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Member Handbooks and Forms

Member Handbook

The Member Handbook contains important information about your plans and acts as our contract with you. It explains:

  • What’s covered
  • What you pay
  • Your rights and responsibilities

See below for the Member Handbook for your plan:

 

If you would like a paper copy mailed to your home, call Member Services at 888-437-0606 (TTY 711), Monday - Friday from Monday - Friday from 8 a.m. - 6:30 p.m.

Authorized Representative Forms

 

Gas Mileage Reimbursement Forms

When a driver requests payment for transportation, they will attest to these requirements in the Attestation of Transportation Provider Qualifications Form (PDF).

Family members with road offenses can get NEMT payment for members that can consent by completing and signing the NEMT Personal Choice Acknowledgement form (PDF).

Please contact Meridian Member Services for assistance with these forms.

Member Notification of Pregnancy Form

We have many ways to help you have a healthy pregnancy. Before we can help, we need to know you are pregnant. Contact Meridian as soon as you learn you are pregnant and our staff will help you submit a Notification of Pregnancy form (PDF). We will help set up special care that you and your baby need.

Notification of Pregnancy Form (PDF)

This form can be submit via fax number 833-341-2052 or mailed to:

Meridian
PO Box 2010
Farmington, MO 63640-8080

Last Updated: 11/17/2022