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McLaren Health Plan | Health Insurance Provider in Michigan
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Provider Directory | McLaren Health Advantage
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Drug Formulary Search – McLaren Health Advantage
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Forms & Documents
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Application Form – Enroll in an Exchange Plan (Healthcare.gov)
Application Form/Request a Quote – Individual, McLaren Health Plan Off Marketplace
Authorization For Use And Disclosure of Protected Health Information
Authorized Representative Form
Change Your PCP Form
Continuity of Care Form
Coordination of Benefits Form
Direct Member Reimbursement
Direct Member Reimbursement - Standard
Direct Member Reimbursement Form - COVID Test
Electronic Funds Transfer Form
Explanation of Benefits Sample
Form 1095-B
Health Risk Assessment – Healthy Michigan Plan
Individual Change Form – McLaren Health Plan Off Marketplace
Mail Order Pharmacy Order Form – Birdi
Medicaid and Healthy Michigan Plan New Member Survey
Medicaid COVID Test Direct Member Reimbursement
Member Enrollment and Change Form
MHP - Continuation of Coverage - Online Form
Non-Opioid Directive Form
PHI Revocation Form
Transportation Request Form
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