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Plan Details

The Summary of Benefits (SOB) and Evidence of Coverage (EOC) list all the benefits and details related to our plans.

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2016 Winner of Senior Gold Choice Award

Clover was awarded the Senior Gold Choice Award for “Excellence in Medicare Benefits Value” by HealthMetrix (October 15, 2015), shown to have the #1 lowest estimated out-of-pocket costs among all Medicare Advantage plans offered for members.

This information isn't endorsed by Medicare. Clover has no affiliation with Medicare News Watch or HealthMetrix.

Medicare evaluates plans based on a 5-star rating system. Star Ratings are calculated each year and may change from one year to the next.

Please visit www.medicare.gov for more information on Star Ratings

Clover Overall Star Rating

3 1/2 stars

2017

Clover Plan Services

3 1/2 stars

2017

Clover Drug Plan Services

3 stars

2017

Clover

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Member Services

1-888-778-1478 (TTY 711)
8 am–8 pm local time, 7 days/week*

Clover Health
NJ P.O. Box 471
Jersey City, NJ 07303

*We are open from 8 am–8 pm local time, 7 days a week. From February 15th through September 30th, alternate technologies (for example, voicemail) will be used on the weekends and holidays.

Out-of-network/non-contracted providers are under no obligation to treat Clover members, except in emergency situations. For a decision about whether we will cover an out-of-network service, we encourage you or your provider to ask us for a pre-service organization determination before you receive the service. Please call our customer service number or see your Evidence of Coverage for more information, including the cost-sharing that applies to out-of-network services.

Disclaimer section

Last Updated: 1/11/2018

Clover Health is a Preferred Provider Organization (PPO) with a Medicare contract. Enrollment in Clover Health depends on contract renewal.

You must continue to pay your Medicare Part B premium. For plans that provide drug coverage, the formulary may change during the year.

ATTENTION: If you speak English, language assistance services, free of charge, are available to you. Call 1-888-657-1207 (TTY 711).

ATENCIÓN: Si usted habla español, tenemos servicios de asistencia lingüística disponibles para usted sin costo alguno. Llame al 1-888-657-1207 (TTY 711).

小贴士：如果您说普通话，欢迎使用免费语言协助服务。请拨 1-888-657-1207 (TTY 711)

Disclaimer:

This information is not a complete description of benefits. Contact the plan for more information.
Limitations, copayments, and restrictions may apply.
Plan performance Medicare Star Ratings are assessed each year and may change from one year to the next.
Benefits, premiums, and/or copayments/coinsurance may change on January 1 of each year.
The formulary, pharmacy network, and/or provider network may change at any time. You will receive notice when necessary.

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Original Medicare

Traditional Medicare covers hospitals (Part A) and doctors (Part B), and you pay standard rates for services. You can go to any doctor, hospital or other provider that accepts Medicare patients anywhere in the country.

You can add drug coverage (Part D) by enrolling in a private "stand-alone" drug plan for an additional premium. You can buy separate Medigap insurance to cover some or most of the out-of-pocket costs of hospitals (Part A) and doctors (Part B).

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Attention:

To enroll in a plan with a 2017 effective date, you must have a qualifying life event.

If you feel you may still qualify for a Special Enrollment, give Clover a call at 1-888-781-3235 (TTY-711), 8am - 8pm, 7 days/week, and we'll help you through the process.