McLaren Health Plan

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McLaren Health Plan

Quality, evidence-based McLaren Health plan for groups and individuals

Founded in 1998, McLaren Health Care is one of the newer health care systems in the United States, serving over 260,000 members in the Michigan area. Since their initial debut as a state Medicaid program, McLaren has grown into a full-service provider of both group and individual health insurance plans, as well as a number of popular Medicare Supplement plans.

McLaren’s system of providers includes 14 major hospitals across the state of Michigan, as well as the McLaren St. Luke’s hospital in Maumee, Ohio.

McLaren Health Plans: What’s available

In addition to traditional group and individual insurance plans, McLaren Health also offers specialized self-funded group plans, Medicare supplement plans, and a low-cost Medicaid expansion plan funded partially by the state.

Here’s a look at some of their options:

mclaren group traditional health plans

Traditional small & large group coverage

Small and large businesses alike can find group coverage though McLaren Health plans. With traditional, fully-insured group insurance plans, the employer pays a premium (or portion of a premium) to an insurance carrier. In exchange, the insurance company will handle all the medical claims.

mclaren medicare supplement

Medicare Supplement Insurance (MediGap)

McLaren Health Care offers Medicare Supplement parts A, C, F, High Deductible F, G, and N. These plans make it easier for Medicare enrollees to pay for the out-of-pocket costs not covered by original Medicare. Medigap plans can also provide coverage for additional care like vision and dental.

individual mclaren  health plans

Individual McLaren health plans

Individuals looking for health insurance coverage can purchase a number of plans from McLaren, each with different premiums and benefit options. Significant tax credits are available to individuals who are qualified.

mclaren michgan health care

Healthy Michigan Plan

The Healthy Michigan Plan is a state-sponsored Medicaid expansion available to qualified residents who are between the ages of 19 and 64. These plans are co-subsidized by the state and federal governments to provide low-cost coverage to those who qualify.

mclaren self-funded group

McLaren Health Advantage: Self-funded group plans

Also known as Administrative Services Only (ASO) plans, self-funded group plans give employers an opportunity to save even more on benefit expenses. Instead of paying an insurance company to handle all the claims, self-funded plans require the employer to cover the costs of medical claims. This is done through a third-party administrator, like McLaren Health Advantage, so there’s no extra work for the employer.

Want to run a quote for a McLaren Health plan?

If you are located in Michigan and are in need of health coverage, McLaren Health Care can provide you with an affordable plan and an expansive statewide network of hospitals and professionals. Click the link to run an instant quote,  schedule a free consultation with one of our Personal Benefits Managers.


Frequently Asked Questions

What Is McLaren Health?

McLaren Health is an HMO founded in Michigan in 1998, originally to provide affordable medical services to Michigan’s Medicaid population. Since then, the HMO has expanded its suite of insurance offerings to include employer group insurance and individual and family group insurance products

Currently, the McLaren health organization also operates 14 hospitals in Michigan and Ohio, a number imaging and ambulatory surgery centers, and an extensive network of primary care and specialist physicians.

Currently, the organization provides affordable health insurance to approximately 640,000 people in Michigan and Indiana.

What services are available in a McLaren Health plan?

McLaren Health members can get a full spectrum of care throughout every stage of life from McLaren’s network of Michigan and Ohio providers. The McLaren Health Plan covers all essential services required under the Affordable Care Act. 

Currently, McLaren retains a regional network of 14 hospitals, plus primary care and specialist physicians, outpatient and ambulatory surgical centers, pharmacists, home health, infusion, clinical laboratories, and hospices. 

McLaren also operates the highly-regarded Karmanos Cancer Institute, one of only 53 National Cancer Institute-designated comprehensive cancer centers in the United States. 

Can I make an appointment directly with a specialist with McLaren Health?

No. McLaren is a health maintenance organization, or HMO. Premiums are relatively affordable, but you will need to go through your primary care physician and get a referral to make an appointment with a specialist.

Otherwise, your plan may not pay for the visit.

Exception: If you have a chronic medical condition, McLaren may allow you to designate a doctor who specializes in your condition as your primary care provider, or PCP. This eliminates having to get two appointments every time you need to see your specialist – one for the referral and then the specialist appointment itself.

Does the McLaren Health Plan qualify for subsidies under the Affordable Care Act?

Yes. The McLaren Health Plan covers all the essential services required under the Affordable Care Act, and therefore qualifies for an ACA subsidy, depending on your income.

However, you don’t have to buy it over the Affordable Care Act exchange to receive a subsidy. You can get your full subsidy and receive professional guidance and advice on choosing a healthcare plan by going through one of our Personal Benefits Managers – at no charge whatsoever.

To get started, Click here to make an appointment.

McLaren Health Plans Review

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4.0
Rated 4.0 out of 5
4.0 out of 5 stars (based on 5 reviews)
5 star40%
4 star40%
3 star0%
2 star20%
1 star0%

Had a heart attack and they covered everything

Rated 4.0 out of 5
December 8, 2022

I have a Medicare Advantage called Inspire Plus from McLaren. I had an unexpected heart attack last month, and had to be hospitalized for five days.

I’m glad I bought a good plan, but I was still out of pocket for $3800. However, that’s the maximum out of pocket charage, so once I hit that limit I could rest easy.

My meds were cheap because everything I needed was available in generics. And the plan makes most drugs affordable.

If you need specialty drugs, like certain cancer drugs, though, you’ll have to pay up to a third of the cost.

Pretty good plan, overall. But I’d carry a cancer policy if I can get one, which will help with any expensive chemo drugs if you have to pay a lot out of pocket.

Hope that helps!

Philip D
Verified

McLaren Medicare supplement plans

Rated 5.0 out of 5
November 14, 2022

We have a medicare supplement plan G with McLaren and are very happy with the coverage and service. Would definitely recommend them for seniors!

Doug G
Verified

Satisfied customer

Rated 4.0 out of 5
September 18, 2022

We live in Rochester Hills and have been very happy with our Mclaren coverage.

Jim M.
Verified

I love my doctor!

Rated 5.0 out of 5
August 2, 2022

My Doctor’s the best, and everyone at McLaren’s been fantastic.

I had to see a specialist for my neurogenic bladder and it was easy and painless. One thing that was nice – when I got to the urologist, they already had all my records and knew my whole medical history.

Which is handy.

It’s not a great plan for travelers, because the network is pretty much specific to Michigan. But it’s been awesome so far!

Patrice T
Verified

Meh.

Rated 2.0 out of 5
May 24, 2022

Meh. It’s managed care. They’re good most of the time. Sometimes it’s a hassle to get a claim through. Also, you have to stay within their care network. So it’s not a great fit if choosing your own doctor is important for you. That’s just the deal with HMOs.

But if you’re healthy, and don’t have preexisting conditions, it doesn’t matter that much. But if that’s an issue for you, check to see of your doc is in the network, or use a Medigap plan.

They’re a good match for us, and affordable. But once in a while you might have to fight to get your claim paid.

Alex K
Verified
 

1001-A E. Harmony Rd #519 Fort Collins, CO 80525
Telephone: 800-913-0172
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