McLaren’s sickle cell program enrolls members with a diagnosis automatically and coordinates with their primary care physician and hematologist.
McLaren describes a comprehensive program for members with sickle cell disease built on education, monitoring and provider coordination. Employers should confirm it applies to their group.
What the program is and what members do.
What the program is
McLaren describes a comprehensive program that begins with early identification of members with sickle cell disease and promotes improved outcomes through patient education and monitoring. The carrier says the emphasis is on self-management and coordination with the primary care physician and hematologist.
How members use it
The carrier describes ongoing individualized contacts, made as needed, to make sure members understand treatment plans and prevent complications. It also describes help getting needed testing and treatment.
What it covers or does not
The carrier lists self-management, follow up with providers, taking prescribed medications and recommended testing. The page states no costs and does not describe specific treatments as covered.
Eligibility, funding and plan design.
Who can use it
The carrier says members with a diagnosis of sickle cell disease are automatically enrolled and can opt out through Customer Service at 1-888-327-0671 (TTY: 711). 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 or fee. It is presented as a plan program.
Where it fits in plan design
Sickle cell disease is rare, so most groups will have no members in it. For a group with an affected member, it is a coordination layer that does not change benefits or cost sharing.
What to settle before relying on it.
Who does the individual contacts?
The page describes individualized contacts as needed. We would ask who makes them, their training and how often.
How does it work with specialty care and pharmacy?
The page mentions hematologist coordination and prescribed medications. We would ask how McLaren handles specialty drug access for these members.
Does it apply to our group?
The page does not state a line of business. We would ask McLaren to confirm eligibility for our group in writing.
Common questions about this program.
Are members enrolled automatically?
McLaren says members with a diagnosis of sickle cell disease are automatically enrolled and can opt out through Customer Service.
Who does the program coordinate with?
The carrier says it coordinates with the member’s primary care physician and hematologist and helps with getting needed testing and treatment.
Does this apply to my employer group?
The page does not state a line of business. Employers should ask McLaren to confirm applicability.
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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