like your browser does not have JavaScript enabled. Your handbook is full of important information about your health care and Meridian. For more information contact the plan or read the Meridian Member Handbook. 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. This is not a complete list. 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. Provider Network 6 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. The Member Handbook, along with your enrollment form, serves as Meridian Medicare-Medicaid Plan's (MMP) contract with 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. The call is free. https://www.illinois.gov/hfs/healthchoice/Pages/HealthPlans.aspx, https://www.illinois.gov/hfs/healthchoice/reportcard. Member ID Cards 5. 0000067354 00000 n You can join our Start Smart for Your Baby program. 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. Want a paper copy? We want you to be happy with the treatment and services you get from Meridian and our providers. Meridian covers all counties in Illinois. You will need Adobe Reader to open PDFs on this site. It outlines services and benefits that areand are notcovered. Copays for prescription drugs may vary based on the level of Extra Help you receive. 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. On weekends and on state or federal holidays, you may be asked to leave a message. It explains the medical, dental, vision, and pharmacy services that are covered by your plan. 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. ATENCIN: Si habla espaol, tiene a su disposicin servicios gratuitos de asistencia lingstica. 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 are now able to view your health information from a third-party app on a mobile device or PC! On weekends and on state or federal holidays, you may be asked to leave a message. 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. You can also visit the Illinois Client Enrollment Services website. 1-855-580-1689 (TTY 711) On weekends and on state or federal holidays, you may be asked to leave a message. The Member Handbook, along with your enrollment form, serves as Meridian Medicare-Medicaid Plan's (MMP) contract with you. 1-855-580-1689 (TTY 711) 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 call will be returned within the next business day. More information is in your Member Handbook(PDF). PDF Welcome to MeridianHealth Intro to Plan Starting January 1, 2018, the Illinois Medicaid Managed Care Program is expanding to include all The call is free. h|kPQevkmNRIDrDI-)Vw*DYS7cgcr!349g3. You can get this document for free in other formats, such as large print, braille, or audio. Our Population Health Management Programs are offered to Meridian members and designed to improve your overall health and quality of care. 0000010510 00000 n 0000001708 00000 n It also explains how to find care and how to earn rewards. v4P+r-k E`:8\TV%F1MeLT=LyMit+GYrUn*mH gp`x Y;EgPCSSphf>op!mOQtkC v^K#x" On weekends and on state or federal holidays, you may be asked to leave a message. 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. If you have any questions, call Meridian Member Services toll-free at 866-606-3700. The Health Library is a free resource exclusively for MeridianComplete members and providers. The handbook will explain your rights, benefits, and responsibilities as a member of Meridian. This site contains various MeridianComplete (Medicare-Medicaid Plan) links and resources. 0000040481 00000 n 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 will also explain our responsibilities to you, as well as outline the following details: Download the free version of Adobe Reader. PDF ILLINOIS MEMBER HANDBOOK - Meridian Illinois Managed Care Plans You are leaving this website to go to a website managed by a contracted company, which provides service on our behalf. %PDF-1.4 % Material ID:H6080_WEBSITE_2023_Accepted_09282022. JB Pritzker, Governor Theresa Eagleson, Director. 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. 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 <. Member Handbooks and Forms An appeal is a way for you to ask for a review of our actions. If your address changes, let us know. Su llamada ser devuelta dentro del siguiente da hbil. Providers - MeridianComplete This site contains various Meridian Medicare-Medicaid Plan (MMP) links and resources. 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 1-855-323-4578 (TTY 711) or visit mmp.mimeridian.com to access our online searchable directory. Out-of-network/non-contracted providers are under no obligation to treat Meridian members, except in emergency situations. We want you to be happy with your healthcare services. It will help you get the care you need. For information regarding our Pharmacy Benefit Manager (PBM), MeridianRx, visit the MeridianRx website. Member Handbook | Meridian Complete of Illinois The call is free. 0000000956 00000 n For example, we may not approve your providers request for a certain drug. You will need Adobe Reader to open PDFs on this site. When you go to file, youll want to write when and where the incident took place, and what happened. Meridian Member Services . For more information contact the plan or read the Meridian Member Handbook. 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 167 33 It explains the medical, dental, vision, and pharmacy services that are covered by your plan. You are leaving this website to go to a website managed by a contracted company, which provides service on our behalf. 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!