Llame al 1-855-580-1689 (los usuarios de TTY deben llamar al 711). The Member Handbook, along with your enrollment form, serves as Meridian Medicare-Medicaid Plan's (MMP) contract with you. // ]]>. With added benefits like support making smart health choices, personal care coordination, 24-hour nursing help line, and more. The Health Library is a free resource exclusively for MeridianComplete members and providers. 167 33 You can get this document for free in other formats, such as large print, braille, or audio. Don't forget to call your local HFS oce and Meridian Member Services with your new address. For a more comprehensive description of the plan benefits, please refer to your Member Handbook. We want you to be happy with the treatment and services you get from Meridian and our providers. You can get this document for free in other formats, such as large print, braille, or audio. Be sure to read your Meridian Member Handbook and keep it handy. Other pharmacies/physicians/providers are available in our network. This handbook will help you understand your coverage. For certain kinds of drugs, you can use the plans network mail-order services. providerhelp.IL@mhplan.com, The Interoperability and Patient Access Rule. // PDF <DATE> Program called HealthChoice Illinois . We have been working hard If you have questions, please call MeridianComplete (Medicare-Medicaid Plan) Member Services at 1-855-580-1689 (TTY users should call 711). 0000046966 00000 n If you wish to stay on this website, please click Cancel. Important Phone Numbers & Contacts In an Emergency 911 Meridian Member Services 866-606-3700 View your Provider Manual, important plan information and more. 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. 0 2023 Llame al. 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. Download the Member Handbook (PDF). 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. 0000025980 00000 n Meridian Medicare Medicaid Plan Documents and Forms - Meridian Medicare Medicaid Plan Open Enrollment 6. 2021 Member Handbook Illinois Counties: Cook, DuPage, Kane, Kankakee, Lake, Will . Want a paper copy? If you are using a Meridian provider, you will not have to pay a plan premium, deductible, or copay. 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. Out-of-network/non-contracted providers are under no obligation to treat Meridian members, except in emergency situations. h|kPQevkmNRIDrDI-)Vw*DYS7cgcr!349g3. You will need Adobe Reader to open PDFs on this site. 0000151745 00000 n You can also file a grievance or appeal on the phone by calling Member Services or in writing via mail or fax. Llame al 1-855-580-1689 (los usuarios de TTY deben llamar al 711). Catching a Breath Complex Case Management Flu Outreach Opioids PDF 2021 Member Handbook - Meridian Medicare Medicaid Plan For information regarding our Pharmacy Benefit Manager (PBM), MeridianRx, visit the MeridianRx website. Call 1-855-580-1689 (TTY: 711). It explains the medical, dental, vision, and pharmacy services that are covered by your plan. 0000041668 00000 n The Member Handbook, along with your enrollment form, serves as MeridianCompletes contract with you. The call is free. Monday-Friday, 7:00 a.m. to 5:30 p.m. (TTY: 711) Ser vice area . La llamada es gratis. It outlines services and benefits that areand are notcovered. You've got questions and we've got answers. 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. The call is free. Download the Member Handbook(PDF). endstream endobj startxref You will need Adobe Reader to open PDFs on this site. 0000046386 00000 n If we fall short, you can file a grievance or appeal. member.ILmeridian.com. 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 List of Covered Drugs and/or pharmacy and provider networks may change throughout the year. A grievance is a complaint about a provider or about the quality of care or services you received. It explains the medical, dental, vision, and pharmacy services that are covered by your plan. 2500 0 obj <>stream 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. Monday-Friday, 8 a.m. to 5 p.m. CST If you experience any problems receiving your mail order prescription, call Member Services at. Please visit our new website to see up to date information about your plan. 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. We are excited to share that MeridianCare, a WellCare company, is changing its name to WellCare, effective January 1, 2020! 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. Member Handbook | Meridian Complete of Illinois Monday-Friday, 8 a.m. to 8 p.m. CST Youll tell us about any health conditions, recent hospital visits, medications, and more. Copyright 2023 Meridian All Rights Reserved. This way, we can connect you with the right care. Download the Member Handbook (PDF). 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. 0000000956 00000 n 2369 0 obj <> endobj 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)! More information is in your Member Handbook(PDF). 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 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. [CDATA[ Complete the Member Notification of Pregnancy(PDF) form in the Member Portal. 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. Meridian covers all counties in Illinois. Call Member Services if youd like paper copies of any of these documents. On weekends and on state or federal holidays, you may be asked to leave a message. 0000010510 00000 n 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. HealthChoice Illinois is the smart way most Medicaid members get quality care. Making healthcare decisions can be tough--who to see for care, what to ask, when to go. Su llamada ser devuelta dentro del siguiente da hbil. Out-of-network/non-contracted providers are under no obligation to treat MeridianComplete members, except in emergency situations. 0000047422 00000 n Fill out the Member Notification of Pregnancy form(PDF)to let us know if you are pregnant. 0000080946 00000 n You can also visit the Illinois Client Enrollment Services website. 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) With added benefitslike supportmakingsmart health choices, personal care coordination, 24-hour nursing help line, and more. For example, we may not approve your providers request for a certain drug. startxref Click the link below to view or save a copy.