%%EOF We will send you a notice before we make a change that affects you. See if you qualify, and explore the HealthChoice Illinois advantage. https://www.illinois.gov/hfs/healthchoice/Pages/HealthPlans.aspx, https://www.illinois.gov/hfs/healthchoice/reportcard. It will help you get the care you need. You are leaving this website to go to a website managed by a contracted company, which provides service on our behalf. The Member Handbook, along with your enrollment form, serves asMeridian Medicare-Medicaid Plan's (MMP) contract with you. 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. %PDF-1.4 % 0000040678 00000 n Want a paper copy? The call is free. Your Member Handbook is a great resource if you have any questions or just want to learn more about your coverage. endstream endobj startxref On weekends and on state or federal holidays, you may be asked to leave a message. A certificate of coverage (COC) tells you what to expect from your healthcare plan. Check out the Interoperability page to learn more. If you wish to stay on this website, please click Cancel. Llame al 1-855-580-1689 (los usuarios de TTY deben llamar al 711). ATENCIN: Si habla espaol, tiene a su disposicin servicios gratuitos de asistencia lingstica. It will also explain our responsibilities to you, as well as outline the following details: The List of Covered Drugs and/or pharmacy and provider networks may change throughout the year. It looks like your browser does not have JavaScript enabled. startxref 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 are excited to share that MeridianCare, a WellCare company, is changing its name to WellCare, effective January 1, 2020! You can get this document for free in other formats, such as large print, braille, or audio. 0000080946 00000 n View our Frequently Asked Questions page. Your call will be returned within the next business day. The Member Handbook, along with your enrollment form, serves as Meridian Medicare-Medicaid Plan's (MMP) contract with you. 2021 Member Handbook Illinois Counties: Cook, DuPage, Kane, Kankakee, Lake, Will . Llame al. 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. 2500 0 obj <>stream 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. 0000000956 00000 n Your call will be returned within the next business day. ATENCIN: Si habla espaol, tiene a su disposicin servicios gratuitos de asistencia lingstica. You are leaving this website to go to a website managed by a contracted company, which provides service on our behalf. Your call will be returned within the next business day. 0000025980 00000 n This is not a complete list. 0000041668 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. With added benefits like support making smart health choices, personal care coordination, 24-hour nursing help line, and more. 1-855-580-1689 (TTY 711) MeridianHealth is now Meridian! 2369 0 obj <> endobj 0000067553 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. Don't forget to call your local HFS oce and Meridian Member Services with your new address. 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. 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. Out-of-network/non-contracted providers are under no obligation to treat MeridianComplete members, except in emergency situations. 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. Your Member Handbook is a great resource if you have any questions or just want to learn more about your coverage. 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 leaving this website to go to a website managed by a contracted company, which provides service on our behalf. Call, Usted puede obtener gratuitamente este documento en espaol o hablar con alguien sobre esta informacin en otros idiomas. Learn more about how being a Meridian provider benefits you. v4P+r-k E`:8\TV%F1MeLT=LyMit+GYrUn*mH gp`x Y;EgPCSSphf>op!mOQtkC v^K#x" Understanding the ins and outs of your health plan can be difficult. Su llamada ser devuelta dentro del siguiente da hbil. ATENCIN: Si habla espaol, tiene a su disposicin servicios gratuitos de asistencia lingstica. 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 providerhelp.IL@mhplan.com, The Interoperability and Patient Access Rule. This site contains various MeridianComplete (Medicare-Medicaid Plan) links and resources. 0000041585 00000 n 0000001708 00000 n La llamada es gratis. You can also file a grievance or appeal on the phone by calling Member Services or in writing via mail or fax. If you have any questions, call Meridian Member Services toll-free at 866-606-3700. Each link will open a new window and is either a PDF or a website. This handbook will help you understand your coverage. Please review the various programs below. If you have questions, please call MeridianComplete (Medicare-Medicaid Plan) Member Services at 1-855-580-1689 (TTY users should call 711). Monday-Friday, 7:00 a.m. to 5:30 p.m. (TTY: 711) Ser vice area . 2022 Provider Manual (PDF) Meridian Provider Manual Errata Sheet (PDF) Documents and Forms Medical Referrals & Authorizations Pharmacy Billing Mandatory Training Attestation Your handbook is full of important information about your health care and Meridian. Find a doctor, explore coverage, review documents and much more. You will need Adobe Reader to open PDFs on this site. 199 0 obj <>stream For more information contact the plan or read the MeridianComplete Member Handbook. Want a paper copy? This is not a complete list. Other pharmacies/physicians/providers are available in our network. hKq?wNe?t!ARk;v6[IqK,h!i2jLnn}>^| ! If we fall short, you can file a grievance or appeal. 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. On weekends and on state or federal holidays, you may be asked to leave a message. 