Speak with a licensed insurance agent

1-833-641-4938

TTY user 711 Mon-Fri : 8am-9pm EST

Clover Medicare Advantage Plans

Reviewed by Russell Noga, Licensed Medicare Insurance Broker (all 50 states) | Last updated October 8, 2026

Clover Health keeps its Medicare Advantage footprint unchanged for 2027, in 5 states and 203 counties, with New Jersey and Georgia as its core markets. It is adding a new $0-premium PPO, according to reports; availability varies by county.

Clover plans may include PPOs; plan types vary by county. In New Jersey, Braven Health is leaving all 21 counties and Horizon is offering only Special Needs Plans, so Clover is one of the remaining options many New Jerseyans will compare.

See Medicare Advantage plans 2027.

✔ Licensed across all 50 states
✔ Built on CMS 2027 data
✔ No-cost plan comparison

Key Highlights

✔

5 states, 203 counties, unchanged.

✔

New $0-premium PPO reported.

✔

Core markets: New Jersey and Georgia.

✔

Nationally, the average 2027 Medicare Advantage premium is $12 a month, down from $14.37 (CMS).

✔

The Annual Enrollment Period is October 15 to December 7, 2026.

Compare plans and enroll online

Clover 2027 at a Glance

5 States

Unchanged footprint.

203 Counties

Unchanged for 2027.

New PPO

$0-premium PPO reported.

Market 2027 Context
New Jersey Braven exits; Horizon SNP-only; Devoted enters
Georgia Georgia plans 166 to 161; average premium about $2.99

Benefits Clover Health Plans May Offer

Clover Health Plans May Include

✔

Hospital and medical coverage matching Original Medicare Part A and B

✔

Part D prescription drug coverage on most plans

✔

Routine dental, vision and hearing benefits

✔

Fitness programs and over-the-counter allowances

✔

Telehealth visits and care coordination programs

✔

A yearly out-of-pocket maximum on every plan

Benefits are not offered by every plan. They differ by plan and county and may change for 2027. Review the Evidence of Coverage for each plan before enrolling.

Clover Medicare Advantage Plans, Discovering Clover's Medicare Advantage Plans

What to Check for 2027

Key Takeaway

Read your Clover Annual Notice of Change.

Keep an eye out: a non-renewal letter will arrive if your plan is ending. You stay covered through December 31, 2026. Taking no action sends you back to Original Medicare with no drug coverage.

Find & Compare Plans Online

Speak with a licensed insurance agent

1-833-641-4938TTY 711

Mon-Fri: 8am-9pm ET

Clover PPO: What to Check

Before You Enroll

✔

Whether your doctors are in network

✔

Out-of-network costs

✔

Drug costs at your pharmacy

✔

The out-of-pocket maximum

✔

Whether the $0-premium PPO is offered in your county

Feature In Network Out of Network
Covered? Yes Yes, from providers who accept Medicare
Your cost Lowest copays Higher copays and coinsurance
Referrals Usually not required Not required
Out-of-pocket maximum In-network limit Higher combined limit

A PPO carries two out-of-pocket limits: one covering in-network care and a higher combined one covering all covered care. If you expect to use out-of-network providers, look at the combined limit.

How Medicare Advantage Works

Medicare Advantage, sometimes called Part C, lets you receive your Medicare benefits through a Medicare-approved private insurer. These plans cover everything Original Medicare Part A and Part B cover, with the exception of hospice care, which Original Medicare continues to pay for. Most also bundle Part D drug coverage, and many may tack on extras like routine dental, vision and hearing benefits.

In exchange, Clover Health plans generally use networks of doctors and hospitals, and may require referrals or prior authorization for some services. Every Medicare Advantage plan has a yearly out-of-pocket maximum for covered medical care, which Original Medicare does not have. You keep paying your Part B premium, plus your plan’s premium if it has one.

Feature HMO PPO
Out-of-network care Not covered except emergencies and urgent care Covered at a higher cost
Referrals for specialists Usually required Usually not required
Premiums Usually lower Usually higher
Out-of-pocket maximum In-network limit In-network limit plus a higher combined limit
Best for Lower costs, local care Flexibility, travel, keeping specific doctors

Clover Medicare Advantage Plans, Enhancing Your Health with Great Benefits

Pros and Cons of Medicare Advantage

Advantages

✔

Often a low or $0 premium

✔

A yearly out-of-pocket maximum

✔

Drug coverage usually included

✔

Dental, vision and hearing benefits may be included in many plans

✔

One card and one plan

Tradeoffs

✔

Networks; except for emergencies, HMOs require in-network care

✔

Prior authorization and referrals are common

✔

Copays add up if you use a lot of care

✔

Plans and networks can change every year

✔

Moving to Medigap later may involve health questions

Clover Health Drug Coverage for 2027

Most Clover Health Medicare Advantage plans include Part D drug coverage. Each plan has its own formulary, drug tiers and pharmacy network, and plans commonly charge less at preferred pharmacies and through mail order. For 2027, any plan’s Part D deductible can be up to $700, and the out-of-pocket cap on covered drugs is $2,400.

