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1 plan for 2017
3 plans for 2017
CarePoint
$0 / month
The lowest cost plan
For those who want low costs for basic benefits.
$0 Primary care visits
$15-$20 Specialist visits
Veteran (VA) benefit friendly
Classic
$0 / month
The lowest cost plan
For those who want low costs for basic benefits.
$0 Primary care visits
$15-$20 Specialist visits
Veteran (VA) benefit friendly
Premier
$38.40 / month
The specialist plan
Great for those who receive help from the government or visit specialists often.
$0 Primary care visits
$0-$10 Specialist visits
Extra Help and PAAD friendly
Prestige
$225 / month
The highest coverage plan
Perfect for those looking for full coverage for their health needs.
$0 Primary care visits
$0 Specialist visits
No part D deductible
| CarePoint | Classic | Premier | Prestige | |
|---|---|---|---|---|
| Monthly premium* | $0 | $0 | $38.40 | $225 |
| Primary care visits (unlimited) | $0 in/out-of-network | $0 in/out-of-network | $0 in/out-of-network | $0 in/out-of-network |
| Specialist visits (unlimited) | $15-$20 in/out-of-network | $15-$20 in/out-of-network | $0-$10 in/out-of-network | $0 in/out-of-network |
| Emergency care | $75 | $75 | $75 | $50 |
| Inpatient hospital stay |
1-6 days: $290/day 7-365 days: $0 |
1-6 days: $290/day 7-365 days: $0 |
1-6 days: $170/day 7-365 days: $0 |
1–5 days: $100/day 6–365 days: $0 |
| Outpatient surgery (hospital) | $290 | $325 | $175 | $50 |
| Ambulance | $200 | $250 | $200 | $0 |
| Prescription costs (preferred pharmacy) |
Tier 1=$0, Tier 2=$10 Tier 3=$35, Tier 4=$85 Tier 5=25% of total cost Deductible=$150 for Tiers 3–5 |
Tier 1=$0, Tier 2=$10 Tier 3=$35, Tier 4=$85 Tier 5=25% of total cost Deductible=$150 for Tiers 3–5 |
Tier 1=$0, Tier 2=$7 Tier 3=$30, Tier 4=$80 Tier 5=25% of total cost Deductible=$220 for Tiers 2–5 |
Tier 1=$0, Tier 2=$7 Tier 3=$37, Tier 4=$80 Tier 5=25% of total cost Deductible=$0 for all tiers |
| Vision exams | $15 | $15 | $0 | $0 |
| Out-of-pocket max | $6,700 | $6,700 | $6,700 | $6,700 |
| Clover Core Benefits Limitations, copayments, and restrictions may apply. | ||||
| No referrals to see specialists |
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| More choices in doctors |
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| Personal care team |
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| Gym membership |
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| Rewards for managing wellness |
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| 24/7 online doctor consults |
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| Eyeglasses/contact lenses benefits |
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Enrollment for 2017 plans begins October 15, 2016.
Enroll
Want a reminder? |
Enrollment for 2017 plans begins October 15, 2016.
Enroll
Want a reminder? |
Enrollment for 2017 plans begins October 15, 2016.
Enroll
Want a reminder? |
Enrollment for 2017 plans begins October 15, 2016.
Enroll
Want a reminder? |
|
Out-of-network/non-contracted providers are under no obligation to treat Clover members, except in emergency situations.
1 plan for 2017
3 plans for 2017
CarePoint
$0 / month
The lowest cost plan
For those who want low costs for basic benefits.
$0 Primary care visits
$15-$20 Specialist visits
Veteran (VA) benefit friendly
Classic
$0 / month
The lowest cost plan
For those who want low costs for basic benefits.
$0 Primary care visits
$15-$20 Specialist visits
Veteran (VA) benefit friendly
Premier
$40 / month
The specialist plan
Great for those who receive help from the government or visit specialists often.
$0 Primary care visits
$0-$10 Specialist visits
Extra Help and PAAD friendly
Prestige
$178 / month
The highest coverage plan
Perfect for those looking for full coverage for their health needs.
$0 Primary care visits
$0 Specialist visits
$750 max out-of-pocket cost
| CarePoint | Classic | Premier | Prestige | |
|---|---|---|---|---|
| Monthly premium* | $0 | $0 | $40 | $178 |
| Primary care visits (unlimited) | $0 in/out-of-network | $0 in/out-of-network | $0 in/out-of-network | $0 in/out-of-network |
| Specialist visits (unlimited) | $15-$20 in/out-of-network | $15-$20 in/out-of-network | $0-$10 in/out-of-network | $0 in/out-of-network |
| Emergency care | $75 | $75 | $75 | $50 |
| Inpatient hospital stay |
1–6 days: $290/day 7–365 days: $0 |
1–6 days: $290/day 7–365 days: $0 |
1–6 days: $170/day 7–365 days: $0 |
$0 |
| Outpatient surgery (hospital) | $90-$290, depending on the service | $90-$325, depending on the service | $90-$175, depending on the service | $0 |
| Ambulance | $200 | $250 | $200 | $0 after deductible |
| Prescription costs (preferred pharmacy) |
Tier 1=$0, Tier 2=$10 Tier 3=$35, Tier 4=$85 Tier 5=25% of total cost Deductible=$150 for Tiers 3–5 |
Tier 1=$0, Tier 2=$10 Tier 3=$35, Tier 4=$85 Tier 5=25% of total cost Deductible=$150 for Tiers 3–5 |
Tier 1=$0, Tier 2=$7 Tier 3=$30, Tier 4=$80 Tier 5=25% of total cost Deductible=$220 for Tiers 2–5 |
Tier 1=$0, Tier 2=$7 Tier 3=$40, Tier 4=$80 Tier 5=25% of total cost Deductible=$0 for all tiers |
| Vision exams | $20 | $20 | $10 | $0 |
| Out-of-pocket max | $6,700 | $6,700 | $6,700 | $750 |
| Clover Core Benefits Limitations, copayments, and restrictions may apply. | ||||
| No referrals to see specialists |
|
|
|
|
| More choices in doctors |
|
|
|
|
| Personal care team |
|
|
|
|
| Gym membership |
|
|
|
|
| Rewards for managing wellness |
|
|
|
|
| 24/7 online doctor consults |
|
|
|
|
| Eyeglasses/contact lenses benefits |
|
|
|
|
|
Enrollment for 2017 plans begins October 15, 2016.
Enroll
Want a reminder? |
Enrollment for 2017 plans begins October 15, 2016.
Enroll
Want a reminder? |
Enrollment for 2017 plans begins October 15, 2016.
Enroll
Want a reminder? |
Enrollment for 2017 plans begins October 15, 2016.
Enroll
Want a reminder? |
|
Out-of-network/non-contracted providers are under no obligation to treat Clover members, except in emergency situations.