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. Complete the Member Notification of Pregnancy(PDF) form in the Member Portal. 0000067354 00000 n It will also explain our responsibilities to you, as well as outline the following details: Report an address update to HFS online. The COC lays out all the details so that you can stay on top of your coverage. Your call will be returned within the next business day. 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. Your call will be returned within the next business day. It also explains how to find care and how to earn rewards. If you wish to stay on this website, please click Cancel. For more information contact the plan or read the Meridian Member Handbook. For a more comprehensive description of the plan benefits, please refer to your Member Handbook. 1-855-580-1689 (TTY 711) 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)! The handbook will explain your rights, benefits, and responsibilities as a member of MeridianComplete. Monday-Friday, 8 a.m. to 8 p.m. CST 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 more information, call MeridianComplete Member Services or read the MeridianComplete Member Handbook. Representatives are available Monday-Friday, 8 a.m. to 8 p.m. to assist you. Language Assistance & Notice of Nondiscrimination. You will need Adobe Reader to open PDFs on this site. 0000017969 00000 n Download the Member Handbook(PDF). 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. 0000046799 00000 n You are leaving this website to go to a website managed by a contracted company, which provides service on our behalf. Be sure to read your Meridian Member Handbook and keep it handy. 0000068680 00000 n Please contact the plan for more details. hbbd``b`R@AH&="> $ $= @+D C[} "Fod(AE+ More information is in your Member Handbook(PDF). It explains the medical, dental, vision, and pharmacy services that are covered by your plan. Monday-Friday, 8 a.m. to 5 p.m. CST Material ID:H6080_WEBSITE_2023_Accepted_09282022. With HealthChoice Illinois, you have a health plan partner to turn to for help. 0000151745 00000 n Representatives are available Monday-Friday, 8 a.m. to 8 p.m. to assist you. 167 0 obj <> endobj The right care for you. Catching a Breath Complex Case Management Flu Outreach Opioids Just call Member Services with your new address. The handbook will explain your rights, benefits, and responsibilities as a member of Meridian. Download the Member Handbook (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. Su llamada ser devuelta dentro del siguiente da hbil. // ]]>. Llame al 1-855-580-1689 (los usuarios de TTY deben llamar al 711). This site contains various Meridian Medicare-Medicaid Plan (MMP) links and resources. h|kPQevkmNRIDrDI-)Vw*DYS7cgcr!349g3. 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. The Member Handbook, along with your enrollment form, serves as Meridian Medicare-Medicaid Plan's (MMP) contract with you. When you go to file, youll want to write when and where the incident took place, and what happened. We are excited to share that MeridianCare, a WellCare company, is changing its name to WellCare, effective January 1, 2020! You will be able to work with one health plan for all of your health insurance needs. Member ID Cards 5. On weekends and on state or federal holidays, you may be asked to leave a message. Call 1-855-580-1689 (TTY: 711). Su llamada ser devuelta dentro del siguiente da hbil. 0000002131 00000 n We want you to be happy with your healthcare services. If you are using a Meridian provider, you will not have to pay a plan premium, deductible, or copay. 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. 2023 At the right time and place. Prior Authorization, Step Therapy and Quantity Limits, Coverage Determinations and Redeterminations for Drugs, Notice of Nondiscrimination & Language Assistance. Important Phone Numbers & Contacts In an Emergency 911 Meridian Member Services 866-606-3700 Each link will open a new window and is either a PDF or a website. 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. With HealthChoice Illinois, you have a health plan partner to turn to for help. 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. For information regarding our Pharmacy Benefit Manager (PBM), MeridianRx, visit the MeridianRx website. Visit your Member Portal or call Member Services. 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! The Provider Manual has everything you need to know about member benefits, coverage, and provider guidelines. Fill out the Member Notification of Pregnancy form(PDF)to let us know if you are pregnant. The benefit information is a brief summary, not a complete description of benefits. Each link will open a new window and is either a PDF or a website. 0000025639 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. Meridian will work with you to make sure you get all of the care you need, when you need it. The Personal Wellness Assessment is a short form about you and your health journey. 0000068208 00000 n 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. Out-of-network/non-contracted providers are under no obligation to treat Meridian members, except in emergency situations. If you wish to stay on this website, please click Cancel. Meridian covers all counties in Illinois. Youll tell us about any health conditions, recent hospital visits, medications, and more. Want a paper copy? Copays for prescription drugs may vary based on the level of Extra Help you receive. 0000046386 00000 n 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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