Meridian Health Plan
Meridian Health Plan is a Centene-owned Medicaid managed care organization delivering capitation-based healthcare coverage to nearly 1 million Illinois Medicaid members through a state-contracted provider network of 220+ hospitals and 64,000+ clinicians.
- Company typePrivate
- Founded1997
- HeadquartersDetroit, United States
- Headcount1,001–5,000
- GTM typeB2C
- OfferingServices
What Meridian Health Plan does
Meridian Health Plan is a Medicaid managed care organization headquartered in Detroit, Michigan, with primary operating focus in Illinois under the brand Meridian Health Plan of Illinois. Founded in 1997, the company operates as a wholly-owned subsidiary of Centene Corporation (NYSE: CNC), a Fortune 500 managed care enterprise. Meridian delivers capitation-based Medicaid coverage to nearly 1 million Illinois members through the state-contracted HealthChoice Illinois program, with a contracted network comprising 220+ hospitals, 21,000+ primary care providers, 43,000+ specialists, and 5,700+ behavioral health providers. The company also operates MLTSS (Managed Long Term Services and Supports), a dual-eligible special needs plan marketed as Wellcare Meridian Dual Align (HMO D-SNP), and Ambetter-branded Health Insurance Marketplace plans.
Revenue is generated primarily through capitation premiums paid by the State of Illinois per enrolled Medicaid beneficiary, negotiated through state MCO contracts effective January 1, 2027. All covered services are provided at no cost to eligible members with no premiums, deductibles, or copayments. Distribution occurs through Illinois Client Enrollment Services (ICES) for member enrollment and through in-network provider referrals across the contracted network. Additional member engagement channels include community events, social media presence, and a member portal with iOS and Android mobile applications (Health Insurance Portal).
The technology stack combines a provider portal with electronic claims processing routed through Availity (Payer ID: MHPIL) and Change Healthcare (Payer ID: MCCIL) clearinghouses, with 6 Degrees Health serving as clean claim vendor and PaySpan handling electronic payments. Telehealth access is delivered through Teladoc for adult care, Blueberry Pediatrics for members under 12, Brave Health for behavioral health for members 13+, and Pyx Health for adolescent loneliness and depression support. The company achieves CARIN Alliance Code of Conduct compliance and CMS-9115-F Patient Access API interoperability, enabling members to connect health records to third-party applications. Operations are led by Sean Kendall as Plan President and CEO, with Kay Judge serving as Chief Medical Officer.
Meridian Health Plan firmographics
Firmographics- Name
- Meridian Health Plan
- Legal name
- Meridian Health Plan of Illinois
- Website
- https://ilmeridian.com
- Company type
- Private
- Founded year
- 1997
- Operating status
- Operating
- Headcount range
- 1,001–5,000 employees
- Short description
- Meridian Health Plan is a Centene-owned Medicaid managed care organization delivering capitation-based healthcare coverage to nearly 1 million Illinois Medicaid members through a state-contracted provider network of 220+ hospitals and 64,000+ clinicians.
- Ownership category
- akta.pro rank
Meridian Health Plan industry classification
Industry- Product category
- Medicaid Managed Care
- NAICS
- Direct Health and Medical Insurance Carriers (524114), Health Care and Social Assistance (62)
- SIC
- Services-Health Services (8000)
- akta.pro primary industry
- Integrated Physical-Behavioral-Social Care (Whole-Person) Medicaid Plans (HLAEAEAI)
- akta.pro secondary industries
- Medicaid Expansion (ACA Adult) Managed Care Plans (HLAEAEAB), Aged, Blind & Disabled (ABD) Managed Care Plans (HLAEAEAC), Healthcare-Linked Social Benefits Administration (e.g., Medicaid/Means-Tested Health Coverage) (BPAIAKAH)
Keywords
Where Meridian Health Plan is headquartered
LocationHeadquarters
- HQ city
- Detroit
- HQ country
- United States
- HQ region
- North America
Offices1 record
Markets served
Meridian Health Plan business model
Business model- GTM type
- B2C
- Offering type
- Services
- Cost components
- Operations, Personnel, Technology or R&D, Marketing or Sales, Infrastructure
Revenue model
- Medicaid Premium Revenue: Meridian generates revenue through capitation premiums paid by the State of Illinois for each enrolled Medicaid beneficiary under the HealthChoice Illinois managed care program. Premium rates are negotiated through state contracts effective January 1, 2027.
