We know quality dental care is an essential part of your overall health, which is why many Clover plans offer an allowance for comprehensive dental services in addition to preventive routine dental.

This additional coverage provides a yearly allowance for most dental services that are not listed as preventive. The allowance amount depends on the policy. Plans with comprehensive dental require a $20 copay for each of the services listed below. Clover partners with DentaQuest to provide dental services.

Comprehensive dental benefits include:

• extractions
• crowns
• bridges
• dentures
• and more

IMPORTANT:

• When you call the dentist, please make sure to ask if they accept DentaQuest.
• Be sure to bring your DentaQuest/EyeQuest card with you to every appointment.
• HMO members must see a DentaQuest provider to use their Clover Health dental benefits. In most cases, the provider will simply bill DentaQuest.

PPO members can submit a reimbursement form when paying for out-of-network services out of pocket. In the event that you have to pay for out-of-network services, you can submit a reimbursement form. Please call Member Services to have the form sent to you.

For approved services, you may be reimbursed up to your annual benefit allowance minus applicable copay. You should receive payment within 30 days from the day Clover receives your completed reimbursement form.

To help you understand your financial responsibility for dental services, please refer to your Evidence of Coverage or call DentaQuest at 1-855-343-7404.

We know that your vision is important to your quality of life. Clover works with EyeQuest to offer routine vision exams and eyewear on all plans. Many Clover plans include an allowance for comprehensive vision services in addition to preventive services. Our comprehensive vision benefits include:

• A yearly allowance for one pair of eyeglasses or contact lenses

How much you pay for glasses or contacts depends on the eyewear you choose.

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 Clover Member Services.

IMPORTANT:

• When you call an eye care provider, please make sure to ask if they accept EyeQuest.
• Be sure to bring your DentaQuest/EyeQuest card with you to every appointment.
• HMO members must see an EyeQuest provider to use their Clover vision benefits. In most cases, the provider will simply bill EyeQuest.

PPO members can submit a reimbursement form when paying for out-of-network services out of pocket. In the event that you have to pay for out-of-network services, you can submit a reimbursement form. Please call Member Services to have the form sent to you.

For approved services, you may be reimbursed up to your annual benefit allowance. You should receive payment within 30 days from the day Clover receives your completed reimbursement form.

To help you understand your financial responsibility for vision services, please refer to your Evidence of Coverage.

At Clover we believe in treating hearing loss early. Clover works with TruHearing to provide hearing aid services at a low cost. Our TruHearing benefit includes:

• 1 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
  • First year of follow-up provider visits from date of hearing aid purchase
  • 60-day trial and
  • 3-year warranty
  • 80 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/TDD 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 thousands of gyms as well as online fitness classes and on-demand videos on exercise, nutrition, and more—at no cost to you. SilverSneakers' gyms offer activities like recreational swimming, aerobics, weight management services, nutrition counseling, individualized fitness programs, and virtual group classes.

You can contact SilverSneakers at 1-888-502-0836 (TTY/TDD 711) 8 am–8 pm EST, Monday through Friday.

Need to see a doctor outside of normal business hours? We know how important this has become recently. All Clover members have the option to see a doctor for non-emergency health issues by video or on the phone. Appointments are available 24 hours a day, 365 days per year, with no referral or prior authorization required.

Some Clover Health plans cover medically necessary one-way trips within the plan service area to any health-related location. Each one-way trip must not exceed 50 miles. Arrangements must be made at least 1 business day in advance. Please contact Clover Member Services to arrange a ride. For emergencies, call 911.

We give you an allowance of at least $120 per year* to shop a selection of thousands of approved over-the-counter (OTC) items, including things like bandages, cough medicine, and vitamins. Plus, you have the convenience of purchasing your OTC items at leading retail locations like CVS, Walgreens, and Walmart, or by phone or online.

*The allowance is distributed quarterly and expires at the end of each quarter (March 31, June 30, September 30, and December 31). Refer to your Evidence of Coverage to find your quarterly allowance amount.

Check your balance, find a store, and more!

Go to cloverhealth.com/livehealthy or download the Healthy Benefits+ mobile app—or both!

