FAQS

Meridian Health Plan is a Medicaid managed care plan that partners with the State of

to provide services for beneficiaries of the State of

Medicaid program.

You can reach

Member Services at

To join Meridian Health Plan, you must be eligible for Michigan Medicaid and live in our service area. The Michigan Department of Health & Human Services can tell you if you qualify. For more information, please call Michigan ENROLLS at 800-975-7630.

To join Meridian Health Plan, you must be eligible for Michigan Medicaid and live in our service area. The Michigan Department of Health & Human Services can tell you if you qualify. For more information, please call Michigan ENROLLS at 800-975-7630. 

You can call our Member Services Department at

Multi-Language Insert

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.

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

Use our Member Portal or

Call Member Services at

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.

No,

does not charge co-pays for any covered services.

The State of Michigan’s Medicaid program covers dental care for all Medicaid enrollees under 18 years old. Michigan contracts with DentaQuest to provide a network of dentists in over 60 counties. Contact the Medicaid Helpline at 800-642-3195 for further assistance.

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."

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

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

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

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.

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.

Take your

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.

Ex:

 Meridian does not charge a co-pay for covered medications.

Michigan Medicaid (instead of Meridian) covers some drugs. Meridian Health Plan members over 21 may have a co-pay if the doctor prescribes one of these drugs. Your co-pay will be $1.00 for generic drugs and $3.00 for brand name drugs. The pharmacy can tell you if a drug is generic or brand name. 

If you have paid cash for a medication, please fill out the form below and attach the medication label name, pharmacy receipt and a note describing the reasons for paying cash. 

Member Request for Reimbursement Form

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

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

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

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.

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.

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

866-984-6462.