Pricing tiers
| Model | Billing | Price |
|---|---|---|
| Subscription | Others | Meridian Medicaid Plan - No-cost coverage for eligible Illinois Medicaid beneficiaries |
Go-to-market motion1 record
Distribution channels3 records
Marketing channels6 records
Meridian Health Plan product offering
Product offeringCore offering
Meridian Health Plan of Illinois is a Medicaid managed care organization that partners with the State of Illinois through the HealthChoice Illinois program to provide no-cost healthcare coverage to nearly one million Illinois Medicaid beneficiaries. Its core offerings include the Meridian Medicaid Plan, Managed Long Term Services & Supports (MLTSS), the Wellcare Meridian Dual Align (HMO D-SNP) for dual-eligible Medicare-Medicaid members, and Ambetter Health Insurance Marketplace plans for individual ACA coverage. Members access comprehensive medical, dental, vision, behavioral health, pharmacy, and transportation benefits through a contracted network of 220+ hospitals and tens of thousands of providers across Illinois.
Differentiator
Problem solved
Functional benefit
Brands
- Health Happens Here Grants: Community health initiative grant program supporting behavioral health, wellness, and social services across Illinois.
- Healthy Rewards
- MindCare
- Mind*Care
Products and services
- Meridian Medicaid Plan No-cost Medicaid managed care plan for Illinois Medicaid-eligible beneficiaries, including families, children, pregnant women, and individuals with disabilities, providing medical, dental, vision, behavioral health, pharmacy, transportation, and preventive care benefits through the HealthChoice Illinois program.
- Meridian MLTSS (Managed Long Term Services & Supports)
Companies that use Meridian Health Plan
Customer profileNamed customers1 record
Segments4 records
Ideal customer profiles3 records
Meridian Health Plan technology and API
TechnologyTechnology focussed No
API detail
- Has API
- No
- API docs
- API detail
Core technology
AI maturity
App detail
Integration7 records
Meridian Health Plan partnerships and signals
Strategic signalPartnerships
Ten partnerships are on record, tiered major, minor and core.
- Safer FoundationmajorMeridian Health Plan of Illinois and Centene Foundation jointly awarded a $2.2 million grant to Safer Foundation for the purchase and renovation of a 23-unit affordable housing building in Chicago's South Austin neighborhood. The project includes 15 one-bedroom, four two-bedroom, and four three-bedroom units, with some designated for justice-involved individuals and Colbert & Williams program graduates. Renovations expected to be completed for occupancy in 2026, expanding affordable housing portfolio for individuals returning to community living.
- Food On The Move / St. Louis Area FoodbankmajorMeridian Health Plan of Illinois committed $1.15 million over three years to Food On The Move, a mobile food pantry program operated by St. Louis Area Foodbank. The funding will support more than 300 mobile market distributions in Metro East and Southern Illinois, serving approximately 60,000 community members through 2028. Starting in 2026, Meridian will partner with local healthcare providers to offer vaccines and health screenings at selected distribution events.
- Local Healthcare ProvidersminorStarting in 2026, Meridian will partner with local healthcare providers to offer vaccines and health screenings at selected mobile food distribution events operated by St. Louis Area Foodbank.
- Illinois Food Pantries NetworkminorMeridian Health Plan of Illinois and Centene Foundation donated $300,000 to food pantries across Illinois to combat food insecurity. The funds support local food banks and nutrition programs including farmers' market vouchers and wellness initiatives. This effort is part of a broader $1.5 million commitment by Centene Foundation to fight food insecurity nationwide.
- TeladoccoreTeladoc provides 24/7 telehealth services for Meridian Medicaid members, offering access to in-network physicians for medical advice, diagnoses, and prescriptions via phone or video.
- Blueberry PediatricscoreBlueberry provides telehealth services for Meridian Medicaid members from birth through age 12, offering access to licensed providers through their mobile application.
- Brave HealthcoreBrave Health provides mental health telehealth services for Meridian members age 13 and older, offering general mental health care through virtual visits.
- AvailitycoreAvaility serves as Meridian's clearinghouse for electronic claims submission (Payer ID: MHPIL). Claims submitted from other clearinghouses are routed to Availity before being sent to Meridian.
- PaySpancorePaySpan is a free solution for electronic payments and automatic reconciliation that simplifies administrative tasks for contracted Meridian providers.
- 6 Degrees Healthcore6 Degrees Health serves as Meridian's clean claim vendor for claims processing and review.
Scale indicators6 records
Recent moves6 records
Expansion highlights5 records
Meridian Health Plan competitors and assessment
Company assessmentDirect peers
- Molina Healthcare: Public Medicaid MCO competing directly with Meridian for Illinois HealthChoice contracts and members across multiple states; comparable capitation-funded model serving TANF, ABD, and D-SNP populations.
