Supplemental Benefits

Clover plans provide all the benefits of Original Medicare, plus access to supplemental benefits that members use to get quality care and services. We partner with national providers to offer dental, vision, hearing, fitness, and other benefits that supplement Medicare-covered or diagnostic services. Refer to your plan's Evidence of Coverage (EOC) for specific services and costs.

Jump to 2019 Supplemental Benefits

2018 Supplemental Benefits

Dental

Quality dental care is an essential part of your overall health. Clover has partnered with DentaQuest to offer routine dental exams and services.

Supplemental dental benefits include:

  • Two Oral Exams per year, $0 copayment
  • Two Teeth Cleanings per year, $0 copayment
  • One Dental X-Ray per year, $0 copayment

For Medicare-covered dental services, like diseases or injuries that are treated in a hospital, refer to your Evidence of Coverage.
 

In-network dentists

DentaQuest is a nationwide network of dentists committed to high-quality dental care. Seeing an in-network dentist is the easiest way to take advantage of your $0 copay. Just present your card at the time of service for the routine dental visit.

Find a DentaQuest dentist near you >

 

Out-of-network dentists

Before you see an out-of-network dentist for your care, ask your provider for a cost estimate. Then call Clover Customer Experience to understand your share of the cost. If you do go out of network, your dentist will need to submit a claim directly to DentaQuest. We will reimburse your dentist up to the allowed amount under your plan; however, you may be responsible for any balance above the allowed amount.

If your out-of-network provider needs to submit a claim to DentaQuest, have them mail or fax the claim and a copy of your Clover member ID card to:

DentaQuest
PO Box 2906
Milwaukee, WI 53201-2906

Fax: 262-834-3589

 

Vision

Clover covers one routine vision exam per year and provides a yearly allowance for eyeglass frames, lenses, or contact lenses through EyeQuest. Your Clover plan also covers medical vision care, such as diabetic retinal exams, cataract surgeries, and other treatments that fall under your medical benefits. For more information, see your Evidence of Coverage or call us at 1-888-778-1478 (TTY 711).

 

In-network eye care

Your Clover plan covers one routine vision exam per year. An EyeQuest provider will perform your routine exam for a fixed copay. Just present your Clover card at the time of service, and be sure your appointment is for a routine exam.

Find an EyeQuest doctor near you >

 

Out-of-network eye care

If you choose to go out of network for your routine vision exam, you will need to pay up-front and submit a claim or have your provider submit a claim for you to EyeQuest. You will be reimbursed up to the allowed amount under your plan; however, you may be responsible for any balance above the allowed amount.

If your out-of-network provider needs to submit a claim to EyeQuest, have them mail or fax the claim and a copy of your Clover member ID card to:

EyeQuest Attn: Vision Claims Processing
PO Box 433
Milwaukee, WI 53201-0433

Fax: 888-696-9552

 

Glasses and contacts

Need a cooler set of glasses, some new lenses, or contacts? Your plan includes an annual allowance for everyday eye wear through EyeQuest or at other retail locations. We’ll reimburse you up to the amount your plan covers.

How much you pay for glasses or contacts depends on the cost of the eyewear you choose. The following are examples only, to show you how your share of the cost is calculated. Your actual benefits may be different; refer to your Evidence of Coverage for details.

Example one:

If your plan has a $20 copay for eyewear and covers up to $100, and you choose glasses that cost $95

  • You pay the $20 copay Clover pays: $75 up to the total cost of the glasses
    • Total cost: $75 + $20 = $95 cost of the glasses

Example two:

If your plan has a $20 copay for eyewear and covers up to $100, and you choose contact lenses that cost $200

  • You pay the $20 copay
  • Clover pays: $100, up to the benefit maximum. This still leaves a $80 balance on the eyewear you picked.
  • You pay the $80 remaining balance in addition to your copay
    • Total cost: $100 + $20 + $80 = $200 cost of the contact lenses

 

