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meridian illinois member handbook
For a more comprehensive description of the plan benefits, please refer to your Member Handbook. For more information, call MeridianComplete Member Services or read the MeridianComplete Member Handbook. 866-606-3700 . %PDF-1.4 % 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. 2021 Member Handbook Illinois Counties: Cook, DuPage, Kane, Kankakee, Lake, Will . 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! Call 1-855-580-1689 (TTY: 711). startxref Meridian is for people eligible for both Medicaid and Medicare. 0000002131 00000 n Open Enrollment 6. 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. The List of Covered Drugs and/or pharmacy and provider networks may change throughout the year. 0000001708 00000 n 0000000956 00000 n It also explains how to find care and how to earn rewards. 0000021917 00000 n 0000080946 00000 n 0000046966 00000 n 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 right care for you. (los usuarios de TTY deben llamar al 711), lunes a domingo, de 8 a.m. a 8 p.m. La llamada es gratuita. The Health Library is a free resource exclusively for MeridianComplete members and providers. 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. You can make an appeal if you disagree with our verdict. Want a paper copy? Don't forget to call your local HFS oce and Meridian Member Services with your new address. You will need Adobe Reader to open PDFs on this site. 1-855-580-1689 (TTY 711) 0000040678 00000 n 0000017969 00000 n Keep in mind that everything you choose to share is confidential. Looking for your plan home page or interested in becoming a member? Out-of-network/non-contracted providers are under no obligation to treat Meridian members, except in emergency situations. La llamada es gratis. On weekends and on state or federal holidays, you may be asked to leave a message. Making healthcare decisions can be tough--who to see for care, what to ask, when to go. If you are using a Meridian provider, you will not have to pay a plan premium, deductible, or copay. 0000002177 00000 n You can also visit the Illinois Client Enrollment Services website. ATTENTION: If you speak a language other than English, language assistance services, free of charge, are available to you. Learn more about how being a Meridian provider benefits you. 0000067354 00000 n 2022 Provider Manual (PDF) Meridian Provider Manual Errata Sheet (PDF) Documents and Forms Medical Referrals & Authorizations Pharmacy Billing Mandatory Training Attestation 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. member.ILmeridian.com. Want a paper copy? It also explains how to find care and how to earn rewards. Download the Member Handbook (PDF). La llamada es gratis. 0000006553 00000 n 167 33 Material ID:H6080_WEBSITE_2023_Accepted_09282022. Prior Authorization, Step Therapy and Quantity Limits, Coverage Determinations and Redeterminations for Drugs, Notice of Nondiscrimination & Language Assistance. 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 <. If you have any questions, call Meridian Member Services toll-free at 866-606-3700. endstream endobj startxref Each link will open a new window and is either a PDF or a website. Representatives are available Monday-Friday, 8 a.m. to 8 p.m. to assist you. 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. +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 View your Provider Manual, important plan information and more. 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 call is free. Llame al 1-855-580-1689 (los usuarios de TTY deben llamar al 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. 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. Monday-Friday, 7:00 a.m. to 5:30 p.m. (TTY: 711) Ser vice area . 0000067553 00000 n If you have questions, please call MeridianComplete (Medicare-Medicaid Plan) Member Services at 1-855-580-1689 (TTY users should call 711). If you wish to stay on this website, please click Cancel. The Member Handbook, along with your enrollment form, serves as Meridian Medicare-Medicaid Plan's (MMP) contract with you. You are now able to view your health information from a third-party app on a mobile device or PC! Our Population Health Management Programs are offered to Meridian members and designed to improve your overall health and quality of care. This handbook will help you understand your coverage. Other pharmacies/physicians/providers are available in our network. At the right time and place. Under our plan, you will have one card for your Medicare and Medicaid services, including long-term services and supports and prescriptions. More information is in your Member Handbook(PDF). MeridianComplete is a health plan that contracts with both Medicare and Illinois Medicaid to provide benefits of both programs to enrollees. Your call will be returned within the next business day. Monday-Friday, 8 a.m. to 8 p.m. CST 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. Call MeridianComplete at 1-855-323-4578 (TTY users should call 711), 8 a.m to 8 p.m., seven days a week. %%EOF When you go to file, youll want to write when and where the incident took place, and what happened. Benefits, List of Covered Drugs, pharmacy and provider networks and/or copayments may change from time to time throughout the year and on January 1 of each year. 