You can join our Start Smart for Your Baby program. The benefit information is a brief summary, not a complete description of benefits. Provider Network 6 It explains the medical, dental, vision, and pharmacy services that are covered by your plan. 2023 2021 Member Handbook Illinois Counties: Cook, DuPage, Kane, Kankakee, Lake, Will . La llamada es gratis. 0 0000000956 00000 n ATENCIN: Si habla espaol, tiene a su disposicin servicios gratuitos de asistencia lingstica. Its full of tips and resources for pregnant members and new parents. You can also visit the Illinois Client Enrollment Services website. If you are using a Meridian provider, you will not have to pay a plan premium, deductible, or copay. If you wish to stay on this website, please click Cancel. PDF here's your member handbook. For more information, or to find out how to get enrolled, please contact Meridian at 888-437-0606. We need to be able to send you important information in the mail. 2023 Limitations, copays, and restrictions may apply. MeridianComplete (Medicare-Medicaid Plan) is a health plan that contracts with both Medicare and Michigan Medicaid to provide benefits of both programs to enrollees. Visit your Member Portal or call Member Services. Download the free version of Adobe Reader. Check out the Interoperability page to learn more. View our Frequently Asked Questions page. Be sure to read your Meridian Member Handbook and keep it handy. %PDF-1.7 % 0000041209 00000 n You also need to make sure that the Department of Healthcare & Family Services (HFS) has your new address. Please contact the plan for more details. 0000021917 00000 n Learn more about how being a Meridian provider benefits you. PDF 2021 Member Handbook - Meridian Medicare Medicaid Plan HealthChoice Illinois | HFS This site contains various MeridianComplete (Medicare-Medicaid Plan) links and resources. Providers - MeridianComplete 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 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)! 2022 Provider Manual (PDF) Meridian Provider Manual Errata Sheet (PDF) Documents and Forms Medical Referrals & Authorizations Pharmacy Billing Mandatory Training Attestation Your Member Handbook is a great resource if you have any questions or just want to learn more about your coverage. Please turn on JavaScript and try again. 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. 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. [CDATA[ %%EOF It also explains how to find care and how to earn rewards. If you have any questions, call Meridian Member Services toll-free at 866-606-3700. The Member Handbook, along with your enrollment form, serves as Meridian Medicare-Medicaid Plan's (MMP) contract with you. MeridianHealth is now Meridian! 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. providerhelp.IL@mhplan.com. This site contains various Meridian Medicare-Medicaid Plan (MMP) links and resources. For information regarding our Pharmacy Benefit Manager (PBM), MeridianRx, visit the MeridianRx website. 0000010510 00000 n 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. Your call will be returned within the next business day. 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 <. For example, we may not approve your providers request for a certain drug. 167 33 1-855-580-1689 (TTY 711) 0000000016 00000 n 0000047422 00000 n Call 1-855-580-1689 (TTY: 711). 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. PDF <DATE> Program called HealthChoice Illinois . We have been working hard 0000025980 00000 n 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! Report an address update to HFS online. Member Handbook - Meridian Medicare Medicaid Plan 0000151745 00000 n On weekends and on state or federal holidays, 0000080946 00000 n We want you to be happy with your healthcare services. It explains the medical, dental, vision, and pharmacy services that are covered by your plan. Documents and Forms - Meridian Medicare Medicaid Plan The handbook will explain your rights, benefits, and responsibilities as a member of Meridian. +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 Copyright 2023 Meridian All Rights Reserved. If you wish to stay on this website, please click Cancel. 0000002074 00000 n On weekends and on state or federal holidays, you may be asked to leave a message. The handbook will explain your rights, benefits, and responsibilities as a member of Meridian. trailer For more information contact the plan or read the MeridianComplete Member Handbook. ATENCIN: Si habla espaol, tiene a su disposicin servicios gratuitos de asistencia lingstica. 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. 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. 0000001774 00000 n You are leaving this website to go to a website managed by a contracted company, which provides service on our behalf. At the right time and place. The benefit information is a brief summary, not a complete description of benefits. You will need Adobe Reader to open PDFs on this site. 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. Starting January 1, 2018, the Illinois Medicaid Managed Care Program is expanding to include all Your call will be returned within the next business day. Download the Member Handbook (PDF). The handbook will explain your rights, benefits, and responsibilities as a member of Meridian. An appeal is a way for you to ask for a review of our actions. 3. Making healthcare decisions can be tough--who to see for care, what to ask, when to go. More information is in your Member Handbook(PDF). https://www.illinois.gov/hfs/healthchoice/Pages/HealthPlans.aspx, https://www.illinois.gov/hfs/healthchoice/reportcard. Our Population Health Management Programs are offered to Meridian members and designed to improve your overall health and quality of care. Complete the Member Notification of Pregnancy(PDF) form in the Member Portal. You can make an appeal if you disagree with our verdict. The call is free. 199 0 obj <>stream Su llamada ser devuelta dentro del siguiente da hbil. 