Hearing

Original Medicare doesn't cover routine hearing services, but your Clover plan does. We believe in treating hearing loss early. Clover works with TruHearing to provide hearing aid services at a low cost: one Routine Hearing Exam per year, two hearing aids, and three provider visits within the first year of receiving your aid. Supplemental hearing benefits include the following services and cost-shares:

  • One Routine Hearing Exam per year with a TruHearing provider, $0 copayment
  • Two TruHearing hearing aids per year, one for each ear:
    • Flyte Advanced aid, $699 copayment for each hearing aid, or;
    • Flyte Premium aid, $999 copayment for each hearing aid
  • Three TruHearing Provider Visits within the first year of the hearing aid purchase,
  • 45-day trial period, 3-year extended warranty, and 48 batteries per aid

Your Clover plan also covers diagnostic hearing exams and audiology services. For more information, see your Evidence of Coverage or call us at 1-888-778-1478 (TTY 711).

 

Fitness

All Clover members receive access to Silver Sneakers, a program that offers members free access to a network of gyms. Silver Sneakers' gyms offer activities like recreational swimming, aerobics, weight management services, nutrition counseling, and individualized fitness programs. 

You can contact SilverSneakers at 1-888-423-4632 (TTY 711) 8 am–8 pm EST, Monday–Friday.

Learn more about Silver Sneakers >

 

Telemedicine

Teladoc is Clover's partner for telemedicine services. With Teladoc, you can arrange to speak with a board-certified doctor or mental health professional by phone or video from the comfort of your home. Teladoc providers can treat your minor symptoms, like cold, flu, allergies, infections; or mild to moderate behavioral health concerns. Teladoc doesn't replace your relationship with your Primary Care Provider (PCP), and we encourage you to coordinate use of Teladoc with the care for serious or chronic conditions that you receive from your regular care team. If you are experiencing a medical emergency, call 911 and do not call Teladoc. 

Learn more about Teladoc >

Schedule an appointment with a mental health specialist >

 

Wellness Rewards

Through Clover’s Hello to Healthy rewards program, you can earn complimentary gift cards from your favorite stores for things like getting a flu shot or scheduling an annual Clover Care visit. We’ll also remind you when you’re due for an annual checkup, certain routine screenings, and other points of interest on your wellness journey. It’s an easy way to get the most out of your plan benefits throughout the year. You should receive more information in the mail about this program in the beginning months of each year.

Sign in or create your Hello to Healthy account >

Jump to 2018 Supplemental Benefits

2019 Supplemental Benefits

Dental

Quality dental care is an essential part of your overall health. Clover has partnered with DentaQuest to offer routine dental exams and services with most plans.

Supplemental dental benefits include:
  • Two Oral Exams per year, $0 copayment
  • Two Cleanings per year, $0 copayment
  • One Dental X-Ray per year, $0 copayment
For Medicare-covered dental services, like diseases or injuries that are treated in a hospital, refer to your Evidence of Coverage. 
 

Comprehensive Dental

In addition to preventive dental care, many Clover plans also include a yearly allowance for comprehensive dental service like fillings, crowns, and dentures.

Comprehensive dental benefits include:

  • Two Fluoride Treatments per year, $0 copayment
  • $1000 yearly allowance for comprehensive dental services, after you pay a $20 copayment for each service

For a list of covered comprehensive dental services, refer to your Evidence of Coverage. 

In-network dentists
DentaQuest is a nationwide network of dentists committed to high-quality dental care. Seeing an in-network dentist is the easiest way to take advantage of your benefits. Just present your card at the time of service.

Find a DentaQuest dentist near you >
 
Out-of-network dentists
Before you see an out-of-network dentist for your care, ask your provider for a cost estimate. Then call Clover Customer Experience to understand your share of the cost. If you do go out of network, your dentist will need to submit a claim directly to DentaQuest. We will reimburse your dentist up to the allowed amount under your plan; however, you may be responsible for any balance above the allowed amount.

