Copays for prescription drugs may vary based on the level of Extra Help you receive. If you wish to stay on this website, please click Cancel. https://www.illinois.gov/hfs/healthchoice/Pages/HealthPlans.aspx, https://www.illinois.gov/hfs/healthchoice/reportcard. Catching a Breath Complex Case Management Flu Outreach Opioids Download the free version of Adobe Reader. Call 1-855-580-1689 (TTY: 711). It also explains how to find care and how to earn rewards. Please visit our new website to see up to date information about your plan. The handbook will explain your rights, benefits, and responsibilities as a member of Meridian. Important Phone Numbers & Contacts In an Emergency 911 Meridian Member Services 866-606-3700 providerhelp.IL@mhplan.com, The Interoperability and Patient Access Rule. The call is free. Copyright 2023 Meridian All Rights Reserved. You can also visit the Illinois Client Enrollment Services website. 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. 0000041209 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. For information regarding our Pharmacy Benefit Manager (PBM), MeridianRx, visit the MeridianRx website. This site contains various MeridianComplete (Medicare-Medicaid Plan) links and resources. Under our plan, you will have one card for your Medicare and Medicaid services, including long-term services and supports and prescriptions. Your Member Handbook is a great resource if you have any questions or just want to learn more about your coverage. 167 33 0000002131 00000 n The List of Covered Drugs and/or pharmacy and provider networks may change throughout the year. This is not a complete list. You are leaving this website to go to a website managed by a contracted company, which provides service on our behalf. 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. 0000080946 00000 n The Member Handbook, along with your enrollment form, serves as Meridian Medicare-Medicaid Plan's (MMP) contract with you. If you are using a Meridian provider, you will not have to pay a plan premium, deductible, or copay. Download the Member Handbook (PDF). 0000040678 00000 n On weekends and on state or federal holidays, you may be asked to leave a message. The Provider Manual has everything you need to know about member benefits, coverage, and provider guidelines. Monday-Friday, 7:00 a.m. to 5:30 p.m. (TTY: 711) Ser vice area . This site contains various Meridian Medicare-Medicaid Plan (MMP) links and resources. We want you to be happy with your healthcare services. An appeal is a way for you to ask for a review of our actions. Call MeridianComplete at 1-855-323-4578 (TTY users should call 711), 8 a.m to 8 p.m., seven days a week. Understanding the ins and outs of your health plan can be difficult. You can get this document for free in other formats, such as large print, braille, or audio. 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. 0000041668 00000 n Want a paper copy? Your Member Handbook is a great resource if you have any questions or just want to learn more about your coverage. 0000047422 00000 n If we fall short, you can file a grievance or appeal. Your handbook is full of important information about your health care and Meridian. 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 If you have questions, please call MeridianComplete (Medicare-Medicaid Plan) Member Services at 1-855-580-1689 (TTY users should call 711). Meridian covers all counties in Illinois. Please review the various programs below. Llame al 1-855-580-1689 (los usuarios de TTY deben llamar al 711). You are leaving this website to go to a website managed by a contracted company, which provides service on our behalf. A certificate of coverage (COC) tells you what to expect from your healthcare plan. 0000067553 00000 n Your call will be returned within the next business day. See if you qualify, and explore the HealthChoice Illinois advantage. Find a doctor, explore coverage, review documents and much more. 0000021917 00000 n On weekends and on state or federal holidays, Su llamada ser devuelta dentro del siguiente da hbil. It looks like your browser does not have JavaScript enabled. You can get this document in Spanish, or speak with someone about this information in other languages for free. Complete the Member Notification of Pregnancy(PDF) form in the Member Portal. 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 wish to stay on this website, please click Cancel. The right care for you. 0000046386 00000 n 199 0 obj <>stream startxref This way, we can connect you with the right care. trailer You can also file a grievance or appeal on the phone by calling Member Services or in writing via mail or fax. 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. Each link will open a new window and is either a PDF or a website. 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. You will need Adobe Reader to open PDFs on this site. With HealthChoice Illinois, you have a health plan partner to turn to for help. Just call Member Services with your new address. 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. The benefit information is a brief summary, not a complete description of benefits. Limitations, copays, and restrictions may apply. If you wish to stay on this website, please click Cancel. Download the Member Handbook(PDF). The call is free. 0000040481 00000 n 0000046966 00000 n For a more comprehensive description of the plan benefits, please refer to your Member Handbook. Meridian Visit your Member Portal or call Member Services. This is not a complete list. 0000002074 00000 n window.location.replace("https://mmp.ilmeridian.com/member/benefits-coverage/whats-covered/member-handbook.html"); If your address changes, let us know. On weekends and on state or federal holidays, you may be asked to leave a message. For more information contact the plan or read the Meridian 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) 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. The Member Handbook, along with your enrollment form, serves as Meridian Medicare-Medicaid Plan's (MMP) contract with you. The Member Handbook, along with your enrollment form, serves asMeridian Medicare-Medicaid Plan's (MMP) contract with you. 0000017969 00000 n hKq?wNe?t!ARk;v6[IqK,h!i2jLnn}>^| ! Out-of-network/non-contracted providers are under no obligation to treat Meridian members, except in emergency situations. If you have any questions, call Meridian Member Services toll-free at 866-606-3700. Su llamada ser devuelta dentro del siguiente da hbil. 0000010510 00000 n The call is free. Out-of-network/non-contracted providers are under no obligation to treat MeridianComplete members, except in emergency situations. 