Sept. 2021

 

 

 

New Cost Share Announced for COVID-19 Testing and Treatment

McLaren Health Plan will continue to provide COVID-19 testing with no cost sharing through Dec. 31, 2021. Member cost share will apply for treatment of COVID-19 related services effective Oct. 1, 2021. This does not apply to McLaren Medicaid or Healthy Michigan Plan members. Please call Customer Service at 888-327-0671 (TTY: 711) if you have any questions.

 

Revised as of Dec. 2020

No Cost Share for COVID-19 Testing and Treatment Extended Through March 31, 2021; vaccine covered at no cost share when it becomes available.

The health and safety of our members and providers during the coronavirus pandemic is our number one priority. It’s important for our members to get the care they need at a cost they can afford.

McLaren Health Plan will continue to provide COVID-19 testing and related treatment with no cost sharing through March 31, 2021. The COVID-19 vaccine will be covered at no cost share for members when it becomes available. McLaren Health Plan will pay an in-office or facility fee for the administration of the vaccine. Providers may not bill for the product if it was received at no cost.

Members who seek services at an out-of-network provider for treatment will be responsible for out-of-network cost share.

COVID-19 Benefit Reminders for MHP Members 

  • There is no cost-sharing for both in-network and out-of-network testing for COVID-19. This includes lab services and items and services related to when or how members receive the test. Services can take place at provider offices, urgent care centers, hospital emergency rooms or through telehealth visits.
  • There is no member cost-sharing for a telehealth visit nor any preauthorization requirements. Bill modifier -GT with the appropriate office call.
  • No authorization is required for any inpatient hospital stay at any in-network facility for any diagnosis.
  • No inpatient authorization is required for COVID-19 admission at in- or out-of-network facilities, including hospitals, SNFs, inpatient rehabs, LTACHs, transfers.
  • No authorization is required for COVID-19 testing at in- or out-of-network labs (CPT codes U0001, U0002, 87635)
  • No authorization is required for any outpatient COVID-19 related services, including DME, oxygen, therapy, etc.

These benefits apply to McLaren Health Plan Medicaid, Health Advantage, Community and Exchange members. This may not apply to self-funded or high-deductible health plans.

Members are encouraged to schedule appointments for missed services via in-person or telemedicine. If you have questions or need help with your McLaren Health Plan patients, please call customer service at 888-327-0671 (TTY: 711).

 

Revised as of Aug. 2020

No Cost Share for COVID-19 Testing and Treatment Extended Through Dec. 31

The health and safety of our members and providers during the coronavirus pandemic is our number one priority. It’s important for our members to get the care they need at a cost they can afford.

McLaren Health Plan will continue to provide COVID-19 testing and related treatment with no cost sharing through Dec. 31, 2020.

If you go to an out-of-network provider for treatment, your out-of-network cost share will apply.

Patients may have been incorrectly charged a copay after March 31 for COVID-19 related services. Please know we have fixed the error and are reprocessing claims.

COVID-19 Benefit Reminders for MHP Members -click to expand

  • There is no cost-sharing for both in-network and out-of-network testing for COVID-19. This includes lab services and items and services related to when or how members receive the test. Services can take place at provider offices, urgent care centers, hospital emergency rooms or through telehealth visits.
  • There is no member cost-sharing for a telehealth visit nor any preauthorization requirements. Bill modifier -GT with the appropriate office call.
  • No authorization is required for any inpatient hospital stay at any in-network facility for any diagnosis.
  • No inpatient authorization is required for COVID-19 admission at in- or out-of-network facilities, including hospitals, SNFs, inpatient rehabs, LTACHs, transfers.
  • No authorization is required for COVID-19 testing at in- or out-of-network labs (CPT codes U0001, U0002, 87635)
  • No authorization is required for any outpatient COVID-19 related services, including DME, oxygen, therapy, etc.

These benefits apply to McLaren Health Plan Medicaid, Health Advantage, Community and Exchange members.

May not apply to self-funded or high-deductible health plans.

Members are encouraged to schedule appointments for missed services via in-person or telemedicine. If you have questions or need help with your McLaren Health Plan patients, please call customer service at 888-327-0671 (TTY: 711).