Clover Health 2025 Plan
Choice Value PPO (042)
Medical & Rx drug coverage
An all-in-one plan that includes prescription drug coverage & $0 to low copays to reduce your out of pocket costs. Plus, allowances for dental, eyewear and OTC items.
Monthly Premium
$56.90
Primary Care Visit
$0
Maximum Out-of-Pocket
$9,350
General Costs
Monthly premium
$56.90
Medical deductible
$0
Maximum out-of-pocket
$9,350 in-network / $14,000 in- & out-of-network combined
Cost to See Your Doctor
In-Network
Out-of-Network
Primary Care visits
$0
$35
Specialist visits
$2
$35
Hospital Costs
In-Network
Out-of-Network
Inpatient hospital (days 1-6)
$399
$549
Emergency care
$110
$110
Urgent care
$35
$35
Outpatient labs (Labcorp or Quest)
$0
$0
Prescription Costs
Prices are for a 30-day supply from an in-network pharmacy.
Part D deductible
$150 Tiers 2-5
Tier 1
$0
Tier 2
$8
Tier 3
25%
Tier 4
35%
Tier 5
31%
Extra Benefits and Services
Clover plans include these important benefits and services. Original Medicare doesn't.
Part B Giveback (monthly)
Not included
Fitness benefit
Included
OTC allowance (quarterly)
$125
Routine dental, vision, & hearing exams
$0 in-network
Worldwide Coverage
Included
LiveHealthy Rewards
$400
Dental allowance (yearly)
$1,500
Eyewear allowance (yearly)
$100
General Costs
Monthly premium
$56.90
Medical deductible
$0
Maximum out-of-pocket
$9,350 in-network / $14,000 in- & out-of-network combined
Cost to See Your Doctor
In-Network
Out-of-Network
Primary Care visits
$0
$35
Specialist visits
$2
$35
Hospital Costs
In-Network
Out-of-Network
Inpatient hospital (days 1-6)
$399
$549
Emergency care
$110
$110
Urgent care
$35
$35
Outpatient labs (Labcorp or Quest)
$0
$0
Prescription Costs
Prices are for a 30-day supply from an in-network pharmacy.
Part D deductible
$150 Tiers 2-5
Tier 1
$0
Tier 2
$8
Tier 3
25%
Tier 4
35%
Tier 5
31%
Extra Benefits and Services
Clover plans include these important benefits and services. Original Medicare doesn't.
Part B Giveback (monthly)
Not included
Fitness benefit
Included
OTC allowance (quarterly)
$125
Routine dental, vision, & hearing exams
$0 in-network
Worldwide Coverage
Included
LiveHealthy Rewards
$400
Dental allowance (yearly)
$1,500
Eyewear allowance (yearly)
$100
Ready to become a Clover member?
We’re available to talk 8 am to 8 pm, 7 days a week.*