Tier Typical Drugs Typical Cost
Tier 1 Preferred generics Lowest copay
Tier 2 Generics Low copay
Tier 3 Preferred brand-name drugs Moderate copay
Tier 4 Non-preferred drugs Higher copay or coinsurance
Tier 5 Specialty drugs Highest coinsurance

Each plan sets its own tiers. Review every plan’s formulary.

A drug you take may not be on a plan’s 2027 formulary, or it may come with a rule such as prior authorization. Even then, you have options:

If Your Drug Is Not Covered

1

Request a transition fill. During the first 90 days of a new plan or plan year, plans generally have to provide a temporary supply of a drug you already take, giving you time to change drugs or ask for an exception.

2

Talk to your doctor about other options. A covered drug from the same class could work just as well for less money.

3

Ask for a tiering or formulary exception. Your doctor sends a statement explaining why you need the drug or a lower copay. Plans have to decide within set time limits.

4

Challenge a denial. When the plan turns you down, you have the right to appeal through several levels of review.

See steps to appeal a Medicare Part D denial.

If Your Plan Is Ending

If your Clover Health plan will not be offered in your county for 2027, you should have received a non-renewal notice in early October. Your coverage does not stop right away: it continues through December 31, 2026, so you have time to choose.

If Your Plan Is Ending

1

Review your non-renewal letter. It verifies that your plan is ending and lays out your choices.

2

Write down your doctors and drugs. Comparing replacement plans requires them.

3

Compare your 2027 plan choices. Look at networks, drug coverage and the out-of-pocket maximum, not only the premium.

4

Pick a plan by December 31 to avoid a gap. If you enroll during Annual Enrollment by December 7, your coverage starts January 1, 2027.

5

Rely on your Special Enrollment Period if necessary. If your plan is ending, you generally have until the end of February 2027 to make a choice.

If you take no action: on January 1, 2027, you go back to Original Medicare, and you will have no drug coverage unless you pick a Part D plan. Being without drug coverage may result in a late enrollment penalty.

Medigap rights: if your Medicare Advantage plan exits your area, you generally get a guaranteed issue right, lasting up to 63 days after your coverage ends, to purchase certain Medicare Supplement plans with no health questions.

How to Compare Clover Health Plans for 2027

How to Compare

1

Review your Annual Notice of Change. It spells out every 2027 change to the plan you have now.

2

Verify your doctors and hospitals. Make sure every provider is in the 2027 network, not only the 2026 network.

3

Review your prescriptions. Verify every drug, the tier it falls on and any step therapy or prior authorization rules.

4

Look at the full annual cost. Total up the premium, usual copays and drug costs, and review the out-of-pocket maximum.

5

Look at star ratings. Medicare scores plans on quality and service using a 1 to 5 star scale.

6

Sign up by December 7. Coverage under your new plan begins January 1, 2027.

2027 Enrollment Dates

Enrollment Period Dates What You Can Do
Annual Enrollment Period October 15 to December 7, 2026 Join, change or drop a Medicare Advantage or Part D plan effective January 1, 2027
Medicare Advantage Open Enrollment January 1 to March 31, 2027 In Medicare Advantage, you can change to another plan or go back to Original Medicare one time
Initial Enrollment Period 7 months around your 65th birthday month Sign up for Medicare and choose your first plan
Special Enrollment Periods Varies Switch plans after events such as a move, a loss of other coverage or your plan exiting your area

Annual Enrollment is when most people make changes. If you like your current plan, no action is needed; it renews on its own. Even so, review your Annual Notice of Change, since networks, premiums, copays and drug lists can all change on January 1.

Special Needs Plans

Special Needs Plans (SNPs) are Medicare Advantage plans designed for particular groups. Their benefits, networks and drug lists are shaped around the members they serve, and many come with care coordinators. In 2027, SNPs are one of the few places large insurers are adding plans, even while cutting PPOs.