If your out-of-network provider needs to submit a claim to DentaQuest, have them mail or fax the claim and a copy of your Clover member ID card to:

DentaQuest
PO Box 2906
Milwaukee, WI 53201-2906
Fax: 262-834-3589

Routine Vision Services

Clover has partnered with EyeQuest to offer routine vision exams and eyewear with most plans. How much you pay for glasses or contacts depends on the cost of the eyewear you choose.

Routine vision benefits include:
  • One Routine eye exam per year, $0 copayment
  • $100 yearly allowance for one pair of eyeglasses or contact lenses

Your Clover plan also covers medical vision care, such as diabetic retinal exams, cataract surgeries, and other treatments that fall under your medical benefits. For more information, see your Evidence of Coverage or call us at 1-888-657-1207  (TTY 711).


In-network eye care
EyeQuest is a nationwide network of optometrists committed to high-quality eye care. Seeing an in-network vision provider is the easiest way to take advantage of your benefits. Just present your Clover card to an EyeQuest provider at the time of service, and be sure your appointment is for a routine exam.

Find an EyeQuest doctor near you >
 
Out-of-network eye care
If you choose to go out of network for your routine vision services, you may need to pay up-front and submit a claim, or have your provider submit a claim for you to EyeQuest. You will be reimbursed up to the allowed amount under your plan; however, you may be responsible for any balance above the allowed amount.

If your out-of-network provider needs to submit a claim to EyeQuest, have them mail or fax the claim and a copy of your Clover member ID card to:

EyeQuest 
Attn: Vision Claims Processing
PO Box 433
Milwaukee, WI 53201-0433
Fax: 888-696-9552
 
Refer to your Evidence of Coverage for details.

Hearing

Original Medicare doesn't cover routine hearing services, but most Clover plans do. We believe in treating hearing loss early. Clover works with TruHearing to provide hearing aid services at a low cost. Our TruHearing benefit includes: 

  • One Routine Hearing Exam per year with a TruHearing provider, $0 copayment
  • Two TruHearing branded hearing aids per year, one for each ear:
    • Advanced aid, $699 copayment for each hearing aid, or;
    • Premium aid, $999 copayment for each hearing aid
    • 3 TruHearing provider visits within the first 12 months of your hearing aid purchase
    • 45-day trial and 3-year warranty
    • 48 free batteries per aid included with non-rechargeable hearing aid models

To learn more and schedule an appointment with a TruHearing provider, call 1-855-205-5570.

Your Clover plan also covers diagnostic hearing exams and audiology services. For more information, see your Evidence of Coverage or call us at 1-888-657-1207  (TTY 711).
 

Fitness

All Clover members receive access to Silver Sneakers, a program that offers members free access to a network of gyms. Silver Sneakers' gyms offer activities like recreational swimming, aerobics, weight management services, nutrition counseling, and individualized fitness programs.

You can contact SilverSneakers at 1-888-423-4632 (TTY 711) 8 am–8 pm EST, Monday–Friday.

Learn more about Silver Sneakers >
 

Over-The-Counter Items Allowance

We understand that the cost of everyday items in your medicine cabinet can add up quickly. Some Clover plans include a quarterly allowance which can be used to pay for select over-the-counter medications and supplies, including allergy medication, digestive health treatments, first aid supplies, pain relievers, and more. If your plan includes this benefit, refer to your Evidence of Coverage to find your quarterly allowance.

OTC items should be ordered online or by calling 1-888-628-2770 (TTY 1-888-672-2688) 9 am–8 pm EST, Monday–Friday.

For more information and a complete list of covered items, see your 2019 OTC Health Solutions Item Catalog and Evidence of Coverage. 

 

Health-Related Transportation

For members who have issues with mobility or who need assistance getting to doctor appointments, some Clover plans include 10 one-way rides per year to health-related locations within the plan service area. 

To arrange for transportation, call Member Services at 1-888-657-1207.

For more information and benefit limitations, see your Evidence of Coverage.