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 has partnered with DentaQuest to offer routine dental exams and services with most plans. Routine 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.
In addition to preventive dental care, many Clover plans also include a yearly allowance for comprehensive dental services like fillings, crowns, and dentures. Comprehensive dental benefits include:
- Two Fluoride Treatments per year, $0 copayment
- A 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.
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.
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:
PO Box 2906
Milwaukee, WI 53201-2906
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
- A 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 call us at 1-888-778-1478 (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.
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:
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 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.
All Clover members receive access to SilverSneakers, a program that offers members 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. 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.
You can order OTC items online at cvs.com/otchs/clover or by calling 1-888-628-2770 (TTY 1-877-672-2688), 9 am - 8 pm EST, Monday - Friday.
24/7 Access to Doctors
All Clover Health members have the option to receive medical consultations with board certified licensed physicians through either phone or web-based video. Physicians can diagnose non-emergent 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 prior 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 Member Services at 1-888-778-1478 (TTY 711) to arrange a ride. Arrangements should be made at least 24 business hours in advance.
For more information, see your Evidence of Coverage.