meridian illinois member handbook

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. You can make an appeal if you disagree with our verdict. Your call will be returned within the next business day. All Rights Reserved. 0000002041 00000 n 0000041585 00000 n 2369 0 obj <> endobj Our Population Health Management Programs are offered to Meridian members and designed to improve your overall health and quality of care. We are excited to share that MeridianCare, a WellCare company, is changing its name to WellCare, effective January 1, 2020! 866-606-3700 . 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. 167 33 0000041668 00000 n 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. You can get this document for free in other formats, such as large print, braille, or audio. You can get this document for free in other formats, such as large print, braille, or audio. 0000014634 00000 n Your call will be returned within the next business day. 0000000956 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. Please contact the plan for more details. The Health Library is a free resource exclusively for MeridianComplete members and providers. Download the Member Handbook (PDF). Keep in mind that everything you choose to share is confidential. If you experience any problems receiving your mail order prescription, call Member Services at. (los usuarios de TTY deben llamar al 711), lunes a domingo, de 8 a.m. a 8 p.m. La llamada es gratuita. 0000046386 00000 n The handbook will explain your rights, benefits, and responsibilities as a member of Meridian. 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! 0000040678 00000 n Your Member Handbook is a great resource if you have any questions or just want to learn more about your coverage. Provider Network 6 If you wish to stay on this website, please click Cancel. Open Enrollment 6. Youll tell us about any health conditions, recent hospital visits, medications, and more. 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 your pregnancy is at high risk, we may call you. 0000068680 00000 n Language Assistance & Notice of Nondiscrimination. If your address changes, let us know. Representatives are available Monday-Friday, 8 a.m. to 8 p.m. to assist you. %PDF-1.4 % Other pharmacies/physicians/providers are available in our network. Call MeridianComplete at 1-855-323-4578 (TTY users should call 711), 8 a.m to 8 p.m., seven days a week. 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. You will need Adobe Reader to open PDFs on this site. Member ID Cards 5. 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. 199 0 obj <>stream You can also file a grievance or appeal on the phone by calling Member Services or in writing via mail or fax. Want a paper copy? Each link will open a new window and is either a PDF or a website. Complete the Member Notification of Pregnancy(PDF) form in the Member Portal. endstream endobj startxref 0000002220 00000 n Learn more about how being a Meridian provider benefits you. 0 The Member Handbook, along with your enrollment form, serves as Meridian Medicare-Medicaid Plan's (MMP) contract with you. La llamada es gratis. Each link will open a new window and is either a PDF or a website. For a more comprehensive description of the plan benefits, please refer to your Member Handbook. Out-of-network/non-contracted providers are under no obligation to treat MeridianComplete members, except in emergency situations. Making healthcare decisions can be tough--who to see for care, what to ask, when to go. Under our plan, you will have one card for your Medicare and Medicaid services, including long-term services and supports and prescriptions. For more information, call MeridianComplete Member Services or read the MeridianComplete Member Handbook. We are excited to share that MeridianCare, a WellCare company, is changing its name to WellCare, effective January 1, 2020! Meridian will help make your Medicare and Medicaid benefits work better together and work better for 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. Catching a Breath Complex Case Management Flu Outreach Opioids Limitations, copays, and restrictions may apply. // ^| ! 0000072727 00000 n For certain kinds of drugs, you can use the plans network mail-order services. 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. 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. It will also explain our responsibilities to you, as well as outline the following details: 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. Check out the Interoperability page to learn more. Download the Member Handbook(PDF). It will help you get the care you need. 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. Monday-Friday, 8 a.m. to 8 p.m. CST Download the Member Handbook (PDF). 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. If you are using a Meridian provider, you will not have to pay a plan premium, deductible, or copay. Each link will open a new window and is either a PDF or a website. The Personal Wellness Assessment is a short form about you and your health journey. MeridianComplete (Medicare-Medicaid Plan) is a health plan that contracts with both Medicare and Michigan Medicaid to provide benefits of both programs to enrollees. Usually a mail-order pharmacy order will get to you in no more than 5 days. A grievance is a complaint about a provider or about the quality of care or services you received. The handbook will explain your rights, benefits, and responsibilities as a member of Meridian. HFS sends paperwork in the mail that you need to renew your Medicaid coverage. You can also visit the Illinois Client Enrollment Services website. Click the link below to view or save a copy. View your Provider Manual, important plan information 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. 3. The Member Handbook, along with your enrollment form, serves as Meridian Medicare-Medicaid Plan's (MMP) contract with you. You are leaving this website to go to a website managed by a contracted company, which provides service on our behalf. 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. If you wish to stay on this website, please click Cancel. Please turn on JavaScript and try again. The call is free. The right care for you. 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. You are leaving this website to go to a website managed by a contracted company, which provides service on our behalf. For more information contact the plan or read the MeridianComplete Member Handbook. 0000000016 00000 n trailer 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. 0000046799 00000 n Llame al. We will send you a notice before we make a change that affects you. Important Phone Numbers & Contacts In an Emergency 911 Meridian Member Services 866-606-3700 Meridian All Rights Reserved. On weekends and on state or federal holidays, you may be asked to leave a message. 167 0 obj <> endobj Its full of tips and resources for pregnant members and new parents. Llame al 1-855-580-1689 (los usuarios de TTY deben llamar al 711). It explains the medical, dental, vision, and pharmacy services that are covered by your plan. 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) Making healthcare decisions can be tough--who to see for care, what to ask, when to go. 1-855-580-1689 (TTY 711) 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. Your call will be returned within the next business day. We want you to be happy with your healthcare services. 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. xref With added benefits like support making smart health choices, personal care coordination, 24-hour nursing help line, and more. With our Medicare-Medicaid Plan (MMP) youre getting: An assigned care manager to help answer questions and coordinate your care. On weekends and on state or federal holidays, 2023 For information regarding our Pharmacy Benefit Manager (PBM), MeridianRx, visit the MeridianRx website. Other pharmacies/physicians/providers are available in our network. Just call Member Services with your new address. 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. You can join our Start Smart for Your Baby program. 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. 2022 Provider Manual (PDF) Meridian Provider Manual Errata Sheet (PDF) Documents and Forms Medical Referrals & Authorizations Pharmacy Billing Mandatory Training Attestation Representatives are available Monday-Friday, 8 a.m. to 8 p.m. to assist you. Call, Usted puede obtener gratuitamente este documento en espaol o hablar con alguien sobre esta informacin en otros idiomas. You are leaving this website to go to a website managed by a contracted company, which provides service on our behalf. %%EOF You will be able to work with one health plan for all of your health insurance needs. We can connect you with support, services, and even rewards. With HealthChoice Illinois, you have a health plan partner to turn to for help. 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.

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