meridian illinois member handbook

It also explains how to find care and how to earn rewards. 0000025639 00000 n Meridian Member Services . More information is in your Member Handbook(PDF). We are excited to share that MeridianCare, a WellCare company, is changing its name to WellCare, effective January 1, 2020! Your Member Handbook is a great resource if you have any questions or just want to learn more about your coverage. Meridian Medicare Medicaid Plan 167 33 +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 The benefit information is a brief summary, not a complete description of benefits. 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. The Health Library is a free resource exclusively for MeridianComplete members and providers. Don't forget to call your local HFS oce and Meridian Member Services with your new address. Meridian Member Handbook | Meridian Complete of Illinois Our Population Health Management Programs are offered to Meridian members and designed to improve your overall health and quality of care. Each link will open a new window and is either a PDF or a website. Click the link below to view or save a copy. You can get this document for free in other formats, such as large print, braille, or audio. On weekends and on state or federal holidays, you may be asked to leave a message. If your address changes, let us know. Meridian covers all counties in Illinois. Monday-Friday, 8 a.m. to 5 p.m. CST 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)! Llame al 1-855-580-1689 (los usuarios de TTY deben llamar al 711). Meridian will work with you to make sure you get all of the care you need, when you need it. 0000046386 00000 n 199 0 obj <>stream member.ILmeridian.com. 0000001708 00000 n If you wish to stay on this website, please click Cancel. Other pharmacies/physicians/providers are available in our network. For more information contact the plan or read the Meridian Member Handbook. Copyright 2023 Meridian All Rights Reserved. You are leaving this website to go to a website managed by a contracted company, which provides service on our behalf. providerhelp.IL@mhplan.com. A grievance is a complaint about a provider or about the quality of care or services you received. Other pharmacies/physicians/providers are available in our network. It also explains how to find care and how to earn rewards. Download the free version of Adobe Reader. 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. For more information contact the plan or read the MeridianComplete Member Handbook. This handbook will help you understand your coverage. Learn more about how being a Meridian provider benefits you. PDF here's your member handbook. Catching a Breath Complex Case Management Flu Outreach Opioids Out-of-network/non-contracted providers are under no obligation to treat Meridian members, except in emergency situations. 167 0 obj <> endobj window.location.replace("https://mmp.ilmeridian.com/member/benefits-coverage/whats-covered/member-handbook.html"); 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. Other pharmacies/physicians/providers are available in our network. You can make an appeal if you disagree with our verdict. The handbook will explain your rights, benefits, and responsibilities as a member of Meridian. The call is free. It will also explain our responsibilities to you, as well as outline the following details: 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. Representatives are available Monday-Friday, 8 a.m. to 8 p.m. to assist you. For example, we may not approve your providers request for a certain drug. Su llamada ser devuelta dentro del siguiente da hbil. Find a doctor, explore coverage, review documents and much more. The List of Covered Drugs and/or pharmacy and provider networks may change throughout the year. 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. Making healthcare decisions can be tough--who to see for care, what to ask, when to go. The call is free. Copays for prescription drugs may vary based on the level of Extra Help you receive. You can get this document for free in other formats, such as large print, braille, or audio. If you wish to stay on this website, please click Cancel. 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. Check out the Interoperability page to learn more. 0000041668 00000 n Your call will be returned within the next business day. The COC lays out all the details so that you can stay on top of your coverage. 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. You can also file a grievance or appeal on the phone by calling Member Services or in writing via mail or fax. 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) Material ID:H6080_WEBSITE_2023_Accepted_09282022. The benefit information is a brief summary, not a complete description of benefits. MeridianHealth is now Meridian! Monday-Friday, 8 a.m. to 8 p.m. CST It looks like your browser does not have JavaScript enabled. The call is free. Call Member Services if youd like paper copies of any of these documents. trailer 0000046966 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. 0000067354 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. 2369 0 obj <> endobj You will need Adobe Reader to open PDFs on this site. 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. HFS sends paperwork in the mail that you need to renew your Medicaid coverage. 2023 0000041585 00000 n You can also visit the Illinois Client Enrollment Services website. An appeal is a way for you to ask for a review of our actions. The call is free. Representatives are available Monday-Friday, 8 a.m. to 8 p.m. to assist you. La llamada es gratis. You can get this document in Spanish, or speak with someone about this information in other languages for free. 0000002131 00000 n When you go to file, youll want to write when and where the incident took place, and what happened. We need to be able to send you important information in the mail. Understanding the ins and outs of your health plan can be difficult. You will need Adobe Reader to open PDFs on this site. If you wish to stay on this website, please click Cancel. Su llamada ser devuelta dentro del siguiente da hbil. Monday-Friday, 7:00 a.m. to 5:30 p.m. (TTY: 711) Ser vice area . A certificate of coverage (COC) tells you what to expect from your healthcare plan. With our Medicare-Medicaid Plan (MMP) youre getting: An assigned care manager to help answer questions and coordinate your care. 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. We want you to be happy with your healthcare services. %%EOF You can get this document for free in other formats, such as large print, braille, or audio. Out-of-network/non-contracted providers are under no obligation to treat Meridian members, except in emergency situations. Su llamada ser devuelta dentro del siguiente da hbil. View your Provider Manual, important plan information and more. Documents and Forms - Meridian Medicare Medicaid Plan 2021 Member Handbook Illinois Counties: Cook, DuPage, Kane, Kankakee, Lake, Will . This site contains various Meridian Medicare-Medicaid Plan (MMP) links and resources. This site contains various MeridianComplete (Medicare-Medicaid Plan) links and resources. All Rights Reserved. You've got questions and we've got answers. 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. 866-606-3700 . hbbd``b`R@AH&="> $ $= @+D C[} "Fod(AE+ 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. Member ID Cards 5. The Provider Manual has everything you need to know about member benefits, coverage, and provider guidelines. 0000000016 00000 n Report an address update to HFS online. 0000002220 00000 n 0000000956 00000 n It outlines services and benefits that areand are notcovered. 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. Provider Manual | Meridian Health Plan of Illinois Please turn on JavaScript and try again. Llame al 1-855-580-1689 (los usuarios de TTY deben llamar al 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. 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. View our Frequently Asked Questions page. Please visit our new website to see up to date information about your plan. Usually a mail-order pharmacy order will get to you in no more than 5 days. With added benefitslike supportmakingsmart health choices, personal care coordination, 24-hour nursing help line, and more. It explains the medical, dental, vision, and pharmacy services that are covered by your plan. // Its full of tips and resources for pregnant members and new parents. For more information contact the plan or read the Meridian Member Handbook. Want a paper copy? Meridian is for people eligible for both Medicaid and Medicare. xref PDF ILLINOIS MEMBER HANDBOOK - Meridian Illinois Managed Care Plans The Member Handbook, along with your enrollment form, serves asMeridian Medicare-Medicaid Plan's (MMP) contract with you. Keep in mind that everything you choose to share is confidential. 0000001774 00000 n 0000014634 00000 n Download the Member Handbook(PDF). 0000068680 00000 n Call 1-855-580-1689 (TTY: 711). %PDF-1.4 % It explains the medical, dental, vision, and pharmacy services that are covered by your plan. It will help you get the care you need. Each link will open a new window and is either a PDF or a website. The Member Handbook, along with your enrollment form, serves as Meridian Medicare-Medicaid Plan's (MMP) contract with you. On weekends and on state or federal holidays, you may be asked to leave a message.

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