- Blue Cross and Blue Shield of Illinois (HCSC): Largest Illinois health insurer with a Blue Cross Community Health Plans Medicaid MCO competing head-to-head for the same state contract; similar provider-network model serving Medicaid beneficiaries.
- Cook County Health (CountyCare): County-owned Medicaid MCO competing for the same HealthChoice Illinois auto-assignment pool; comparable capitation revenue model focused on lower-income Cook County residents.
- Aetna Better Health of Illinois (CVS Health): CVS-owned Medicaid MCO operating in Illinois HealthChoice with substantially overlapping member populations; similar model with pharmacy integration advantages.
- UnitedHealthcare Community Plan of Illinois: UnitedHealth Group's Illinois Medicaid plan competing for the same state contract; comparable managed-care infrastructure with broader Optum health-services integration.
- CareSource: Nonprofit Medicaid MCO with multi-state footprint and similar government-program focus; comparable member demographics and managed-care delivery model.
- Humana Healthy Horizons: Humana's Medicaid managed care division; comparable capitation revenue model across multiple states with growing emphasis on D-SNP and integrated products.
- WellCare (Centene subsidiary): Centene-owned Medicaid and Medicare brands sharing infrastructure and parent company with Meridian; directly comparable D-SNP and Medicare Advantage product strategy.
Broad incumbents
- Elevance Health (Anthem): Large diversified parent with state Medicaid health plans overlapping Meridian's Illinois contract footprint; comparable scale, broader portfolio including commercial and Medicare.
- Cigna Healthcare: National health services carrier with select Medicaid presence and Medicare focus; broader portfolio but overlapping capabilities in managed-care administration and provider contracting.
Market position
Strengths5 records
Weaknesses5 records
Competitive moat4 records
Key risks6 records
Key highlights7 records
Customer concentration
Meridian Health Plan social profiles
Digital presenceMeridian Health Plan financial estimates
Financial estimateRevenue estimate
Valuation estimate
Meridian Health Plan leadership team
Management profileNumber of profiles
Profiles2 records
Meridian Health Plan funding detail
Funding detailFunding overview
Funding rounds
Investors
Funding detail is available on the Subscription and Enterprise plan.Contact sales →
Meridian Health Plan M&A and investment
M&A and investmentM&A
Investments18 records
M&A and investment is available on the Subscription and Enterprise plan.Contact sales →
Frequently asked questions about Meridian Health Plan
What does Meridian Health Plan do?
Meridian Health Plan of Illinois is a Medicaid managed care organization that partners with the State of Illinois through the HealthChoice Illinois program to provide no-cost healthcare coverage to nearly one million Illinois Medicaid beneficiaries. Its core offerings include the Meridian Medicaid Plan, Managed Long Term Services & Supports (MLTSS), the Wellcare Meridian Dual Align (HMO D-SNP) for dual-eligible Medicare-Medicaid members, and Ambetter Health Insurance Marketplace plans for individual ACA coverage. Members access comprehensive medical, dental, vision, behavioral health, pharmacy, and transportation benefits through a contracted network of 220+ hospitals and tens of thousands of providers across Illinois.
Is Meridian Health Plan a public or private company?
Meridian Health Plan is a private company. It is classified as corporate owned and is currently operating.
When was Meridian Health Plan founded?
Meridian Health Plan was founded in 1997. It employs 1,001 to 5,000 people.
Where is Meridian Health Plan based?
Meridian Health Plan is headquartered in Detroit, United States, in the North America region.
How does Meridian Health Plan make money?
One revenue line is on record: medicaid Premium Revenue.
Who are Meridian Health Plan's main competitors?
Direct peers on record are Molina Healthcare, Blue Cross and Blue Shield of Illinois (HCSC), Cook County Health (CountyCare), Aetna Better Health of Illinois (CVS Health), UnitedHealthcare Community Plan of Illinois, CareSource, Humana Healthy Horizons and WellCare (Centene subsidiary). Broad incumbents are Elevance Health (Anthem) and Cigna Healthcare.
Does Meridian Health Plan have an API?
No public API is recorded for Meridian Health Plan.
What industry is Meridian Health Plan in?
Meridian Health Plan's product category is Medicaid Managed Care. Its primary akta.pro industry code is HLAEAEAI, Integrated Physical-Behavioral-Social Care (Whole-Person) Medicaid Plans, with a secondary code of HLAEAEAB, Medicaid Expansion (ACA Adult) Managed Care Plans. Its NAICS code is 524114 and its SIC code is 8000.