Use the website or app to:

• Get more details on using your OTC benefit
• Check your account balance for both your OTC allowance and rewards earned through our new program (see below)
• Find participating stores

For a sample selection of covered items, view the 2023 LiveHealthy Item Catalog.

Clover Health has partnered with DentaQuest to provide your dental benefits. We can answer any questions you may have about your dental plan.

Regular dental visits are important to your health and well-being. Your dentist will be able to find dental problems early when they’re easier to fix. That will usually help save you money.

Most plans cover preventive and comprehensive services.

Preventive Dental Coverage

These routine dental services are covered at low costs to you:

• Cleanings
• X-ray
• Fluoride treatments
• Oral exam

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

If you call to ask if a dentist accepts your insurance, please refer to your dental plan as “DentaQuest,” not “Clover Health,” to avoid confusion.

Comprehensive Dental Coverage

Comprehensive dental includes most services that are not listed as preventive services.

Plans that include comprehensive dental coverage have an annual allowance. These plans also have a low copay for each comprehensive service. The allowance can be used to cover the dental services listed below. (Limitations may apply.) Once your allowance is used, you will be responsible to pay for any additional dental costs for the rest of the year.

Comprehensive dental services include:

• Extractions
• Root canals
• Crowns
• Bridges and fillings
• Dentures
• And more

How to find an In-Network Dentist:

Use our online Find a Dentist tool to find an in-network dentist that is close to you. Here’s a step-by-step guide:

1. Go to dentaquest.com/find-a-provider/cloverdental.
2. Select your state.
3. Select “Choose a location and plan.”
4. Enter your address, city, or zip code.
5. Confirm your location by selecting “Yes, this is correct.”
6. Type or scroll through the listings in your state.
7. Select Clover Medicare. You have the option to search for dentists by name, specialty, or location. You can also perform an advanced search to further filter your search results, or search for all.

HMO plan members: You must see a dentist who is contracted with DentaQuest to use your dental coverage. If you visit a dentist who is outside of the DentaQuest network, you will be responsible for the full cost of the service.

Reimbursement for Services We encourage you to see a dentist who accepts DentaQuest. In most cases, the provider will simply bill DentaQuest. Just present your DentaQuest/EyeQuest ID card at the time of service.

In the event that you prefer to see a non-DentaQuest dentist you will have to first pay out of pocket. You can then submit a Reimbursement Form to DentaQuest. The form is located at cloverheatlh.com/dmr.

For covered and approved services, you should receive payment up to your annual benefit allowance minus applicable copay. To help you understand your financial responsibility for dental services, please refer to your Evidence of Coverage.

Clover Health partners with EyeQuest to cover one eye exam and an annual allowance for one pair of eyeglasses or contact lenses per year.

To find an in-network vision provider, click here.

Reimbursement for Services

We encourage you to see an eye doctor who accepts EyeQuest. In most cases, the provider will simply bill EyeQuest. Just present your DentaQuest/EyeQuest ID card at the time of service.

In the event that you have to pay out of pocket, you can submit a Reimbursement Form to EyeQuest. The form is located at cloverheatlh.com/dmr.

For covered and approved services, you should receive payment up to your annual benefit allowance minus applicable copay. 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.

Hearing aids can cost up to $2,400 or more per aid, but Clover Health partners with TruHearing to provide hearing aid services at a low cost ($699 or $999 per aid). Your plan offers one routine hearing exam and two hearing aids (one for each ear) per year.

We want to help you to move and feel as strong as possible. The free SilverSneakers® membership included in your Clover plan offers live and on-demand video classes for times when you can’t go to a class in person. Try the online classes if you enjoy learning at home, or choose from over 17,000 fitness locations if you prefer to take classes in-person.

Access a broad selection of healthy lifestyle offerings. Some in-person classes even meet outside at local parks and include group walks so you can enjoy that fresh air and sunshine! Just go to silversneakers.com to access classes and the many other benefits available on the site.

SilverSneakers Tuition Rewards As a SilverSneakers member, you can save thousands on tuition for your loved ones. The program is easy to use and it’s free. Imagine helping your grandkids or other students in your life pay for school while you’re staying fit. Your workouts can add up to big savings. (Note: This program is not managed by Clover)

For more information, visit silversneakers.tuitionrewards.com.