In Texas, Clover Health offers HMO Medicare Advantage plans in Bexar and El Paso, and PPO Medicare Advantage plans in Atascosa, Bandera, Bexar, Comal, El Paso, Guadalupe, Medina, and Wilson counties. Our Medicare Advantage plans vs. Original Medicare in Texas
Full Answer
What kind of insurance is Clover Health?
Clover Health - Clover Health is a Preferred Provider Organization (PPO) plan and a Health Maintenance Organization (HMO) plan with a Medicare contract. Enrollment in Clover Health depends on contract renewal. This information is not a complete description of benefits.
How do I get in touch with Clover Health?
Call 1-800-836-6890 (TTY 711) Request a call. Last Updated: 10/1/2018. Clover Health is a Preferred Provider Organization (PPO) and a Health Maintenance Organization (HMO) with a Medicare contract.
Does clover cover out-of-network/non-contracted providers?
Clover Health - Out-of-network/non-contracted providers are under no obligation to treat Clover members, except in emergency situations. For a decision about whether we will cover an out-of-network service, we encourage you or your provider to ask us for a pre-service organization determination before you receive the service.
Is Clover Health in Texas?
Clover Health is a Medicare Advantage provider that services Texas communities.
How many counties is Clover Health in?
Clover currently offers Medicare Advantage (MA) plans in 34 counties across seven states where it cares for 57,000 members.
Which states is Clover Health expanding into new counties 2022?
With this approved service area expansion beginning January 1, 2022, Clover's Medicare Advantage (MA) plans will be available to eligible individuals in 101 new counties across Georgia, New Jersey, South Carolina, Texas, and Alabama – a new state for the company.
What states is Clover Medicare in?
The company manages care for Medicare beneficiaries in eleven states, including Arizona, Georgia, Kansas, Mississippi, New Jersey, New York, Pennsylvania, South Carolina, Tennessee, Texas and Vermont.
What is happening with Clover Health?
Clover Health posted a $48.4 million loss in the first quarter of 2021, nearly doubling its year-over-year losses as medical costs jumped under the pandemic. The startup insurer reported a $28.2 million loss in the first quarter of 2020, according to the company's earnings report released this week.
Is Clover and Clover Health the same company?
Clover Health Investments, Corp is an American health care company founded in 2014. The company provides Medicare Advantage (MA) insurance plans and operates as a direct contracting entity with the U.S. government....Clover Health.TypePublicWebsitecloverhealth.com8 more rows
Which states have a Clover Health parity PPO plan?
The expansion will add 74 additional counties to the insurer's reach, with 69 located in the states it already serves: Arizona, Georgia, New Jersey, Pennsylvania, South Carolina, Tennessee and Texas. In addition, Clover will add five counties in Mississippi, a new market for the 2021 plan year.
Is Clover Health a good company?
Is Clover Health a good company to work for? Clover Health has an overall rating of 4.2 out of 5, based on over 183 reviews left anonymously by employees. 81% of employees would recommend working at Clover Health to a friend and 80% have a positive outlook for the business.
What makes Clover Health different?
At Clover, we see healthcare differently. With $0 premiums, $0 copays for primary care providers (PCPs) and preferred generic drugs, the same low copays in- and out-of-network, home visits with a personal clinical care team, and additional benefits, you get more with Clover than any other insurance plan.
Who owns Clover Health insurance?
Vivek GaripalliVivek Garipalli is the co-founder and CEO of Clover Health. Prior to founding Clover, he founded CarePoint Health in 2008, a fully integrated healthcare system in New Jersey.
Is Clover part of Medicare?
At Clover Health, we bring high-quality, affordable, and easy-to-understand healthcare plans to America's seniors. Our Medicare Advantage plans reflect what you value most so you can spend your moments on what matters. We focus on preventive care and providing you with healthcare that supports and enhances your life.
What type of insurance is Clover Health?
Clover Health is a Preferred Provider Organization (PPO) plan with a Medicare contract. Enrollment in Clover Health depends on contract renewal. This information is not a complete description of benefits.
What is SPAP in healthcare?
State Pharmaceutical Assistance Programs (SPAPs) are state-run programs that help qualifying low- income seniors or adults with disabilities pay for prescription drugs by covering premiums or copayments. SPAP coverage varies by state, so reach out to your state government office to see whether you're eligible, and to understand the details of your state's coverage. Access the program contact information by state at https://www.medicareinteractive.org/pdf/SPAP-Chart.pdf, or call our Member Services Department at 1-888-657-1207 for additional questions.
What is a clover care visit?
To support your health, Clover offers an annual check-in called a Clover Care Visit (CCV). Our care team includes nurse practitioners, medical assistants, and other licensed clinicians. In the comfort of your own home, or other private location of your choice, our team delivers a one-hour one-on-one wellness assessment to help you better understand your medical needs. This may include a physical examination, a review of current and past diagnoses and medications, and an opportunity to address your concerns and questions. To schedule a CCV with one of our staff, please call us at 1-888-778-1478.
