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.
Quality dental care is an essential part of your overall health. Clover Health has partnered with DentaQuest to offer routine dental exams and services with all plans. Routine dental benefits include:
- 2 oral exams per year, $0 copay
- 2 cleanings per year, $0 copay
- 1 set of dental x-rays per year, $0 copay
For Medicare-covered dental services, like diseases or injuries that are treated in a hospital, refer to your Evidence of Coverage.
In addition to preventive dental care, many Clover Health plans also include a yearly allowance for comprehensive dental services like fillings, crowns, and dentures. Comprehensive dental benefits include:
- A yearly allowance for comprehensive dental services, after you pay up to a $20 copay for each service
For a list of covered comprehensive dental services, refer to your Evidence of Coverage.
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 Clover Health member ID card at the time of service.
HMO members must see a DentaQuest provider to use their supplemental dental benefits. This section does not apply to HMO members.
Before you see an out-of-network dentist for your care, ask your provider for a cost estimate. Then call Clover Health Member Services to understand your share of the cost. If you do see a dentist who is out of the network, you or your dentist will need to submit a claim directly to DentaQuest. We will reimburse up to the allowed amount under your plan; however, you may be responsible for any balance above the allowed amount.
If you or your out-of-network provider needs to submit a claim to DentaQuest, the claim and a copy of your Clover Health member ID card should be mailed or faxed to:
PO Box 2906
Milwaukee, WI 53201-2906
Clover Health has partnered with EyeQuest to offer routine vision exams and eyewear on all plans. How much you pay for glasses or contacts depends on the cost of the eyewear you choose. Routine vision benefits include:
- 1 routine eye exam per year, $0 copay
- A yearly allowance for one pair of eyeglasses or contact lenses
Your Clover Health 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) 8 am-8 pm, 7 days/week*
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 Health member ID card to an EyeQuest provider at the time of service, and be sure your appointment is for a routine exam.
Out-of-network eye care
HMO members must see an EyeQuest provider to use their supplemental vision benefits. This section does not apply to HMO members.
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 you or 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 Health member ID card to:
Attn: Vision Claims Processing
PO Box 433
Milwaukee, WI 53201-0433
Refer to your Evidence of Coverage for details.
Routine hearing care
Original Medicare doesn't cover routine hearing services, but Clover Health does. We believe in treating hearing loss early. Clover Health works with TruHearing to provide hearing aid services at a low cost. Our TruHearing benefit includes:
- 1 routine hearing exam per year with a TruHearing provider, $0 copay
- 2 TruHearing branded hearing aids per year, one for each ear:
- Advanced aid, $699 copay for each hearing aid, or;
- Premium aid, $999 copay 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 (TTY 711) 7 am–6 pm Mountain time, Monday through Friday.
All Clover Health members receive access to SilverSneakers, a program that offers you access to a network of gyms at no cost to you. SilverSneakers' 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.
Over-the-counter items allowance
We understand that the cost of everyday items in your medicine cabinet can add up quickly. All Clover Health plans include a quarterly allowance that 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. Refer to your Evidence of Coverage to find your quarterly allowance.
If your plan is in Arizona, Mississippi, New Jersey, Pennsylvania, Tennessee, or Texas, you can order OTC items online at cvs.com/otchs/clover or by calling 1-888-628-2770 (TTY 1-877-672-2688) 8 am–8 pm local time, Monday through Friday.
If your plan is in Georgia or South Carolina, you can order OTC items online at healthybenefitsplus.com/cloverhealthotc or by calling 1-844-529-5869, 8 am - 11 pm EST, Monday - Friday.
For a sample selection of covered items, consult your 2021 Healthy Benefits Plus Item Catalog.
24/7 Access to Doctors
All Clover Health members have the option to receive medical consultations with board-certified licensed physicians either through web-based video or on the phone. Physicians can diagnose non-emergency common health issues, recommend therapy, and if necessary and appropriate, write non-DEA-controlled prescriptions. Appointments are available 24 hours a day, 365 days per year, with no referral or pre-authorization required.
For more information, see your Evidence of Coverage.
Some Clover Health plans cover 10 one-way non-emergent trips within the plan service area to any health-related location. Each one-way trip must not exceed 50 miles. Please contact Clover Health Member Services at 1-888-778-1478 (TTY 711) 8 am–8 pm local time, 7 days a week* to arrange a ride. Arrangements should be made at least 24 business hours in advance.
For more information, see your Evidence of Coverage.