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 1-888-437-0606 (TTY 711).
General
What Kind Of Health Plan Is Meridian?
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.
What Is The Phone Number And Hours Of Operation For Meridian?
You can reach Meridian Member Services at 1-888-437-0606 (TTY 711)
Am I Eligible To Enroll In Meridian?
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 1-800-975-7630.
How Do I Enroll?
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 1-800-975-7630.
How Do I Replace My Member ID Card?
You can call our Member Services Department at: 1-888-437-0606 (TTY 711)
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 1-888-437-0606 (TTY 711).
Nondiscrimination Notice and Multi-Language Insert (PDF)
What Is A PCP?
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.
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 1-888-437-0606 (TTY: 711), Monday - Friday from 8 a.m. - 6:30 p.m.
How Do I Change My PCP?
Use our Member Portal or call Member Services at 1-888-437-0606 (TTY 711).
Do I Need A Referral To See A Specialist?
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.
Does Meridian Have Copays?
No, Meridian does not charge co-pays for any covered services.
Does Meridian Cover Dental Services?
We offer dental coverage to all beneficiaries enrolled in Healthy Michigan Plan, as well as enrollees ages 21 and older enrolled in Medicaid. We are contracted with Delta Dental to provide your dental benefits. Children under age 21 and enrolled in Medicaid are automatically enrolled into the Healthy Kids Dental program. If you have any questions about your dental services, please contact Delta Dental at 1-855-898-1478 (TTY: 711) and select prompt from menu.
Does Meridian Cover Routine Eye Care (Vision Services)?
Yes. Check your Member Handbook or call Member Services if you have questions at 1-888-437-0606 (TTY 711)
Does Meridian Help With Transportation?
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.
Does Meridian Cover Chiropractic Services?
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.
What Services Are Available For Newly Transitioned Members?
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 1-888-437-0606 (TTY 711)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 1-888-437-0606.
For assistance with requesting continuity of care for dental services, please contact DentaQuest at 1-855-898-1478
What Is Behavioral Health?
Behavioral health is a type of health care that offers mental health and substance abuse counseling.
How Do I Find Behavioral Health Services?
Call our Behavioral Health Department at 888-222-8041 if you need help finding a behavioral health provider in your area.
Do I Need A Referral From My PCP For Behavioral Health Services?
No, you do not need a referral from your PCP (Primary Care Provider).
What Is Preauthorization? Do I Need It For Behavioral Health Services?
Preauthorization is approval from a plan that is required before the plan pays for certain:
- Services
- Medical equipment or
- Prescriptions
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.
When Can I Call 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.
I Need To Fill A Prescription. What Should I Take To The Pharmacy?
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 I Paid Cash For A Medication, How Do I Receive Reimbursement?
If you have paid cash for a medication, please call Member Services at 1-888-437-0606 (TTY 711) for instructions regarding a request for reimbursement.
What Is A Drug Formulary?
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.
What Is A Pharmacy Benefit Manager (PBM)?
Meridian has contracted with 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.
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?
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.
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 Prescription Coverage Phone Number?
You can call the pharmacy department at 866-984-6462