The bottom line: Clover Health Medicare Advantage plans are mostly PPOs, which can allow more flexibility than HMOs to choose your health care providers. More than half of Clover Health plans have $0 premiums, but the out-of-pocket maximums can be high, and the company serves only five states. Jump to: Full Review
Clover Health Medicare Advantage pros and cons
Pros
- Mostly PPO plans: Most of Clover Health’s Medicare Advantage plans are PPO plans, which offer more flexibility than HMOs.
- $0 plans: More than half of Clover Health Medicare Advantage plans offer a $0 premium.
Cons
- Out-of-pocket max: Clover Health’s average out-of-pocket maximum — the most you would be responsible for paying in a plan year — is higher than those of the major providers at about $7,900.
- Limited availability: Clover Health offers Medicare Advantage plans in just five states.
Compare against other providers
🔍 UnitedHealthcare Medicare Advantage
» More options in our roundup of the best Medicare Advantage plans
Compare against other providers
🔍 UnitedHealthcare Medicare Advantage
» More options in our roundup of the best Medicare Advantage plans
Our full review
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Clover Health Medicare star ratings
Average star rating, weighted by enrollment: 3.98
Clover Health Medicare Advantage plans are rated on par with the industry average, receiving an average rating of 3.98 stars out of 5 from the Centers for Medicare & Medicaid Services (CMS) for 2025, weighted by enrollment.
For comparison, the average weighted star rating for plans from all providers is 3.96.
Of Clover Health members who are in Medicare Advantage plans with a star rating, 97% are in plans that have been rated 4 stars or above for 2025.
CMS maintains star ratings for Medicare Advantage plans on a 5-point scale, ranking plans from best (5 stars) to worst (1 star). The agency bases these ratings on plans’ quality of care and measurements of customer satisfaction, and ratings may change from year to year.
You can find a plan’s rating with the Medicare plan finding tool.
What does Clover Health Medicare Advantage cost?
In 2025, slightly more than half (56%) of Clover Health Medicare Advantage plans with prescription drug coverage have a $0 premium. In addition, all of Clover Health’s plans that don’t include prescription drug coverage have a $0 premium.
You'll also be responsible for paying your Medicare Part B premium, which is $185 per month in 2025. (Most people pay this standard amount, but if your income is above a certain threshold, you'll pay the income-related monthly adjustment amount (IRMAA). Some Medicare Advantage plans cover part or all of your Part B premium.)
Requirements for copays, coinsurance and deductibles vary depending on your plan, location and the services you use. Other out-of-pocket costs to consider include:
Whether the plan covers any part of your monthly Medicare Part B premium.
The plan’s yearly deductibles and any other deductibles, such as a drug deductible.
Copayments and/or coinsurance for each visit or service. For instance, there may be a $10 copay for seeing your primary doctor and a $45 copay for seeing a specialist.
The plan’s in-network and out-of-network out-of-pocket maximums.
Whether your medical providers are in-network or out-of-network, or how often you may go out of network for care.
Whether you require extra benefits, and if the plan charges for them.
To get a sense of costs, use Medicare’s plan-finding tool to compare information among available plans in your area. You can select by insurance carrier to see only Clover Health plans or compare across carriers.
Available Medicare Advantage plans
Clover Health offers mostly PPO Medicare Advantage plans, but also offers some HMO plans. About two thirds (68%) of Clover Health Medicare Advantage plans include prescription drug coverage.
Plan offerings include the following types:
- HMO plans
A health maintenance organization (HMO) generally requires that you use a specific network of doctors and hospitals. You may need a referral from your primary doctor in order to see a specialist, and out-of-network benefits are usually very limited.
- PPO plans
Preferred provider organization (PPO) plans provide the most freedom, allowing you to see any provider that accepts the insurance. You may not need to choose a primary doctor, and you don’t need referrals to see specialists. You can seek out-of-network care, although it may cost more than seeing an in-network doctor.
Clover Health Medicare Advantage service area
Clover Health offers Medicare Advantage plans in five states: Georgia, New Jersey, Pennsylvania, South Carolina and Texas.
Clover Health covers nearly 100,000 Medicare Advantage beneficiaries.
Compare Medicare Advantage providers
Get more information below about some of the major Medicare Advantage providers. These insurers offer plans in most states. The plans you can choose from will depend on your ZIP code and county.