What is a clover clinical team?
Our Clinical Team works in your community and is available to visit you in your home, or other place you choose, to address your unique health concerns. Clover’s clinical staff offers a personalized approach, and a different kind of health care service than you might receive in your provider's office.
Does Clover Pharmacy cover maintenance?
Clover's plans cover 100-day fills of common maintenance medications. You can take advantage of this benefit as long as your provider feels that 100-day fills are suitable for your circumstances. You can fill these prescriptions at a preferred retail pharmacy, or by mail order through CVS Caremark Mail Order Pharmacy.
Does Clover have Medicare?
Your Clover plan includes Medicare Part D prescription drug coverage. Clover’s comprehensive formulary lists all brand name and generic drugs that are covered by your plan. We also have relationships with a network of pharmacies. In many cases, you'll save money at an in-network pharmacy.
Does Silver Sneakers have a gym?
All Clover members receive access to Silver Sneakers gym locations. Silver Sneakers' gyms offer recreational swimming, aerobics, weight management services, nutrition counseling, and individualized fitness programs. To learn more about the program and see gyms in your area, visit www.silversneakers.com, or call our Member Services Department at 1-888-657-1207.
Does Clover Dental offer dental care?
Quality dental care is an essential part of your overall health. Clover has partnered with DentaQuest to offer routine dental services. For additional Medicare-covered services treating a dental condition, disease, or injury in a hospital setting, please refer to your EOC.
When is Clover Health Classic HMO?
This is a summary of drug and health services covered by the Texas Clover Health Choice Value (PPO) and Clover Health Classic (HMO) for the plan year: January 1, 2019 – December 31, 2019.
How often can I use Clover Health Choice Value?
You are eligible for a $25 allowance for Clover Health Choice Value (PPO) every three months to use towards the purchase of select over-the-counter (OTC) products, available through our mail order service. Orders are limited to one (1) every three months and benefits are available at the beginning of each quarter of the calendar year (January, April, July, and October). Any unused amount will not be carried over. Orders can be placed over the phone at 1-888-628-2770; TTY: 1-877-672-2688 Monday to Friday, 9am–8pm EST, or online at: clover.otchs.com. Orders will be shipped to your home at no charge.
What is a clover care visit?
To support your health, Clover offers an annual check-in called a Clover Care Visit (CCV). Our care team includes nurse practitioners, medical assistants, and other licensed clinicians. In the comfort of your own home, or other private location of your choice, our team delivers a one-hour one-on-one wellness assessment to help you better understand your medical needs. This may include a physical examination, a review of current and past diagnoses and medications, and an opportunity to address your concerns and questions. To schedule a CCV with one of our staff, please call us at 1-888-778-1478.
What is a clover clinical team?
Our Clinical Team works in your community and is available to visit you in your home, or other place you choose, to address your unique health concerns. Clover’s clinical staff offers a personalized approach, and a different kind of health care service than you might receive in your provider's office.
Does Clover have Medicare?
Your Clover plan includes Medicare Part D prescription drug coverage. Clover’s comprehensive formulary lists all brand name and generic drugs that are covered by your plan. We also have relationships with a network of pharmacies. In many cases, you'll save money at an in-network pharmacy.
Does Clover Dental offer dental care?
Quality dental care is an essential part of your overall health. Clover has partnered with DentaQuest to offer routine dental services. For additional Medicare-covered services treating a dental condition, disease, or injury in a hospital setting, please refer to your EOC.
Does clover insurance cover vision?
Clover plans provide all the benefits of Original Medicare, plus access to supplemental benefits that include some of the services and items our members use the most often to stay healthy. These benefits supplement Medicare-covered or diagnostic services for vision, hearing, or dental, so please refer to your plan's EOC for specific services, costs, and prior authorization requirements. See the supplemental benefits you may receive by Clover in the categories below.
Dental, vision, and hearing
Plans include routine dental, vision, and hearing coverage plus allowances for eyeglasses or contacts, and hearing aids. Many plans include allowances for comprehensive dental coverage.
Easy access to doctors
In addition to in-person office visits, you can now see your doctor from the comfort of your home with a telehealth appointment. If your personal doctor isn’t available, Clover Health can connect you with a doctor or nurse practitioner via video or phone.
Over-the-counter allowances
All plans include quarterly allowances for over-the-counter (OTC) items. Save on everyday health-related items like thermometers, vitamins, allergy tablets, cough drops, bandages, cotton swabs, and more.
Broad and open networks
Clover Health puts your needs first. Our PPO provider networks are broad and open, enabling our members to see any doctor participating in Medicare who is willing to accept them.
Prescription drug coverage
All plans include prescription drug coverage, so there is no need for an additional plan. You'll also save time (and often money) by getting 100-day refills of your prescriptions via mail order.
The Clover Assistant
We provide doctors with our Clover Assistant technology at no cost. The Clover Assistant helps your primary care doctor get a more complete view of your overall health.
Our Clover Health promise
We'll only enroll you in a Clover Health plan if it's the best option for you.