McLaren’s care management is aimed at members with complex conditions, and the published detail is mostly member education.
McLaren Health Plan publishes member information on adult and child complex care management, asthma and diabetes, and says Health Advantage includes disease management. The details of how a group accesses them are thin.
What the program is and what members do.
What is published
The McLaren Health Plan wellness page links to member documents titled Adult Complex Care Management, Child Complex Care Management, Asthma Awareness, Living With Diabetes and Diabetes Psychiatric Medications. These are downloadable member information, not a program description with enrollment steps.
What Health Advantage says
McLaren says McLaren Health Advantage is a PPO that integrates features to help members manage their health, such as preventive services and disease management programs. The member page names disease management but does not list the conditions covered or how members enroll.
What members do
Members can read the published guides and use the plan’s nurse line for more support. Care management itself usually involves a nurse or care manager contacting members with complex needs, but McLaren’s wellness page does not describe the outreach process, so do not assume details beyond what it states.
Eligibility, funding and plan design.
Who can use it
The documents are addressed to McLaren members, and the disease management reference sits on the Health Advantage page for the self-funded PPO. Which conditions and which employer groups are included is not published. Eligibility may vary by plan, funding and employer.
How it is funded or sold
McLaren does not list care management as a priced add-on on these pages. It appears to be part of how the plan manages medical care, but whether it is included for every fully insured and self-funded group needs written confirmation from the carrier.
Where it fits in plan design
Care management matters most for groups with a few high-cost members, where early nurse outreach can influence care. It is not an employee-facing perk. Employers should know what it is and how it works, then use it as one input when evaluating a McLaren renewal or alternative.
What to settle before relying on it.
Which conditions are managed and how are members found?
Ask McLaren how members are identified for care management, whether through claims, authorizations or referral, and which conditions trigger outreach. A published list of guides is not the same as a program that reaches members, so ask for the process in writing.
What does the employer see?
Ask what group-level reporting comes from care management, such as number of members engaged, and what stays private. Employers should not expect to see which employees are in a program, and should be wary of any request that would expose it.
Is it the same on our product?
The disease management reference appears on the Health Advantage page. Ask whether fully insured McLaren groups get an equivalent program, in writing, and request the contact route for member referrals. Care management should not be tied to financial rewards without counsel review under HIPAA, ACA, ADA and GINA rules.
Common questions about this program.
What conditions does McLaren publish information about?
The McLaren Health Plan wellness page links to member documents on adult and child complex care management, asthma, living with diabetes and diabetes with psychiatric medications. Whether a formal program exists for each condition is not stated.
Does McLaren Health Advantage include disease management?
McLaren says Health Advantage is a PPO that integrates features to help members manage their health, such as preventive services and disease management programs. The conditions covered are not listed on that page.
How does a member enter care management?
McLaren does not describe the process on its wellness page. Members can call the plan’s customer service or nurse support number, and employers should ask the carrier how referrals and outreach work.
Where these details come from.
This page summarizes what McLaren Health Plan publishes. Programs change, so confirm current details with the carrier before relying on them.
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