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. Each link will open a new window and is either a PDF or a website. Your call will be returned within the next business day. The call is free. It explains the medical, dental, vision, and pharmacy services that are covered by your plan. Call 1-855-580-1689 (TTY: 711). You can get this document for free in other formats, such as large print, braille, or audio. For certain kinds of drugs, you can use the plans network mail-order services. If your pregnancy is at high risk, we may call you. hKq?wNe?t!ARk;v6[IqK,h!i2jLnn}>^| ! window.location.replace("https://mmp.ilmeridian.com/member/benefits-coverage/whats-covered/member-handbook.html"); The handbook will explain your rights, benefits, and responsibilities as a member of MeridianComplete. You will be able to work with one health plan for all of your health insurance needs. A grievance is a complaint about a provider or about the quality of care or services you received. Be sure to read your Meridian Member Handbook and keep it handy. Out-of-network/non-contracted providers are under no obligation to treat Meridian members, except in emergency situations. // ]]>. Member ID Cards 5. Usually a mail-order pharmacy order will get to you in no more than 5 days. 0000041585 00000 n La llamada es gratis. Monday-Friday, 8 a.m. to 8 p.m. CST With our Medicare-Medicaid Plan (MMP) youre getting: An assigned care manager to help answer questions and coordinate your care. 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. Report an address update to HFS online. Moving? Meridian will help make your Medicare and Medicaid benefits work better together and work better for you. For more information contact the plan or read the Meridian Member Handbook. This is not a complete list. Want a paper copy? Material ID:H6080_WEBSITE_2023_Accepted_09282022. Provider Network 6 trailer Your call will be returned within the next business day. View our Frequently Asked Questions page. You are leaving this website to go to a website managed by a contracted company, which provides service on our behalf. HFS sends paperwork in the mail that you need to renew your Medicaid coverage. For more information contact the plan or read the MeridianComplete Member Handbook. 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 handbook will explain your rights, benefits, and responsibilities as a member of Meridian. Meridian The handbook will explain your rights, benefits, and responsibilities as a member of Meridian. ATENCIN: Si habla espaol, tiene a su disposicin servicios gratuitos de asistencia lingstica. This is not a complete list. The Member Handbook, along with your enrollment form, serves asMeridian Medicare-Medicaid Plan's (MMP) contract with you. Your call will be returned within the next business day. 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. 0000046799 00000 n A certificate of coverage (COC) tells you what to expect from your healthcare plan. Download the free version of Adobe Reader. We will send you a notice before we make a change that affects you. It explains the medical, dental, vision, and pharmacy services that are covered by your plan. 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. MeridianComplete (Medicare-Medicaid Plan) is a health plan that contracts with both Medicare and Michigan Medicaid to provide benefits of both programs to enrollees. Language Assistance & Notice of Nondiscrimination. Meridian Member Services . 0000040481 00000 n The handbook will explain your rights, benefits, and responsibilities as a member of Meridian. Representatives are available Monday-Friday, 8 a.m. to 8 p.m. to assist you. You can also visit the Illinois Client Enrollment Services website. Su llamada ser devuelta dentro del siguiente da hbil. You are leaving this website to go to a website managed by a contracted company, which provides service on our behalf. We need to be able to send you important information in the mail. Find a doctor, explore coverage, review documents and much more. Youll tell us about any health conditions, recent hospital visits, medications, and more. The COC lays out all the details so that you can stay on top of your coverage. 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.
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