Provider / Pharmacy Directory Information
SECTION 1 – INTRODUCTION
This directory provides a list of McLaren Medicare network providers.
Welcome to McLaren Medicare. McLaren Medicare has thousands of doctors and many leading hospitals ready to care for you. We combine the resources of independent physicians, multi-specialty groups, ambulatory care centers, ancillary providers, and hospitals to offer our members access to the highest quality health care providers you expect.
You will have to choose one of our network Providers listed in this directory to be your Primary Care Provider (PCP). Generally, you must get your health care services from your PCP.
PCPs are Family or General Practitioners, Geriatricians, or Internal Medicare physicians. You should receive all of your routine care from your PCP. Your PCP will also coordinate your specialty care, ancillary services, and inpatient services. In many situations, you must receive approval in advance before you can use other providers the plan’s network. This is called giving you a “referral”.
Please use this directory as a reference when you need to choose a provider for health care services. This directory lists whether the PCP is taking new patients, their office practice hours, and if the doctor speaks a language other than English. If you need help choosing a PCP, you can call Member Services at 833-358-2404 (TTY: 711). You can change your PCP at any time.
The network providers listed in this directory have agreed to provide you with your health care services. You may go to any network providers listed in this directory; however, some services may require a referral.
As a member of a McLaren Medicare plan, you must receive your care from in-network providers, except in emergency or urgent care situations or for out-of-area renal dialysis or other services the plan authorizes out-of-network.
If you are enrolled in a plan with a Point of Service (POS) benefit. You can use your POS benefit to receive care from in-network or out-of-network providers, but you will pay more for these services if you use an out-of-network provider. Refer to your Evidence of Coverage to see if you have a POS benefit and what you will pay for out-of-network services.
In cases where out-of-network providers submit a bill directly to you, you should not pay the bill. Submit the bill to McLaren Medicare for processing and determination of your liability, if any. Please refer to your Evidence of Coverage for complete details.
You may get covered emergency or urgent care whenever you need it, anywhere in the United States or its territories. Some of our plans cover emergency and urgent care worldwide. Se your Evidence of Coverage to find out if your plan covers emergency and urgent care services anywhere in the world.
What is the Service Area for McLaren Medicare?
The counties in our service area are listed below:
Alcona, Antrim, Arenac, Barry, Bay, Benzie, Berrien, Calhoun, Cass, Charlevoix, Clare, Clinton, Crawford, Eaton, Emmet, Genesee, Gladwin, Grand Traverse, Gratiot, Hillsdale, Huron, Ingham, Ionia, Iosco, Isabella, Kalamazoo, Kalkaska, Kent, Lake, Lapeer, Leelanau, Livingston, Macomb, Manistee, Mecosta, Midland, Missaukee, Montcalm, Montmorency, Newaygo, Oakland, Ogemaw, Osceola, Oscoda, Otsego, Ottawa, Roscommon, Saginaw, St. Clair, St. Joseph, Sanilac, Tuscola, Van Buren, Washtenaw, Wayne, and Wexford.
How do you find a McLaren Medicare provider in your area?
The providers listed in this directory are listed by Provider type (PCP, Specialists, Hospital, etc.), alphabetically by county, specialty type and provider last name.
If you have questions about McLaren Medicare’s Provider/Pharmacy Directory, want to report a directory discrepancy or require assistance in selecting a PCP, please call Member Services at 833-358-2404, April 1st through September 30th Monday through Friday, 8 a.m. to 8 p.m. or October 1st through March 31st seven days a week (except Thanksgiving and Christmas days), 8 a.m. to 8 p.m. TTY users should call 711.
McLaren Medicare
2023 Pharmacy Directory
This Pharmacy Directory is current as of 05/2023. For more recent information or other questions, please contact McLaren Medicare Member Services, at 833-358-2404 or, for TTY users, 711, April 1st through September 30th Monday through Friday, 8 a.m. to 8 p.m. or October 1st through March 31st seven days a week (except Thanksgiving and Christmas days), 8 a.m. to 8 p.m., or visit www.mclarenhealthplan.org/medicare.
Changes to our pharmacy network may occur during the benefit year. An updated Provider/Pharmacy Directory is located on our website at ww.mclarenhealthplan.org/medicare. You may also call Member Services at 833-358-2404 (TTY/TDD users should call 711) for updated information.
INTRODUCTION
This booklet provides a list of McLaren Medicare’s network pharmacies. To get a complete description of your prescription coverage, including how to fill your prescriptions, please review the Evidence of Coverage and McLaren Medicare’s formulary.
We call the pharmacies on this list our “network pharmacies” because we have made arrangements with them to provide prescription drugs to Plan members. In most cases, your prescriptions are covered under McLaren Medicare only if they are filled at a network pharmacy or through our mail order or specialty pharmacy service. Once you go to one pharmacy, you are not required to continue going to the same pharmacy to fill your prescription but can switch to any other of our network pharmacies. We will fill prescriptions at non-network pharmacies under certain circumstances as described in your Evidence of Coverage.
All network pharmacies may not be listed in this directory. Pharmacies may have been added or removed from the list after this directory was printed. This means the pharmacies listed here may no longer be in our network, or there may be newer pharmacies in our network that are not listed. This list is current as of 10/01/2021. For the most current list, please contact us. Our contact information appears on the front and back cover pages.
You can get prescription drugs shipped to your home through our network mail order delivery program which is called MedImpact Direct Mail® For more information, please contact us or see the mail order section of this pharmacy directory.
We also list pharmacies that are in our network but are outside of our service area, the area in which you live. You may also fill your prescriptions at these pharmacies. For more information, please see the section in this directory on Network Pharmacies outside of the service area.
If you have questions about any of the above, please see the first and last cover pages of this directory for information on how to contact us.