meridian illinois member handbook

Call 1-855-580-1689 (TTY: 711). It explains the medical, dental, vision, and pharmacy services that are covered by your plan. Your call will be returned within the next business day. Understanding the ins and outs of your health plan can be difficult. The Provider Manual has everything you need to know about member benefits, coverage, and provider guidelines. Your Member Handbook is a great resource if you have any questions or just want to learn more about your coverage. 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 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. Find a doctor, explore coverage, review documents and much more. 2021 Member Handbook Illinois Counties: Cook, DuPage, Kane, Kankakee, Lake, Will . 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 <. You also need to make sure that the Department of Healthcare & Family Services (HFS) has your new address. ATENCIN: Si habla espaol, tiene a su disposicin servicios gratuitos de asistencia lingstica. Llame al. Out-of-network/non-contracted providers are under no obligation to treat MeridianComplete members, except in emergency situations. Complete the Member Notification of Pregnancy(PDF) form in the Member Portal. The benefit information is a brief summary, not a complete description of benefits. Meridian Member Services . Want a paper copy? If you wish to stay on this website, please click Cancel. It will help you get the care you need. La llamada es gratis. ATENCIN: Si habla espaol, tiene a su disposicin servicios gratuitos de asistencia lingstica. Youll tell us about any health conditions, recent hospital visits, medications, and more. hbbd``b`R@AH&="> $ $= @+D C[} "Fod(AE+ 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. Its full of tips and resources for pregnant members and new parents. If we fall short, you can file a grievance or appeal. 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. This is not a complete list. Meridian will work with you to make sure you get all of the care you need, when you need it. xref member.ILmeridian.com. 0000068680 00000 n https://www.illinois.gov/hfs/healthchoice/Pages/HealthPlans.aspx, https://www.illinois.gov/hfs/healthchoice/reportcard. Meridian will help make your Medicare and Medicaid benefits work better together and work better for you. 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. For more information contact the plan or read the Meridian Member Handbook. Call 1-855-580-1689 (TTY: 711). It also explains how to find care and how to earn rewards. The handbook will explain your rights, benefits, and responsibilities as a member of MeridianComplete. v4P+r-k E`:8\TV%F1MeLT=LyMit+GYrUn*mH gp`x Y;EgPCSSphf>op!mOQtkC v^K#x" Llame al 1-855-580-1689 (los usuarios de TTY deben llamar al 711). You will need Adobe Reader to open PDFs on this site. Learn more about how being a Meridian provider benefits you. Meridian For more information, call MeridianComplete Member Services or read the MeridianComplete Member Handbook. %PDF-1.4 % hKq?wNe?t!ARk;v6[IqK,h!i2jLnn}>^| ! Want a paper copy? When you go to file, youll want to write when and where the incident took place, and what happened. A certificate of coverage (COC) tells you what to expect from your healthcare plan. Moving? Su llamada ser devuelta dentro del siguiente da hbil. You will need Adobe Reader to open PDFs on this site. Call MeridianComplete at 1-855-323-4578 (TTY users should call 711), 8 a.m to 8 p.m., seven days a week. Other pharmacies/physicians/providers are available in our network. This is not a complete list. We will send you a notice before we make a change that affects you. 0000010510 00000 n With HealthChoice Illinois, you have a health plan partner to turn to for help. You can also visit the Illinois Client Enrollment Services website. Out-of-network/non-contracted providers are under no obligation to treat Meridian members, except in emergency situations. For certain kinds of drugs, you can use the plans network mail-order services. 2022 Provider Manual (PDF) Meridian Provider Manual Errata Sheet (PDF) Documents and Forms Medical Referrals & Authorizations Pharmacy Billing Mandatory Training Attestation 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. The call is free. 2023 0000067354 00000 n Your Member Handbook is a great resource if you have any questions or just want to learn more about your coverage. We want you to be happy with your healthcare services. Each link will open a new window and is either a PDF or a website. 866-606-3700 . You will be able to work with one health plan for all of your health insurance needs. %%EOF 0000021917 00000 n 0000046576 00000 n It will also explain our responsibilities to you, as well as outline the following details: We need to be able to send you important information in the mail. See if you qualify, and explore the HealthChoice Illinois advantage. Prior Authorization, Step Therapy and Quantity Limits, Coverage Determinations and Redeterminations for Drugs, Notice of Nondiscrimination & Language Assistance. It explains the medical, dental, vision, and pharmacy services that are covered by your plan. Language Assistance & Notice of Nondiscrimination. 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. There are a few ways to complete the form: We want you to have a safe, healthy, and happy pregnancy! This site contains various Meridian Medicare-Medicaid Plan (MMP) links and resources. Your handbook is full of important information about your health care and Meridian. We are excited to share that MeridianCare, a WellCare company, is changing its name to WellCare, effective January 1, 2020! 0000080946 00000 n The Member Handbook, along with your enrollment form, serves as MeridianCompletes contract with you. Download the Member Handbook (PDF). The call is free. providerhelp.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.il@mhplan.com. Su llamada ser devuelta dentro del siguiente da hbil. Other pharmacies/physicians/providers are available in our network. 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. <<0B5A082EC79D7049BD46C1656B63CA22>]/Prev 539953>> Out-of-network/non-contracted providers are under no obligation to treat Meridian members, except in emergency situations. On weekends and on state or federal holidays, you may be asked to leave a message. 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. Your call will be returned within the next business day. window.location.replace("https://mmp.ilmeridian.com/member/benefits-coverage/whats-covered/member-handbook.html"); Representatives are available Monday-Friday, 8 a.m. to 8 p.m. to assist you. Su llamada ser devuelta dentro del siguiente da hbil. For information regarding our Pharmacy Benefit Manager (PBM), MeridianRx, visit the MeridianRx website. Provider Network 6 For example, we may not approve your providers request for a certain drug. 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 The handbook will explain your rights, benefits, and responsibilities as a member of Meridian. +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