2021 Member Handbook Illinois Counties: Cook, DuPage, Kane, Kankakee, Lake, Will . 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. You are leaving this website to go to a website managed by a contracted company, which provides service on our behalf. 0000001774 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. On weekends and on state or federal holidays, you may be asked to leave a message. 2023 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. You will need Adobe Reader to open PDFs on this site. 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)! For more information contact the plan or read the MeridianComplete Member Handbook. You will need Adobe Reader to open PDFs on this site. // . 0000067354 00000 n Making healthcare decisions can be tough--who to see for care, what to ask, when to go. The benefit information is a brief summary, not a complete description of benefits. The call is free. On weekends and on state or federal holidays, you may be asked to leave a message. Representatives are available Monday-Friday, 8 a.m. to 8 p.m. to assist you. Meridian Meridian will work with you to make sure you get all of the care you need, when you need it. It will help you get the care you need. You will need Adobe Reader to open PDFs on this site. 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. With our Medicare-Medicaid Plan (MMP) youre getting: An assigned care manager to help answer questions and coordinate your care. Youll tell us about any health conditions, recent hospital visits, medications, and more. Each link will open a new window and is either a PDF or a website. Looking for your plan home page or interested in becoming a member? View our Frequently Asked Questions page. 0 Call, Usted puede obtener gratuitamente este documento en espaol o hablar con alguien sobre esta informacin en otros idiomas. More information is in your Member Handbook(PDF). 0000014634 00000 n We need to be able to send you important information in the mail. 0000046799 00000 n The COC lays out all the details so that you can stay on top of your coverage. Starting January 1, 2018, the Illinois Medicaid Managed Care Program is expanding to include all 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 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. The benefit information is a brief summary, not a complete description of benefits. You've got questions and we've got answers. Monday-Friday, 8 a.m. to 8 p.m. CST This is not a complete list. You can get this document for free in other formats, such as large print, braille, or audio. 0000002220 00000 n h|kPQevkmNRIDrDI-)Vw*DYS7cgcr!349g3. 0000025639 00000 n With HealthChoice Illinois, you have a health plan partner to turn to for help. 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. You are now able to view your health information from a third-party app on a mobile device or PC! Download the Member Handbook (PDF). 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 <. hbbd``b`R@AH&="> $ $= @+D C[} "Fod(AE+ We want you to be happy with the treatment and services you get from Meridian and our providers. 0000072727 00000 n ATENCIN: Si habla espaol, tiene a su disposicin servicios gratuitos de asistencia lingstica. You will be able to work with one health plan for all of your health insurance needs. Your Member Handbook is a great resource if you have any questions or just want to learn more about your coverage. v4P+r-k E`:8\TV%F1MeLT=LyMit+GYrUn*mH gp`x Y;EgPCSSphf>op!mOQtkC v^K#x" The handbook will explain your rights, benefits, and responsibilities as a member of Meridian. Open Enrollment 6. 0000151745 00000 n 866-606-3700 . It also explains how to find care and how to earn rewards. Don't forget to call your local HFS oce and Meridian Member Services with your new address. You can also visit the Illinois Client Enrollment Services website. With added benefits like support making smart health choices, personal care coordination, 24-hour nursing help line, and more. At the right time and place. Your call will be returned within the next business day. You also need to make sure that the Department of Healthcare & Family Services (HFS) has your new address. 167 0 obj <> endobj Meridian is for people eligible for both Medicaid and Medicare. 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. You can make an appeal if you disagree with our verdict. 1-855-580-1689 (TTY 711) Provider Network 6 The Health Library is a free resource exclusively for MeridianComplete members and providers. 0000001708 00000 n Please contact the plan for more details. 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. Su llamada ser devuelta dentro del siguiente da hbil. La llamada es gratis. 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. 0000000016 00000 n member.ILmeridian.com. 0000025980 00000 n 0000068208 00000 n Call 1-855-580-1689 (TTY: 711). Want a paper copy? This handbook will help you understand your coverage. endstream endobj startxref 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. The call is free. %PDF-1.7 % We will send you a notice before we make a change that affects you. If you experience any problems receiving your mail order prescription, call Member Services at. Representatives are available Monday-Friday, 8 a.m. to 8 p.m. to assist you. 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.

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