McLaren Health Plan’s asthma program enrolls members with an asthma diagnosis automatically and focuses on self-management.
McLaren describes a comprehensive asthma program that starts with early identification of the member and relies on education, monitoring and coordination with the primary care physician. Employers should confirm it applies to their group.
What the program is and what members do.
What the program is
McLaren describes a comprehensive asthma disease management program that begins with early identification of the asthmatic member and, through patient education and monitoring, promotes improved outcomes. The carrier says the emphasis is on self-management and coordination with the primary care physician.
How members use it
The carrier describes ongoing individualized contacts to make sure members understand their treatment plans and the preventive measures. It also describes follow-up after hospital, emergency room or urgent care visits, and help making appointments or finding a ride.
What it covers or does not
McLaren lists asthma trigger education, promotion of peak flow meter use and regular use of inhaled anti-inflammatory agents. The page does not state a cost, a benefit design or any outcome results, so treat it as a care support service and not as a coverage change.
Eligibility, funding and plan design.
Who can use it
The carrier says members with a diagnosis of asthma are automatically enrolled and can opt out by calling Customer Service at 1-888-327-0671 (TTY: 711). The page also refers to Medicaid fact sheets. The page does not state a line of business (Medicaid, Medicare or commercial). Employers should confirm with McLaren that it applies to their group.
How it is funded or sold
The page states no price, rider or fee. McLaren presents it as a plan program for its members, not as a separate product. We would not assume any cost or savings from it.
Where it fits in plan design
It sits alongside the medical plan as a support layer for members already identified with asthma. It does not replace a pharmacy benefit or a wellness program, and it works only if the member’s claims are visible to the carrier.
What to settle before relying on it.
Is this program part of our group’s plan?
The page does not say which lines of business it serves. We would ask McLaren to confirm in writing that members of our group are eligible and enrolled automatically.
How are members identified and contacted?
The carrier describes early identification of members with asthma. We would ask what claims or diagnosis triggers enrollment, how soon contact starts and how members opt out.
What reporting do employers get?
The page describes no reporting. We would ask whether McLaren gives employers any group level information on participation, keeping member privacy in mind, and in what form.
Common questions about this program.
Are members enrolled automatically?
McLaren says members with a diagnosis of asthma are automatically enrolled in the Asthma Disease Management program and can opt out through Customer Service.
What does the program focus on?
The carrier describes patient education, monitoring, coordination with the primary care physician, trigger education and use of peak flow meters and inhaled anti-inflammatory agents.
Does this apply to my employer group?
The page does not state a line of business. Employers should ask McLaren to confirm that the program applies to their group.
Where these details come from.
This page summarizes what McLaren publishes. Programs change, so confirm current details with the carrier before relying on them.
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