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. Meridian Other pharmacies/physicians/providers are available in our network. With HealthChoice Illinois, you have a health plan partner to turn to for help. 0000002131 00000 n Fill out the Member Notification of Pregnancy form(PDF)to let us know if you are pregnant. On weekends and on state or federal holidays, you may be asked to leave a message. Monday-Friday, 8 a.m. to 5 p.m. CST Meridian is for people eligible for both Medicaid and Medicare. The Member Handbook, along with your enrollment form, serves as Meridian Medicare-Medicaid Plan's (MMP) contract with you. We are excited to share that MeridianCare, a WellCare company, is changing its name to WellCare, effective January 1, 2020! 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. %PDF-1.4 % It also explains how to find care and how to earn rewards. Su llamada ser devuelta dentro del siguiente da hbil. 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. 1-855-580-1689 (TTY 711) Language Assistance & Notice of Nondiscrimination. All Rights Reserved. The right care for you. 0000041585 00000 n For more information contact the plan or read the Meridian Member Handbook. If your address changes, let us know. 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. 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 1-855-580-1689 (TTY: 711) or visit mmp.ILmeridian.com to access our online searchable directory. 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. Your call will be returned within the next business day. With added benefits like support making smart health choices, personal care coordination, 24-hour nursing help line, and more. On weekends and on state or federal holidays, you may be asked to leave a message. Your call will be returned within the next business day. This is not a complete list. With added benefitslike supportmakingsmart health choices, personal care coordination, 24-hour nursing help line, and more. The benefit information is a brief summary, not a complete description of benefits. PDF ILLINOIS MEMBER HANDBOOK - Meridian Illinois Managed Care Plans A grievance is a complaint about a provider or about the quality of care or services you received. 0000068680 00000 n Each link will open a new window and is either a PDF or a website. The call is free. If you have questions, please call MeridianComplete (Medicare-Medicaid Plan) Member Services at 1-855-580-1689 (TTY users should call 711). 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. A certificate of coverage (COC) tells you what to expect from your healthcare plan. We can connect you with support, services, and even rewards. JB Pritzker, Governor Theresa Eagleson, Director. Member Handbook | Meridian Health Plan of Illinois It explains the medical, dental, vision, and pharmacy services that are covered by your plan. 0000017969 00000 n All Rights Reserved. Catching a Breath Complex Case Management Flu Outreach Opioids It will help you get the care you need. On weekends and on state or federal holidays, you may be asked to leave a message. 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. HealthChoice Illinois is the smart way most Medicaid members get quality care. ATTENTION: If you speak a language other than English, language assistance services, free of charge, are available to you. Your handbook is full of important information about your health care and Meridian. (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. If you wish to stay on this website, please click Cancel. Each link will open a new window and is either a PDF or a website. 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. You will need Adobe Reader to open PDFs on this site. Making healthcare decisions can be tough--who to see for care, what to ask, when to go. 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. Call, Usted puede obtener gratuitamente este documento en espaol o hablar con alguien sobre esta informacin en otros idiomas. Your Member Handbook is a great resource if you have any questions or just want to learn more about your coverage. Your call will be returned within the next business day. 0000068208 00000 n 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. For more information contact the plan or read the Meridian Member Handbook. // Provider Manual | Meridian Health Plan of Illinois HFS sends paperwork in the mail that you need to renew your Medicaid coverage. The call is free. Don't forget to call your local HFS oce and Meridian Member Services with your new address. Material ID:H6080_WEBSITE_2023_Accepted_09282022. Material ID:H6080_WEBSITE_2023_Accepted_09282022. The benefit information is a brief summary, not a complete description of benefits. If we fall short, you can file a grievance or appeal. 1-855-580-1689 (TTY 711) 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. hbbd``b`R@AH&="> $ $= @+D C[} "Fod(AE+ You can get this document for free in other formats, such as large print, braille, or audio. xref // ]]>. 2500 0 obj <>stream 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. Want a paper copy? You will need Adobe Reader to open PDFs on this site. For more information, call MeridianComplete Member Services or read the MeridianComplete Member Handbook. 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) 0000001708 00000 n For a more comprehensive description of the plan benefits, please refer to your Member Handbook which can also be found on this page. See if you qualify, and explore the HealthChoice Illinois advantage. Call 1-855-580-1689 (TTY: 711). The call is free. %%EOF startxref 0000046576 00000 n 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. Member ID Cards 5. The Member Handbook, along with your enrollment form, serves asMeridian Medicare-Medicaid Plan's (MMP) contract with you. 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. Other pharmacies/physicians/providers are available in our network. 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. Representatives are available Monday-Friday, 8 a.m. to 8 p.m. to assist you. Click the link below to view or save a copy. The COC lays out all the details so that you can stay on top of your coverage. 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. <<0B5A082EC79D7049BD46C1656B63CA22>]/Prev 539953>> View your Provider Manual, important plan information and more. 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meridian illinois member handbook