Contact

Call

Member

Services at

1-855-323-4578 (TTY 711), Monday - Sunday 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).

Email support is available at Memberservices.MI@mhplan.com

Our office is located at:

1 Campus Martius, Suite 700

Detroit, Michigan 48226

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

1-855-323-4578 (TTY 711), Monday - Sunday from 8 a.m. – 8 p.m.
General

What is MeridianComplete?


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

MeridianComplete is Meridian’s partnership with the MI Health Link program. MI Health Link is a program that will allow you to get health care and services covered by Medicare and Medicaid. MI Health Link lets you use one plan and one card for health care, behavioral health care, home and community-based services, nursing home care and medications.


What is the phone number and hours of operation for MeridianComplete?


Call our MeridianComplete Member Services with any questions or concerns, or to file a grievance (complaint), at 1-855-323-4578 (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.


Am I eligible to enroll in MeridianComplete?


MeridianComplete is a Medicare-Medicaid Plan (MMP).

You are eligible for MeridianComplete if you:

  • Live in our service area, and
  • Have Medicare Part A, Part B, and Part D, and
  • Are eligible for full Michigan Medicaid benefits, and
  • Are not enrolled in hospice, and
  • Are not enrolled in the MI Choice waiver program or the Program of All-inclusive Care for the Elderly (PACE). If you are enrolled in either of these programs, you need to disenroll before enrolling in the MI Health Link program through MeridianComplete.

 

For other questions about MeridianComplete, please contact MeridianComplete Member Services at 1-855-323-4578 (TTY 711), Monday - Sunday, 8a.m. to 8 p.m.

 

The MeridianComplete contract with the Centers for Medicare & Medicaid Services (CMS) and the State of Michigan is renewed annually. Coverage beyond the end of the current contract year is not guaranteed.


How do I enroll?


You can enroll in MeridianComplete by contacting Michigan ENROLLS at 1-800-975-7630 (TTY 888-263-5897), Monday - Friday from 8 a.m. to 7 p.m.

 

If you have questions about enrollment or disenrollment in MI Health Link, please call Michigan ENROLLS toll-free at 1-800-975-7630. Persons with hearing and speech disabilities may call the TTY number at 1-888-263-5897. The office hours are Monday through Friday, 8 a.m. to 7 p.m.

 

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

1-855-323-4578 (TTY 711), Monday - Sunday from 8 a.m. – 8 p.m.

 

Multi-Language Insert


What are the costs (e.g., copays, deductibles, premiums, etc.) associated with enrollment in MeridianComplete?


As a member of MeridianComplete, there are no premiums, deductibles, co-payments or coinsurance for covered medical services or prescription drugs.

 

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

1-855-323-4578 (TTY 711), Monday - Sunday from 8 a.m. – 8 p.m.

How do I replace my Member ID card?


You can call our Member Services Department at

1-855-323-4578 (TTY 711), Monday - Sunday 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

1-855-323-4578 (TTY 711), Monday - Sunday from 8 a.m. – 8 p.m.

 


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

1-855-323-4578 (TTY 711), Monday - Sunday from 8 a.m. – 8 p.m.

How do I change my PCP?


Call Member Services at

1-855-323-4578 (TTY 711), Monday - Sunday from 8 a.m. – 8 p.m.

Do I need a referral or authorization to have services performed?


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.


What if I need emergency care?


Emergency care within the United States is a benefit covered by

MeridianComplete

.

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 1-855-323-4578 (TTY 711), Monday - Sunday from 8 a.m. - 8 p.m. for help with finding an urgent care center.


What if I travel out of town and need health care services?


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).


Does MeridianComplete cover dental services?


MeridianComplete does cover some dental services. Please review your Member Handbook for more information.

PHARMACY

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


 

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.

 

 

 

 

2017 Member ID Card

 


What is a List of Covered Drugs?


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.


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 MeridianComplete. 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?


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.


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

1-855-580-1693 (TTY: 711), Monday - Sunday, 8 a.m. to 8 p.m.


MEDICARE DISCLAIMER

MeridianComplete is a health plan that contracts with both Medicare and Michigan Medicaid to provide benefits of both programs to enrollees.

 

You can get this information for free in other languages. Call

1-855-323-4578 (TTY users should call 711) Monday - Sunday, 8 a.m. to 8 p.m.

The call is free.

 

Puede obtener esta información en otros idiomas de manera gratuita. Llame al

1-855-323-4578

(los usuarios de TTY deben llamar al 711), lunes a domingo, de 8 a.m. a 8 p.m. La llamada es gratuita.

 

 

يمكنكم الحصول على هذه المعلومات بلغات أخرى عبر الاتصال بالرقم التالي 4578-323-855 (على الذين يعانون من  صعوبة في السمع الاتصال على الرقم 711) من الاثنين إلى الأحد، من الثامنة صباحًا ولغاية الثامنة مساءً. إن هذا الاتصال مجاني.

 

Limitations, restrictions, and patient pay amounts may apply. This means that you may have to pay for some services and that you need to follow certain rules to have MeridianComplete pay for your services. For more information, call MeridianComplete Member Services or read the MeridianComplete Member Handbook. Benefits, List of Covered Drugs, and pharmacy and provider networks may change from time to time throughout the year and on January 1 of each year. Please contact the plan for more details.

The List of Covered Drugs and/or pharmacy and provider networks may change throughout the year. We will send you a notice before we make a change that affects you.

 

For certain kinds of drugs, you can use the plan’s network mail-order services. We also have an optional automatic mail-order delivery program under which we will automatically fill all new prescriptions your health care provider sends to us, as well as refills for prescriptions that have already been filled but are running out. Usually a mail-order pharmacy order will get to you in no more than 5 days. If you experience any problems receiving your mail order prescription, call Member Services at

1-855-323-4578 (TTY users should call 711)

.

Page Last Modified: 11/20/2017 2:43:27 PM