Starting January 1, 2018, the Illinois Medicaid Managed Care Program is expanding to include all MeridianHealth is now Meridian! window.location.replace("https://mmp.ilmeridian.com/member/benefits-coverage/whats-covered/member-handbook.html"); Call MeridianComplete at 1-855-323-4578 (TTY users should call 711), 8 a.m to 8 p.m., seven days a week. It looks like your browser does not have JavaScript enabled. Out-of-network/non-contracted providers are under no obligation to treat Meridian members, except in emergency situations. 0000041668 00000 n 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. 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. For more information contact the plan or read the Meridian Member Handbook. A certificate of coverage (COC) tells you what to expect from your healthcare plan. PDF ILLINOIS MEMBER HANDBOOK - Meridian Illinois Managed Care Plans Call 1-855-580-1689 (TTY: 711). The call is free. It will also explain our responsibilities to you, as well as outline the following details: 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. 167 0 obj <> endobj 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. 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) The List of Covered Drugs and/or pharmacy and provider networks may change throughout the year. If you wish to stay on this website, please click Cancel. Provider Manual | Meridian Health Plan of Illinois 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. Other pharmacies/physicians/providers are available in our network. Open Enrollment 6. Meridian Medicare Medicaid Plan 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. The Personal Wellness Assessment is a short form about you and your health journey. 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. providerhelp.IL@mhplan.com. This handbook will help you understand your coverage. La llamada es gratis. It also explains how to find care and how to earn rewards. Important Phone Numbers & Contacts In an Emergency 911 Meridian Member Services 866-606-3700 %%EOF Other pharmacies/physicians/providers are available in our network. Out-of-network/non-contracted providers are under no obligation to treat MeridianComplete members, except in emergency situations. We want you to be happy with your healthcare services. 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 You are leaving this website to go to a website managed by a contracted company, which provides service on our behalf. For Members | Meridian Member Handbook | Meridian Complete of Illinois 167 33 With added benefits like support making smart health choices, personal care coordination, 24-hour nursing help line, and more. 0 0000046386 00000 n Language Assistance & Notice of Nondiscrimination. PDF here's your member handbook. HealthChoice Illinois is the smart way most Medicaid members get quality care. More information is in your Member Handbook(PDF). We can connect you with support, services, and even rewards. Download the free version of Adobe Reader. h|kPQevkmNRIDrDI-)Vw*DYS7cgcr!349g3. Download the Member Handbook (PDF). 866-606-3700 . 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). hKq?wNe?t!ARk;v6[IqK,h!i2jLnn}>^| ! 0000014634 00000 n This site contains various Meridian Medicare-Medicaid Plan (MMP) links and resources. 0000010510 00000 n We are excited to share that MeridianCare, a WellCare company, is changing its name to WellCare, effective January 1, 2020! 0000002220 00000 n 2022 Provider Manual (PDF) Meridian Provider Manual Errata Sheet (PDF) Documents and Forms Medical Referrals & Authorizations Pharmacy Billing Mandatory Training Attestation 2369 0 obj <> endobj Meridian is for people eligible for both Medicaid and Medicare. For information regarding our Pharmacy Benefit Manager (PBM), MeridianRx, visit the MeridianRx website. Each link will open a new window and is either a PDF or a website. Monday-Friday, 7:00 a.m. to 5:30 p.m. (TTY: 711) Ser vice area . 0000002177 00000 n Llame al. The handbook will explain your rights, benefits, and responsibilities as a member of MeridianComplete. 0000017969 00000 n 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. 0000002131 00000 n Call 1-855-580-1689 (TTY: 711). View our Frequently Asked Questions page. 0000000956 00000 n 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. MeridianComplete is a health plan that contracts with both Medicare and Illinois Medicaid to provide benefits of both programs to enrollees. 0000151745 00000 n You can get this document for free in other formats, such as large print, braille, or audio. You can also visit the Illinois Client Enrollment Services website. Member ID Cards 5. PDF 2021 Member Handbook - Meridian Medicare Medicaid Plan 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). Monday-Friday, 8 a.m. to 8 p.m. CST On weekends and on state or federal holidays, you may be asked to leave a message. startxref xref If your pregnancy is at high risk, we may call you. When you go to file, youll want to write when and where the incident took place, and what happened. JB Pritzker, Governor Theresa Eagleson, Director. <<0B5A082EC79D7049BD46C1656B63CA22>]/Prev 539953>> You can join our Start Smart for Your Baby program. Each link will open a new window and is either a PDF or a website. Want a paper copy? The Member Handbook, along with your enrollment form, serves as Meridian Medicare-Medicaid Plan's (MMP) contract with you. You are now able to view your health information from a third-party app on a mobile device or PC! Learn more about how being a Meridian provider benefits you. Under our plan, you will have one card for your Medicare and Medicaid services, including long-term services and supports and prescriptions. 