MeridianComplete is a Medicare-Medicaid Plan (MMP) for beneficiaries eligible for both Medicaid and Medicare.

Call our MeridianComplete Member Services with any questions or concerns, or to file a grievance (complaint), at 1-855-580-1689 (TTY 711), Monday - Sunday from 8 a.m. - 8 p.m.

You should call your Primary Care Provider (PCP) with any medical concerns that you have.

The state of Illinois will soon be enrolling some members who are enrolled in WellCare Medicare plans in a Medicare-Medicaid Alignment Initiative (MMAI). It is a program that combines Medicare and Medicaid. Members have the option of keeping MMAI. It can replace a current WellCare (Medicare only) health plan.

The state has identified those members who qualify for both Medicare and Medicaid programs.

What is MMAI?

MMAI is a healthcare plan that covers Medicare, Medicaid, and prescription drug benefits. Our MMAI plan is called MeridianComplete. It is one of the MMAI plans offered in Illinois. MeridianComplete and WellCare are both part of Centene Corporation. That means the plan will change, but members will keep the same insurance group.

Full MMAI Passive Expansion notice for IL WellCare Members FAQ Document

MeridianComplete is a Medicare-Medicaid Plan (MMP).

You are eligible for MeridianComplete if you:

• Live in our service area, and
• Have both Medicare Part A and Medicare Part B, and
• Are eligible for Medicaid, and
• Are age 21 and older at the time of enrollment, and
• Are enrolled in the Medicaid Aid to the Aged, Blind and Disabled category of assistance, and
• Meet all other Demonstration criteria and are in one of the following Medicaid 1915(c) waivers:
  • Persons who are Elderly;
  • Persons with Disabilities;
  • Persons with HIV/AIDS;
  • Persons with Brain Injury; or
  • Persons residing in Supportive Living Facilities.

For other questions about MeridianComplete, please contact MeridianComplete Member Services at 1-855-580-1689 (TTY 711), Monday - Sunday, 8 a.m. to 8 p.m.

You can enroll in MeridianComplete 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 - Friday from 8 a.m. to 7 p.m. The call is free. You can also visit the Illinois Client Enrollment Services website at http://enrollhfs.illinois.gov/. 

For other questions about MeridianComplete, please contact MeridianComplete Member Services at

MeridianComplete has no premiums, deductibles, or coinsurance for medical services.

In 2021 for generic drugs covered by Medicare (including brand drugs treated as generic) you will pay a $0 copay. In 2021, for brand drugs covered by Medicare, you will pay a $0 copay. 

If you have any questions or concerns about premiums and/or cost-sharing associated with enrollment in MeridianComplete, or you receive a bill for medical or prescription services, please call Member Services at

You can call our Member Services Department at:

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

A Primary Care Provider (PCP) is a licensed physician, nurse practitioner, clinical nurse specialist or physician assistant, as allowed under state law, who provides and manages your health care services. This can also be called a Primary Care Physician.

Your primary care provider is the person you see first for most health problems. They make sure that you get the care you need to keep you healthy. They also may talk with other doctors and healthcare providers about your care and refer you to them.

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

1-877-902-6784 (TTY: 711), Monday - Sunday from 8 a.m. – 8 p.m.

Call Member Services at

Some healthcare services require a "prior-authorization" before they are performed. Before you visit the doctor, these services need to be approved by MeridianComplete. Your PCP or specialist can inform you if you need a prior-authorization and will take care of submitting the necessary information to coordinate these services.

Emergency care within the United States is a benefit covered by

.

You do not need to contact MeridianComplete for approval before receiving emergency services. If your situation is urgent but not life threatening, you should call your Primary Care Provider's (PCP's) office or MeridianComplete at 1-855-580-1689 (TTY 711), Monday - Sunday from 8 a.m. - 8 p.m. for help with finding an urgent care center.

When you travel out of MeridianComplete's service area, you may go to an emergency room (ER) or go to an urgent care clinic. Make sure you tell the provider you are a MeridianComplete member and show them your MeridianComplete Member ID card. MeridianComplete will pay for your out-of-area emergency care, but routine care is not covered out of MeridianComplete's service area (even if it is provided in an ER).

MeridianComplete does cover some dental services. Please review your Member Handbook for more information. For a list of in-network dental providers, please visit the †DentaQuest website: www.dentaquest.com.

†Other Pharmacies/Physicians/Providers are available in our network.

Take your MeridianComplete 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.

A List of Covered Drugs (Drug List) is a list of prescription drugs covered by Meridian Complete. The plan chooses the drugs on this list with the help of doctors and pharmacists. The Drug List tells you if there are any rules you need to follow to get your drugs. The Drug List is sometimes called a “formulary.” For more information on how to fill your prescriptions, please review your Member Handbook.

A PBM is a business that works with insurance companies to fill member prescriptions. MeridianRx is the PBM for MeridianComplete. MeridianRX also takes care of drug prior authorization (PA) requests.

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.

MeridianComplete 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.

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.

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.

You can call MeridianRx toll-free at

1-855-898-1480 (TTY: 711), Monday - Sunday, 8 a.m. to 8 p.m.