get the most out of your health plan.
Understanding the ins and outs of your health plan can be difficult. On this page, you’ll learn more about your Member Handbook and some important forms that can help you understand your plan and get the care you need.
Call Member Services if you’d like paper copies of any of these documents.
Your Member Handbook
Your Member Handbook is a great resource if you have any questions or just want to learn more about your coverage. It explains the medical, dental, vision, and pharmacy services that are covered by your plan. It also explains how to find care and how to earn rewards.
Download the Member Handbook (English) (PDF). Want a paper copy? Visit your Member Portal or call Member Services.
Your Personal Wellness Assessment form
The Personal Wellness Assessment is a short form about you and your health journey. You’ll tell us about any health conditions, recent hospital visits, medications, and more. This way, we can connect you with the right care.
There are a few ways to complete the form:
- Call us at 866-606-3700
- Submit through the Member Portal
- Or if you receive the form by mail, complete it and send it back to us in the prepaid envelope
Your Notification of Pregnancy
We want you to have a safe, healthy, and happy pregnancy! Fill out the Member Notification of Pregnancy (PDF) form to let us know if you are pregnant.
We can connect you with support, services, and even rewards. You can join our Start Smart for Your Baby® program. It’s full of tips and resources for pregnant members and new parents.
If your pregnancy is at high risk, we may call you. Keep in mind that everything you choose to share is confidential.
Complete the Member Notification of Pregnancy (PDF) form in the Member Portal.
Your Address Update Form
If your address changes, let us know. We need to be able to send you important information in the mail. Just call Member Services with your new address. You also need to make sure that the Department of Healthcare & Family Services (HFS) has your new address. HFS sends paperwork in the mail that you need to renew your Medicaid coverage. Report an address update to HFS online.
Your Certificate of Coverage
How to File Appeals and Grievances
We want you to be happy with the treatment and services you get from Meridian and our providers. If we fall short, you can file a grievance or appeal.
A grievance is a complaint about a provider or about the quality of care or services you received. When you go to file, you’ll want to write when and where the incident took place, and what happened.
An appeal is a way for you to ask for a review of our actions. For example, we may not approve your provider’s request for a certain drug. You can make an appeal if you disagree with our verdict.
Your Family Health History
Knowing your family’s health history is important. It can help your provider decide what screenings you need and when.
Here’s how to use this form:
- Talk to your family to collect their history of diseases. Knowing their age at diagnosis can help too.
- Check the boxes for each family member that has a disease on the form.
- Share the Family Health History Chart with your provider during your next appointment. Ask any questions you may have about screenings.
What are HBIA and HBIS programs?
The state of Illinois has Medicaid programs for two legal resident immigrant populations:
- Health Benefits for Immigrant Adults (HBIA), ages 42 through age 64, regardless of immigration status
- Health Benefits for Immigrant Seniors (HBIS), ages 65 and older
*New enrollment in the program is paused. The state intends to re-open program enrollment. The pause does not affect current enrollees.
Which benefits or services are not covered in HBIA/HBIS health plans?
- Long Term Care Services
- 90-day rehab stays in a nursing facility are an exception
- Home and Community Based Services
- Most transplant services (stem cell and kidney transplants are covered)
Which services require copayments for HBIA/HBIS health plans?
- Non-emergency inpatient hospital stays – $250
- Hospital or Ambulatory Surgical Treatment Center outpatient services − 10% of the Department rate
See our Member Handbook insert on the program. (PDF)
Enrollment in a health coverage program with a Managed Care Organization, such as Health Benefits for Immigrant Seniors and Health Benefits for Immigrant Adults, is not counted in the public charge test. Enrollment in these programs will not affect your immigration status and immigration application. For more information about public charge, visit Protecting Immigrant Families Illinois or Keep Your Benefits Illinois. You can also call ICIRR’s Family Support Hotline in English/Spanish/Korean/Polish: 1-855-HELP-MY-FAMILY (1-855-435-7693).