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 are using a Meridian provider, you will not have to pay a plan premium, deductible, or copay. 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. // ]]>. Our Population Health Management Programs are offered to Meridian members and designed to improve your overall health and quality of care. 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. Copays for prescription drugs may vary based on the level of Extra Help you receive. 0000001774 00000 n Providers - MeridianComplete This site contains various Meridian Medicare-Medicaid Plan (MMP) links and resources. For example, we may not approve your providers request for a certain drug. Su llamada ser devuelta dentro del siguiente da hbil. With our Medicare-Medicaid Plan (MMP) youre getting: An assigned care manager to help answer questions and coordinate your care. Making healthcare decisions can be tough--who to see for care, what to ask, when to go. Material ID:H6080_WEBSITE_2023_Accepted_09282022. HFS sends paperwork in the mail that you need to renew your Medicaid coverage. Representatives are available Monday-Friday, 8 a.m. to 8 p.m. to assist you. You will need Adobe Reader to open PDFs on this site. For a more comprehensive description of the plan benefits, please refer to your Member Handbook which can also be found on this page. The benefit information is a brief summary, not a complete description of benefits. The Member Handbook, along with your enrollment form, serves as Meridian 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. ATTENTION: If you speak a language other than English, language assistance services, free of charge, are available to you. For more information contact the plan or read the Meridian 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.il@mhplan.com. Its full of tips and resources for pregnant members and new parents. 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. Out-of-network/non-contracted providers are under no obligation to treat Meridian members, except in emergency situations. %PDF-1.7 % trailer 0000002041 00000 n Other pharmacies/physicians/providers are available in our network. You also need to make sure that the Department of Healthcare & Family Services (HFS) has your new address. You are leaving this website to go to a website managed by a contracted company, which provides service on our behalf. The Provider Manual has everything you need to know about member benefits, coverage, and provider guidelines. Copyright 2023 Meridian All Rights Reserved. Your call will be returned within the next business day. For more information contact the plan or read the MeridianComplete 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 La llamada es gratis. 0000046966 00000 n If you wish to stay on this website, please click Cancel. All Rights Reserved. Limitations, copays, and restrictions may apply. You've got questions and we've got answers. Don't forget to call your local HFS oce and Meridian Member Services with your new address. Visit your Member Portal or call Member Services. 0000025639 00000 n On weekends and on state or federal holidays, you may be asked to leave a message. Provider Network 6 %%EOF ATENCIN: Si habla espaol, tiene a su disposicin servicios gratuitos de asistencia lingstica. Want a paper copy? Member Handbooks and Forms Each link will open a new window and is either a PDF or a website. It explains the medical, dental, vision, and pharmacy services that are covered by your plan. It also explains how to find care and how to earn rewards. You are leaving this website to go to a website managed by a contracted company, which provides service on our behalf. You can make an appeal if you disagree with our verdict. 0000006553 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 <. Please review the various programs below. Monday-Friday, 8 a.m. to 5 p.m. CST Want a paper copy? hbbd``b`R@AH&="> $ $= @+D C[} "Fod(AE+ Click the link below to view or save a copy. 1-855-580-1689 (TTY 711) Member Handbook - Meridian Medicare Medicaid Plan Download the Member Handbook (PDF). The handbook will explain your rights, benefits, and responsibilities as a member of Meridian. A grievance is a complaint about a provider or about the quality of care or services you received. This is not a complete list. Documents and Forms - Meridian Medicare Medicaid Plan You can get this document for free in other formats, such as large print, braille, or audio. 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. 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. On weekends and on state or federal holidays, you may be asked to leave a message. 0000040481 00000 n 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)! MeridianComplete (Medicare-Medicaid Plan) is a health plan that contracts with both Medicare and Michigan Medicaid to provide benefits of both programs to enrollees. 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. Fill out the Member Notification of Pregnancy form(PDF)to let us know if you are pregnant. This way, we can connect you with the right care. 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. An appeal is a way for you to ask for a review of our actions. Llame al 1-855-580-1689 (los usuarios de TTY deben llamar al 711). You will be able to work with one health plan for all of your health insurance needs. Understanding the ins and outs of your health plan can be difficult. The Member Handbook, along with your enrollment form, serves asMeridian Medicare-Medicaid Plan's (MMP) contract with you. //