Type Who Qualifies What Is Different
Dual Special Needs Plan (D-SNP) People with both Medicare and Medicaid Coordinates both programs; costs are often very low, with extra benefits
Chronic Condition SNP (C-SNP) People who have qualifying conditions like diabetes, heart failure or chronic lung disease Doctors, drugs and programs designed around the condition
Institutional SNP (I-SNP) People who live in a nursing home or need that level of care at home Care delivered where the member lives

Turning 65 in 2027

When you turn 65 in 2027, you get a seven-month Initial Enrollment Period: the three months before your birthday month, the birthday month itself and the three months that follow. If you sign up in the first three months, coverage begins on the first day of your birthday month.

Turning 65 Checklist

✔

Enroll in Part A and Part B, unless you have qualifying employer coverage and decide to postpone Part B

✔

Choose between Medicare Advantage and Original Medicare plus Medigap

✔

Enroll in a drug plan, or a Medicare Advantage plan that includes drugs, to avoid a late Part D penalty

✔

If you go with Medigap, purchase during your six-month Medigap Open Enrollment Period

Star Ratings

Each fall, Medicare gives every Medicare Advantage and Part D plan a rating of 1 to 5 stars, based on factors such as preventive care, how well chronic conditions are managed, member complaints, customer service and accuracy of drug pricing. You can see the ratings in Medicare Plan Finder.

Using Star Ratings

✔

Ratings of 4 stars or more are generally a good indicator of quality and service

✔

A special enrollment period lets you move into a five-star plan once during the year

✔

A new plan may not have a rating yet, and that alone isn’t a bad sign

✔

Ratings reflect the plan as a whole, not how well it covers your particular doctors and drugs

Medicare Advantage or Medigap?

Medicare Advantage Original Medicare + Medigap
Monthly premium Often low or $0 (2027 average $12, CMS) Higher; varies by plan letter, age and ZIP
Doctors Usually a network Any provider in the U.S. that accepts Medicare
Costs when you get care Copays and coinsurance up to a yearly maximum Low and predictable; on Plan G, little or nothing once the Part B deductible is met
Drug coverage Usually included Add a separate Part D plan
Dental, vision, hearing Many plans may include some coverage Not included
Changing later Every year during Annual Enrollment Health questions in most states once your Medigap Open Enrollment Period ends

Guaranteed issue: when your Medicare Advantage plan exits your area, you can generally purchase certain Medicare Supplement plans with no health questions asked, up until 63 days after that coverage ends.

Help Paying Medicare Costs

When your income and savings are limited, two programs can greatly lower your Medicare costs:

Medicare Savings Programs

✔

Run by your state Medicaid office

✔

May cover your Part B premium, and in some cases deductibles and coinsurance

✔

Income and asset limits vary by state

Extra Help (Part D)

✔

Run by Social Security

✔

Lowers Part D premiums, deductibles and copays

✔

Those enrolled in a Medicare Savings Program qualify automatically

If you qualify for both Medicare and full Medicaid, you may also be able to join a Dual Special Needs Plan. See help for low-income Part D beneficiaries.

Getting Help

You do not need to compare plans by yourself, and help should not cost you anything. Here are the free options:

Free Help Comparing Plans

✔

Available any time: Medicare Plan Finder on Medicare.gov

✔

1-800-MEDICARE (1-800-633-4227), reachable 24 hours a day on all seven days of the week

✔

Your State Health Insurance Assistance Program (SHIP), which provides free, unbiased counseling

✔

A licensed agent or insurance broker, who can compare plans across several insurers for free

Gather your Medicare card, a list of your drugs and doses, your doctors and your preferred pharmacies before you call. That way a long conversation becomes a quick one.

Bottom Line

The Bottom Line

Clover holds steady for 2027 and adds a new PPO. In New Jersey and Georgia, compare Clover with the other remaining plans before December 7, 2026.

Compare plans and enroll online

Frequently Asked Questions

➤ Where does Clover Health offer Medicare Advantage for 2027?

Clover Health offers Medicare Advantage in 5 states and 203 counties for 2027, unchanged from 2026, with New Jersey and Georgia as its core markets. Enter your ZIP code to confirm a Clover plan serves your county.

➤ Is Clover Health leaving Medicare Advantage?

No. Clover is keeping its 5-state, 203-county footprint unchanged for 2027 and adding a new PPO. Read your Annual Notice of Change for plan-level premium, copay and network changes. If your plan is changing, the notice will explain how, and you can compare other plans during Annual Enrollment.

➤ Does Clover have a $0-premium plan for 2027?

Clover is adding a new $0-premium PPO for 2027, according to reports. Availability varies by county, and a $0 premium does not mean $0 costs, since you still pay the Part B premium, copays and coinsurance.

