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).
Meridian is a Medicaid managed care plan that offers healthcare services to members who meet State eligibility rules. The State contracts with certain Health Maintenance Organizations (HMO) to provide health services for those who are eligible. The State pays the premium on behalf of the member.
You can reach Meridian Member Services at 888-437-0606 (TTY 711)
To join Meridian, 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: 888-437-0606 (TTY 711)
Yes, we offer interpreter services for over 140 different languages. For more information, call Member Services at 888-437-0606 (TTY 711).
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 888-437-0606 (TTY: 711), Monday - Friday from 8 a.m. - 6:30 p.m.
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, Meridian 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. Check your Member Handbook or call Member Services if you have questions at 888-437-0606 (TTY 711)
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 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.
As soon as you become an active member of the plan, you will have access to all of the services detailed in the member handbook. Members will be provided with continued access to services the entire time they are on Meridian's plan.
Requests for continuity of care either due to being newly enrolled or when a transition in care has occurred can be made by contacting Meridian's Member Services department at 888-437-0606 or by connecting with your Care Coordinator to obtain instructions on how to work with your provider to submit any necessary authorizations.
Requests can be made by your provider on your behalf and submitted to Meridian via our Provider Portal.
If you need assistance accessing care, you can reach out to your Primary Care Provider (PCP), or contact Meridian Member Services at 888-437-0606.
For assistance with requesting continuity of care for dental services, please contact DentaQuest at 855-898-1478.
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).
Preauthorization is approval from a plan that is required before the plan pays for certain:
- Medical equipment or
This is also called prior authorization, prior approval or precertification. Your plan may require preauthorization for certain services before you receive them. This excludes an emergency.
Prior Authorization is not needed for outpatient behavioral health services from Meridian.
You can reach Meridian's Behavioral Health Department Monday - Friday from 8 a.m. - 6:30 p.m. at 888-222-8041.
If you are having a Behavioral Health crisis or emergency please call 911.
Take your Meridian 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.
If you have paid cash for a medication, please call Member Services at 888-437-0606 for instructions regarding a request for reimbursement.
A drug formulary is a list of prescription drugs approved by your plan. The Meridian Formulary uses the clinical advice of doctors, pharmacists and other medical experts to come up with this drug list.
Meridian has contracted with CVS, a Pharmacy Benefit Manager (PBM), to manage your pharmacy benefit. The pharmacy department has a list of covered pharmacies for you to use. You can also call the pharmacy department at 866-984-6462 if you need help with your pharmacy benefit, including limitations, generic substitutions, and step-therapy protocols.
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 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 the pharmacy department at 866-984-6462.