Family Planning and Contraceptive Coverage
McLaren Health Plan members have comprehensive coverage for family planning and contraception needs. The following are covered under your McLaren Health Plan benefits
For McLaren Health Plan Medicaid: Contraceptive Medications and Devices: These services and supplies do not require a referral and include, among other things, birth control pills; implantable contraceptive drugs; condoms, contraceptive foams or devices; I.U.D.s (including insertion and removal); contraceptive jellies and ointments, even if for a medical condition other than birth control. Condoms for Members age 10 and above are to be dispensed in quantities no greater than 12 at one time and no more than 36 in a 30-day period.
For McLaren Health Plan Community: “Contraceptive methods” include Coverage for designated contraceptive medications, devices and appliances when prescribed by an MHP Community Participating Provider. Coverage for contraceptives includes Coverage at no cost for at least one drug/device in each of the FDA’s categories. Some devices and appliances (e.g., IUD’s) are Covered under your medical Benefits and are subject to the medical conditions of Coverage.
MHP Community also covers, without cost sharing, contraceptive services and FDA approved, cleared, or granted contraceptive products that your attending provider, who is a Participating Provider, and has determined to be medically appropriate for you, even if the contraceptives are not in the categories listed in the then applicable HRSA-Supported Guidelines (“HRSA Guidelines”). This can include contraceptive products more recently approved, cleared, or granted by FDA. Contraceptives must be prescribed and administered by an MHP Community Participating Provider. When obtained through the pharmacy benefit, contraceptives must be ordered by an MHP Community Participating Provider and delivered through a Participating Pharmacy.
Please contact McLaren Health Plan Customer Service at 888-327-0671 with questions regarding coverage of contraception.