Your call will be returned within the next business day. Monday-Friday, 7:00 a.m. to 5:30 p.m. (TTY: 711) Ser vice area . You can get this document for free in other formats, such as large print, braille, or audio. Learn more about how being a Meridian provider benefits you. 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. MeridianHealth is now Meridian! With our Medicare-Medicaid Plan (MMP) youre getting: An assigned care manager to help answer questions and coordinate your care. Looking for your plan home page or interested in becoming a member?
For example, we may not approve your providers request for a certain drug. Each link will open a new window and is either a PDF or a website. Other pharmacies/physicians/providers are available in our network. PDF <DATE> Program called HealthChoice Illinois . We have been working hard The benefit information is a brief summary, not a complete description of benefits. 0000046386 00000 n
The call is free. %PDF-1.7
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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. 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) Monday-Friday, 8 a.m. to 5 p.m. CST 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. A grievance is a complaint about a provider or about the quality of care or services you received. You will be able to work with one health plan for all of your health insurance needs. You are leaving this website to go to a website managed by a contracted company, which provides service on our behalf. You also need to make sure that the Department of Healthcare & Family Services (HFS) has your new address. This site contains various MeridianComplete (Medicare-Medicaid Plan) links and resources. 3. providerhelp.IL@mhplan.com, The Interoperability and Patient Access Rule. 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, Prior Authorization, Step Therapy and Quantity Limits, Coverage Determinations and Redeterminations for Drugs, Illinois Client Enrollment Services website, Language Assistance & Notice of Nondiscrimination. All Rights Reserved. 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. 2021 Member Handbook Illinois Counties: Cook, DuPage, Kane, Kankakee, Lake, Will . Want a paper copy? 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. Prior Authorization, Step Therapy and Quantity Limits, Coverage Determinations and Redeterminations for Drugs, Notice of Nondiscrimination & Language Assistance. MeridianComplete (Medicare-Medicaid Plan) is a health plan that contracts with both Medicare and Michigan Medicaid to provide benefits of both programs to enrollees. For information regarding our Pharmacy Benefit Manager (PBM), MeridianRx, visit the MeridianRx website. Want a paper copy? 1-855-580-1689 (TTY 711) This is not a complete list. With added benefitslike supportmakingsmart health choices, personal care coordination, 24-hour nursing help line, and more. +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
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Please contact the plan for more details. 866-606-3700 . Your call will be returned within the next business day. The handbook will explain your rights, benefits, and responsibilities as a member of Meridian. HealthChoice Illinois | HFS Representatives are available Monday-Friday, 8 a.m. to 8 p.m. to assist you. At the right time and place. All Rights Reserved. Other pharmacies/physicians/providers are available in our network. Download the Member Handbook (PDF). 0000067553 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. HFS sends paperwork in the mail that you need to renew your Medicaid coverage. It explains the medical, dental, vision, and pharmacy services that are covered by your plan. Monday-Friday, 8 a.m. to 8 p.m. CST The handbook will explain your rights, benefits, and responsibilities as a member of Meridian. If we fall short, you can file a grievance or appeal. Meridian is for people eligible for both Medicaid and Medicare. You will need Adobe Reader to open PDFs on this site. Important Phone Numbers & Contacts In an Emergency 911 Meridian Member Services 866-606-3700 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. For more information contact the plan or read the MeridianComplete Member Handbook. 1-855-580-1689 (TTY 711) PDF here's your member handbook. 0000067354 00000 n
La llamada es gratis. 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. JB Pritzker, Governor Theresa Eagleson, Director. If your address changes, let us know. 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. 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. La llamada es gratis. 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. Fill out the Member Notification of Pregnancy form(PDF)to let us know if you are pregnant. If your pregnancy is at high risk, we may call you. Meridian Medicare Medicaid Plan 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. 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. 2022 Provider Manual (PDF) Meridian Provider Manual Errata Sheet (PDF) Documents and Forms Medical Referrals & Authorizations Pharmacy Billing Mandatory Training Attestation Download the Member Handbook (PDF). 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. 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 1-855-580-1689 (TTY: 711) or visit mmp.ILmeridian.com to access our online searchable directory. The call is free. Provider Manual | Meridian Health Plan of Illinois hbbd``b`R@AH&="> $ $= @+D C[} "Fod(AE+
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ATTENTION: If you speak a language other than English, language assistance services, free of charge, are available to you. 167 33
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Meridian covers all counties in Illinois. Member Handbook | Meridian Complete of Illinois 0000002177 00000 n
Material ID:H6080_WEBSITE_2023_Accepted_09282022. You can also visit the Illinois Client Enrollment Services website. Representatives are available Monday-Friday, 8 a.m. to 8 p.m. to assist you. We need to be able to send you important information in the mail. Keep in mind that everything you choose to share is confidential. 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. We can connect you with support, services, and even rewards. On weekends and on state or federal holidays, The Member Handbook, along with your enrollment form, serves as Meridian Medicare-Medicaid Plan's (MMP) contract with you. 0000001708 00000 n
Please review the various programs below. 0
We want you to be happy with the treatment and services you get from Meridian and our providers. Don't forget to call your local HFS oce and Meridian Member Services with your new address. It will also explain our responsibilities to you, as well as outline the following details: 2500 0 obj
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The call is free. 0000046576 00000 n
Each link will open a new window and is either a PDF or a website. member.ILmeridian.com. 2023
Making healthcare decisions can be tough--who to see for care, what to ask, when to go. 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. We are excited to share that MeridianCare, a WellCare company, is changing its name to WellCare, effective January 1, 2020! Starting January 1, 2018, the Illinois Medicaid Managed Care Program is expanding to include all Just call Member Services with your new address. Su llamada ser devuelta dentro del siguiente da hbil. You can make an appeal if you disagree with our verdict. This site contains various Meridian Medicare-Medicaid Plan (MMP) links and resources. You will need Adobe Reader to open PDFs on this site. For certain kinds of drugs, you can use the plans network mail-order services. Call MeridianComplete at 1-855-323-4578 (TTY users should call 711), 8 a.m to 8 p.m., seven days a week. 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. hKq?wNe?t!ARk;v6[IqK,h!i2jLnn}>^| ! The handbook will explain your rights, benefits, and responsibilities as a member of Meridian. %%EOF
Other pharmacies/physicians/providers are available in our network. Visit your Member Portal or call Member Services. Call 1-855-580-1689 (TTY: 711). Your call will be returned within the next business day. Representatives are available Monday-Friday, 8 a.m. to 8 p.m. to assist you. 0000000956 00000 n
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providerhelp.IL@mhplan.com. Download the Member Handbook(PDF). 0000151745 00000 n
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. You can also file a grievance or appeal on the phone by calling Member Services or in writing via mail or fax. If you wish to stay on this website, please click Cancel. 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. You can get this document for free in other formats, such as large print, braille, or audio. 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. If you experience any problems receiving your mail order prescription, call Member Services at. 0000025639 00000 n
(los usuarios de TTY deben llamar al 711), lunes a domingo, de 8 a.m. a 8 p.m. La llamada es gratuita. 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.
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