Meridian Health Plan of Michigan is rated 4 out of 5 by the NCQA among Medicaid plans in the US for 2016-2017.

Contact

Call

Member

Services at

888-437-0606 (TTY 711), Monday - Friday from 8 a.m. – 8 p.m.

with any questions. You can also use our Live Chat for fast and friendly service (on the left side of the page).

 

Health Library

The Health Library is a free resource exclusively for Meridian members where you can get tips to help you manage your health.


ACCESS HEALTH LIBRARY

FAQS


 

You’ve got questions, we’ve got answers. If there’s a question you can’t find the answer to on our website, call

Member

Services at

888-437-0606 (TTY 711), Monday - Friday from 8 a.m. – 8 p.m.
General

What kind of health plan is

Healthy Michigan Plan

?


Healthy Michigan Plan is a health insurance plan through the State of Michigan that provides health care benefits to Michigan residents at a low cost. For more information, please contact Member Services at

888-437-0606 (TTY 711), Monday - Friday from 8 a.m. – 8 p.m.

You must also live in the State of Michigan (residents of Leelanau County are not eligible for Meridian's Healthy Michigan Plan).


What is the phone number and hours of operation for

Healthy Michigan Plan

?


You can reach

Healthy Michigan Plan

Member Services at

888-437-0606 (TTY 711), Monday - Friday from 8 a.m. – 8 p.m.

Am I eligible to enroll in

Healthy Michigan Plan

?


To find out if you are eligible for Healthy Michigan Plan, call Michigan Enrolls at 800-975-7630.


How do I enroll?


To join Healthy Michigan Plan, call Michigan ENROLLS at 800-975-7630.


How do I replace my Member ID card?


You can call our Member Services Department at

888-437-0606 (TTY 711), Monday - Friday from 8 a.m. – 8 p.m.

Do you offer interpreter services for non-English speakers?


Yes, we offer interpreter services for over 140 different languages. For more information, call Member Services at

888-437-0606 (TTY 711), Monday - Friday from 8 a.m. – 8 p.m.

 

Multi-Language Insert


What is a PCP?


A Primary Care Provider (PCP) is a person who practices medicine. A provider can be a doctor, a nurse practitioner, a physician assistant, or other health care professional.


How do I find a PCP in my area?


Use our Find a Doctor tool to locate a provider near you. You can also call our Member Services Department at

888-437-0606 (TTY 711), Monday - Friday from 8 a.m. – 8 p.m.

How do I change my PCP?


Use our Member Portal or

Call Member Services at

888-437-0606 (TTY 711), Monday - Friday from 8 a.m. – 8 p.m.

Do I need a referral to see a specialist?


No, you do not need a referral from your PCP to see a specialist. You do not need a referral for routine vision care, chiropractic services, or mental health/counseling services.


Does

Healthy Michigan Plan

have copays?


Everyone enrolled in Healthy Michigan Plan (except Native Americans, pregnant women, and other populations exempt from co-pays under federal law) will have to pay some co-pays or monthly contributions for their health services.

 

There are no co-pays for preventive services, emergency services or emergency hospital admissions.

 

Co- pays will be collected beginning in the seventh month of enrollment with Healthy Michigan Plan. Members will pay co-pays to a special healthcare account called the MI Health Account. 

Healthy Michigan Co-Pay Chart

 

Your co-pays will be an average of all the co-pays you incurred in your first six months enrolled in the program. This will be your co-pay amount moving forward.

 

This average will be collected and recalculated every six months to reflect your current use of services.

Copays are not paid at the time of the service. You will receive a statement at a later date.


Does Meridian cover dental services?


Diagnostic, preventive, restorative, prosthetic and medically/clinically necessary oral surgery services (including extractions) are covered. Meridian is contracted with DentaQuest for your dental check-ups. Please call 855-898-1478 to find a dentist.


Does

Healthy Michigan Plan

cover routine eye care (vision services)?


Yes. Check your Member Handbook or call Member Services if you have questions at 888-437-0606 (TTY 711), Monday - Friday from 8 a.m. – 8 p.m.

Does

Healthy Michigan Plan

help with transportation?


Yes, Meridian does offer help with transportation. Please refer to your Member Handbook for more information.  You can schedule your gas reimbursement up to 30 days BEFORE your appointment date. The earlier you let us know about your transportation needs, the better we can help you.  We may also be able to provide alternative methods of transportation based on needs or medical necessity."


Does Meridian cover chiropractic services?


Yes, Meridian Health Plan covers chiropractic services for members of all ages. All members are covered for up to 18 visits each year without prior authorization. Prior authorization is needed for more visits or to see an out-of-network provider.


BEHAVIORAL HEALTH

What is behavioral health?


Behavioral health is a type of health care that offers mental health and substance abuse counseling.


How do I find behavioral health services?


Call our Behavioral Health Department at 888-222-8041 if you need help finding a behavioral health provider in your area.


Do I need a referral from my PCP for behavioral health services?


No, you do not need a referral from your PCP (Primary Care Provider).

 

 

 

 


What is Prior Authorization? Do I need it for behavioral health services?


Prior Authorization means that a service must be approved before you get that service. Prior Authorization is not needed for outpatient behavioral health services from Meridian Health Plan.


When can I call Meridian?


You can reach Meridian Health Plan's Behavioral Health Department Monday through Friday from 8 a.m. – 6 p.m. at 888-222-8041.

 

If you are having a Behavioral Health crisis or emergency please call 911.


PHARMACY

I need to fill a prescription. What should I take to the pharmacy?


Take your

Healthy Michigan Plan

Member ID Card to the pharmacy. You should also take personal identification, like a driver's license or state issued identification card, with your picture on it.

 

 

 

 

 

 

 


What is a Drug Formulary?


A drug formulary is a list of prescription drugs approved by your plan. The

Healthy Michigan Plan

Formulary uses the clinical advice of doctors, pharmacists and other medical experts to come up with this drug list.


What is a Pharmacy Benefit Manager (PBM)?


 A PBM is a business that works with insurance companies to fill member prescriptions. MeridianRx is the PBM for

Healthy Michigan Plan.

  

MeridianRx also takes care of drug prior authorization (PA) requests.


What is Prior Authorization (PA)?


There may be times when your doctor prescribes a drug for you that is not approved in your plan. Your doctor can fill out a PA request form, giving facts about your medical history and why you need the drug. Note: We must approve the drug before you can fill the prescription.


What happens if the Prior Authorization (PA) is not approved?


Meridian and the MeridianRx Formulary Team may deny a drug request for medical reasons. If your doctor's PA request is not approved, you and your doctor will get a letter explaining why. The letter will also explain the appeal process if you and your doctor disagree with the denial.


What is a quantity limit (QL)?


For some drugs, there are limits to how much you can take safely. This limit is based on research from the drug maker and the FDA. The QL is the amount of drug that can be filled safely each month. If your doctor feels that you need more of a medication, he/she must fill out a PA request.


What is Step Therapy?


Sometimes more than one medication can be used to treat your condition. Step therapy means that one medication must be tried first before another medication can be tried. Your healthcare provider or pharmacist can explain which medication must be tried first.


I have a question about my drug. What is the MeridianRx phone number?


You can call MeridianRx toll-free at

866-984-6462.

 

 


Page Last Modified: 12/19/2016 8:20:49 AM