Submit a Prior Authorization

For Meridian Medicare-Medicaid Plan plan information on how to submit a prior authorization request, please refer to our new authorization lookup tool.

For pharmacy authorization requests, visit Pharmacy.

Meridian partners with several external entities to manage prior authorizations for certain services or populations. The following grid outlines all entities including the request submission options, applicable plans, and delegated services.

Entity	Type of Service	Request Submission Options	Meridian (Medicaid)
eviCore	Sleep Studies, Genetic Testing	Portal: http://www.evicore.com Phone: 888-333-8641

Phone: 888-832-2006
Fax: 844-868-5054

FOR MEDICAL PROFESSIONAL USE ONLY

Prior Authorization Instructions

For MeridianComplete (Medicare-Medicaid Plan) plan information on how to submit a prior authorization request, please refer to our new authorization lookup tool.

For pharmacy authorization requests, visit our Pharmacy Benefit Manager (PBM) website, MeridianRx. (This will open in a new window).

Entity	Type of Service	Request Submission Options	MeridianHealth (Medicaid)
eviCore	Sleep Studies, Genetic Testing	Portal: http://www.evicore.com Phone: 888-333-8641

Phone: 888-832-2006
Fax: 844-868-5054

Updated Date: 10/01/23

Material ID: H6080_WEBSITE_2024_Accepted_10012023

Updated Date: 10/01/23

Material ID: H6080_WEBSITE_2024_Accepted_10012023

Meridian Medicare-Medicaid Plan (MMP) is a health plan that contracts with both Medicare and Illinois Medicaid to provide benefits of both programs to enrollees. This is not a complete list. The benefit information is a brief summary, not a complete description of benefits. For more information contact the plan or read the Meridian Member Handbook. For information on Meridian and other options for your health care, call the Illinois Client Enrollment Services at 1-877-912-8880 (TTY: 1-866-565-8576) or visit enrollhfs.illinois.gov. Out-of-network/non-contracted providers are under no obligation to treat Meridian members, except in emergency situations. Please call our Member Services number or see your Member Handbook for more information, including the cost-sharing that applies to out-of-network services. You can get this document for free in other formats, such as large print, braille, or audio. Call 1-855-580-1689 (TTY: 711). Representatives are available Monday-Friday, 8 a.m. to 8 p.m. to assist you. On weekends and on state or federal holidays, you may be asked to leave a message. Your call will be returned within the next business day. The call is free.