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MeridianComplete (Medicare-Medicaid Plan) Members

As of January 1, 2026, your MeridianComplete (Medicare-Medicaid Plan) will change and you will be enrolled in a new plan called Wellcare Meridian Dual Align (HMO D-SNP).
Learn about Wellcare By Meridian and all that it has to offer.

 

 

Submit a Prior Authorization

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.

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.

EntityType of ServiceRequest Submission Options
eviCoreSleep Studies, Genetic Testing  Portal: www.evicore.com
Phone: 888-333-8641
Fax - PT/OT: 855-744-1319
Fax - All other services: 800-540-2406
National Imaging Associates, Inc Radiology/Cardiology, Pain Management, Physical/Occupational Therapy  Portal: RadMD.com
Phone: 866-842-1767
HealthHelpMedical oncology, radiation therapy Portal: portal.healthhelp.com
Phone: 888-285-0562
Fax: 866-203-7271
TurningPoint  Musculoskeletal surgical procedures Portal: www.myturningpoint-healthcare.com
Phone: 877-659-9496
Fax: 313-915-5036
ProgenyHealth   NICU admissions 

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

Alternately, view Prior Authorization requirements, training tools, submission options and user guides online.

Last Updated: 10/01/2024

H0480_WEBSITE_2025 Accepted 09302024


Last Updated: 10/01/2024

H0480_WEBSITE_2025 Accepted 09302024

MeridianComplete (Medicare-Medicaid Plan) is a health plan that contracts with both Medicare and Michigan 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 MeridianComplete Member Handbook. Out-of-network/non-contracted providers are under no obligation to treat MeridianComplete 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 1-855-323-4578 (TTY: 711), 8 a.m. to 8 p.m., seven days a week. 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.

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