➤ What types of plans does Clover offer?

Clover plans may include PPOs, which cover in-network and out-of-network care, with higher costs out of network. Its new 2027 plan is a PPO. Check the specific plans in your county, since plan types and benefits vary.

➤ Is Clover a good option in New Jersey for 2027?

It can be, especially as Braven Health leaves all 21 New Jersey counties and Horizon offers only Special Needs Plans. Compare Clover with Aetna, Devoted and other plans using your doctors and drugs. Check total yearly cost too.

➤ What changed in Georgia for 2027?

Georgia has 161 Medicare Advantage plans for 2027, down from 166, with an average premium of about $2.99. GeorgiaCares offers free Medicare counseling to help compare Clover with other Georgia plans. Compare plans by your doctors and drugs.

➤ What benefits may Clover plans include?

Depending on the plan, Clover plans may include drug coverage, dental, vision, hearing or over-the-counter benefits. Not all plans offer all benefits, and amounts can change for 2027, so read the Summary of Benefits. Check dollar limits and networks for extras.

➤ What if my current plan is ending and I want Clover?

If your plan is ending, you get a Special Enrollment Period to choose any plan in your area, including Clover if offered. You also generally have a guaranteed issue right to certain Medigap plans. Act by December 7.

➤ How do I compare Clover with other insurers?

Enter your ZIP code in Medicare Plan Finder or work with a licensed agent, add your drugs and pharmacy, and check your doctors. Compare total yearly cost, the out-of-pocket maximum and star ratings. Include out-of-network costs.

➤ When can I enroll in a Clover plan for 2027?

Annual Enrollment runs October 15 to December 7, 2026, with coverage starting January 1, 2027. Medicare Advantage members can also make one change from January 1 to March 31, 2027. If your plan is ending, you also get a Special Enrollment Period, and enrolling by December 7 avoids a coverage gap.

Have Questions?

Speak with a licensed insurance agent

1-833-641-4938

TTY users 711

Mon-Fri: 8am-9pm ET

Find & Compare Plans Online

Speak with a licensed insurance agent

1-833-641-4938TTY 711

Mon-Fri: 8am-9pm ET

ZRN Health & Financial Services, LLC, a Texas limited liability company

Russell Noga, licensed insurance agent
( Medicare Expert )

Russell Noga is the CEO of ZRN Health & Financial Services, and head content editor of several Medicare insurance online publications. He has over 15 years of experience as a licensed Medicare insurance broker helping Medicare beneficiaries learn about Medicare, Medicare Advantage Plans, Medigap insurance, and Medicare Part D prescription drug plans.

CompareMedicareAdvantagePlans.org
215 RR 620 South Austin, TX 78734

TERMS & CONDITIONS | PRIVACY POLICY
This website and Medicare Supplement Insurance plans are not affiliated or connected with the Federal Medicare program or any other government agency. We do not offer every plan available in your area. Currently we represent 193 organizations which offer 4,624 products in your area. Please contact Medicare.gov, 1-800-MEDICARE, or your local State Health Insurance Program (SHIP) to get information on all of your options. Data represented is for the plan year 2027. Comparemedicareadvantageplans.org is a Website owned and operated by ZRN Health & Financial Services, LLC, a Texas limited liability company. *You must continue to pay your Medicare Part B premium. $0 premium plans may not be available in all areas. Not all plans offer all benefits mentioned. By submitting your information in the form and clicking ‘Find Plans’, you agree to this site’s privacy policy and expressly consent to be contacted at the number entered in the form, (including a wireless number if provided) by insurance professionals or other partners offering related offers that might be of interest to me by phone or email. You understand that these calls may be generated using an automatic telephone dialing system, a pre-recorded message or artificial voice, or by sending SMS messages. Your telephone company may impose additional charges on the subscriber for such messages. You understand that you are not required to provide this authorization to purchase goods or services. Receiving quotes through our website is always free and you are under no obligation to purchase any goods or services as a result of this request. The Medicare plans represented are PDP, HMO, PPO or PFFS plans with a Medicare contract. Enrollment in plans depends on contract renewal. Enrollment in a plan may be limited to certain times of the year unless you qualify for a special period or you are in your Medicare Initial Election Period. Deductibles, copay and coinsurance may apply. We do not offer every plan available in your area. Any information we provide is limited to those plans we do offer in your area. Please contact Medicare.gov or 1-800-MEDICARE (TTY users should call 1-877-486-2048) 24 hours a day/7 days a week to get information on all of your options. MMR-658-2023 _Medisupps LP_Final