meridian illinois member handbook

meridian illinois member handbook

This is not a complete list. 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. Your Member Handbook is a great resource if you have any questions or just want to learn more about your coverage. 0000068680 00000 n The Member Handbook, along with your enrollment form, serves as Meridian Medicare-Medicaid Plan's (MMP) contract with you. More information is in your Member Handbook(PDF). Other pharmacies/physicians/providers are available in our network. Catching a Breath Complex Case Management Flu Outreach Opioids Under our plan, you will have one card for your Medicare and Medicaid services, including long-term services and supports and prescriptions. 1-855-580-1689 (TTY 711) 0000002131 00000 n Understanding the ins and outs of your health plan can be difficult. Llame al 1-855-580-1689 (los usuarios de TTY deben llamar al 711). 0000072727 00000 n Please contact the plan for more details. 0000041209 00000 n 0000067354 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 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. You also need to make sure that the Department of Healthcare & Family Services (HFS) has your new address. 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 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 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. JB Pritzker, Governor Theresa Eagleson, Director. Your Member Handbook is a great resource if you have any questions or just want to learn more about your coverage. (los usuarios de TTY deben llamar al 711), lunes a domingo, de 8 a.m. a 8 p.m. La llamada es gratuita. This is not a complete list. You can get this document for free in other formats, such as large print, braille, or audio. The Member Handbook, along with your enrollment form, serves as Meridian Medicare-Medicaid Plan's (MMP) contract with you. 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. La llamada es gratis. 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. Fill out the Member Notification of Pregnancy form(PDF)to let us know if you are pregnant. Please visit our new website to see up to date information about your plan. Member ID Cards 5. For certain kinds of drugs, you can use the plans network mail-order services. You are leaving this website to go to a website managed by a contracted company, which provides service on our behalf. 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. If you wish to stay on this website, please click Cancel. 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. It will also explain our responsibilities to you, as well as outline the following details: 0000002177 00000 n The Member Handbook, along with your enrollment form, serves as MeridianCompletes contract with you. If we fall short, you can file a grievance or appeal. Your call will be returned within the next business day. The Health Library is a free resource exclusively for MeridianComplete members and providers. You will need Adobe Reader to open PDFs on this site. trailer 0000040481 00000 n With HealthChoice Illinois, you have a health plan partner to turn to for help. Open Enrollment 6. This handbook will help you understand your coverage. 1-855-580-1689 (TTY 711) Starting January 1, 2018, the Illinois Medicaid Managed Care Program is expanding to include all For more information contact the plan or read the MeridianComplete Member Handbook. Other pharmacies/physicians/providers are available in our network. Download the Member Handbook (PDF). You will need Adobe Reader to open PDFs on this site. With added benefits like support making smart health choices, personal care coordination, 24-hour nursing help line, and more. It outlines services and benefits that areand are notcovered. 0 Call Member Services if youd like paper copies of any of these documents. Monday-Friday, 8 a.m. to 8 p.m. CST Material ID:H6080_WEBSITE_2023_Accepted_09282022. It looks like your browser does not have JavaScript enabled. Youll tell us about any health conditions, recent hospital visits, medications, and more. For more information contact the plan or read the Meridian Member Handbook. The handbook will explain your rights, benefits, and responsibilities as a member of Meridian. 2022 Provider Manual (PDF) Meridian Provider Manual Errata Sheet (PDF) Documents and Forms Medical Referrals & Authorizations Pharmacy Billing Mandatory Training Attestation 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 0 The right care for you. 0000014634 00000 n 866-606-3700 . You are leaving this website to go to a website managed by a contracted company, which provides service on our behalf. 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. For more information contact the plan or read the Meridian Member Handbook. You can join our Start Smart for Your Baby program. If your pregnancy is at high risk, we may call you. A certificate of coverage (COC) tells you what to expect from your healthcare plan. Other pharmacies/physicians/providers are available in our network. If you have any questions, call Meridian Member Services toll-free at 866-606-3700. Download the Member Handbook(PDF). This is not a complete list. If you wish to stay on this website, please click Cancel. See if you qualify, and explore the HealthChoice Illinois advantage. 0000006553 00000 n 0000025639 00000 n 0000046386 00000 n Each link will open a new window and is either a PDF or a website. 0000068208 00000 n You are leaving this website to go to a website managed by a contracted company, which provides service on our behalf. 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. 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. Llame al 1-855-580-1689 (los usuarios de TTY deben llamar al 711). The handbook will explain your rights, benefits, and responsibilities as a member of Meridian. 2023 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. You can get this document in Spanish, or speak with someone about this information in other languages for free. At the right time and place. Check out the Interoperability page to learn more. Monday-Friday, 8 a.m. to 8 p.m. CST 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. Looking for your plan home page or interested in becoming a member? Copays for prescription drugs may vary based on the level of Extra Help you receive. On weekends and on state or federal holidays, you may be asked to leave a message. You can also file a grievance or appeal on the phone by calling Member Services or in writing via mail or fax. For information regarding our Pharmacy Benefit Manager (PBM), MeridianRx, visit the MeridianRx website. We want you to be happy with your healthcare services. You can also visit the Illinois Client Enrollment Services website. xref 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. Provider Network 6 HFS sends paperwork in the mail that you need to renew your Medicaid coverage. Out-of-network/non-contracted providers are under no obligation to treat Meridian members, except in emergency situations. 3. We are excited to share that MeridianCare, a WellCare company, is changing its name to WellCare, effective January 1, 2020! 0000001708 00000 n The handbook will explain your rights, benefits, and responsibilities as a member of Meridian. We will send you a notice before we make a change that affects you. The call is free. For more information, or to find out how to get enrolled, please contact Meridian at 888-437-0606. An appeal is a way for you to ask for a review of our actions. For more information contact the plan or read the Meridian Member Handbook. 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.

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