Find the right Medicare Advantage plan
It’s important to do your research before selecting a Medicare Advantage plan for yourself. Here are some questions to consider asking:
What are the plan’s costs? Do you understand what the plan’s premium, deductibles, copays and/or coinsurance will be? Can you afford them?
Is your doctor in-network? If you have a preferred medical provider or providers, make sure they participate in the plan’s network.
Are your prescriptions covered? If you’re on medication, it’s crucial to understand how the plan covers it. What tier are your prescription drugs on, and are there any coverage rules that apply to them?
Is there dental coverage? Does the plan offer routine coverage for vision, dental and hearing needs?
Are there extras? Does the plan offer any extra benefits, such as fitness memberships, transportation benefits or meal delivery?
If you have additional questions about Medicare, visit Medicare.gov or call 800-MEDICARE (800-633-4227, TTY 877-486-2048).
- PPO plans offer more flexibility than HMOs.
- More than half of plans have $0 premiums.
- Out-of-pocket maximums can be high.
- Available only in five states.
Article sources
NerdWallet writers are subject matter authorities who use primary, trustworthy sources to inform their work, including peer-reviewed studies, government websites, academic research and interviews with industry experts. All content is fact-checked for accuracy, timeliness and relevance. You can learn more about NerdWallet's high standards for journalism by reading our editorial guidelines.
- 1.Centers for Medicare & Medicaid Services. 2025 Star Ratings Data Tables (ZIP). Accessed Apr 23, 2025.
- 2.Centers for Medicare & Medicaid Services. CY2025 Landscape (202412). Accessed Apr 23, 2025.
- 3.Chartis. Medicare Advantage market growth slows amid intensified headwinds. Accessed Apr 23, 2025.
Medicare Advantage review methodology
The Medicare Advantage marketplace is concentrated among just a handful of companies; in many places, one insurer serves more than half of the market. NerdWallet reviewed 26 Medicare Advantage brands, with some insurers having more than one brand under their umbrella. (For example, Blue Cross Blue Shield includes the brands Anthem and Highmark.) At the national level, these reviews include nine of the 10 largest brands by enrollment. At the state level, our research includes at least one major insurer in 47 of the 49 states that offer Medicare Advantage plans, and includes the top two insurers in 35 of those states. (Alaska doesn't offer Medicare Advantage plans.) We also look at online search volume to identify regional and other notable players in the space.
NerdWallet’s Medicare Advantage reviews are based on ratings data from the Centers for Medicare & Medicaid Services, as well as pricing, plan availability by state, plan types available, consumer experience, extra benefits offered and more. These reviews are a guide, but we encourage you to shop around and compare several plans to find the best coverage and rate for you. NerdWallet does not receive compensation for any reviews. Read our editorial guidelines for additional information.
Compare Medicare Advantage plans
Insurance company | CMS star rating | States available | Members in high-rated plans | Member experience | Learn more |
|---|---|---|---|---|---|
(855) 821-0556 / TTY 711 Call UnitedHealthcarefrom UnitedHealthcare | |||||
3.95 | 3.95/5 | 49 states and Washington, D.C. | Medium (50% to 84%) | 3.41 (Average) | |
(855) 432-0512 / TTY 711 M-F 9AM-9PM, Sat 10AM-6PM ETSpeak to a licensed insurance agent on askchapter.orgon NerdWallet | |||||
(855) 432-0512 / TTY 711 M-F 9AM-9PM, Sat 10AM-6PM ETSpeak to a licensed insurance agent on askchapter.orgon NerdWallet | 3.63 | 3.63/5 | 48 states, Washington, D.C., and Puerto Rico | Low (49% or less) | 3.62 (Above average) |
(855) 432-0512 / TTY 711 M-F 9AM-9PM, Sat 10AM-6PM ETSpeak to a licensed insurance agent on askchapter.orgon NerdWallet | |||||
(855) 432-0512 / TTY 711 M-F 9AM-9PM, Sat 10AM-6PM ETSpeak to a licensed insurance agent on askchapter.orgon NerdWallet | 4.29 | 4.29/5 | 44 states and Washington, D.C. | High (85% to 100%) | 4.01 (Above average) |
(855) 432-0512 / TTY 711 M-F 9AM-9PM, Sat 10AM-6PM ETSpeak to a licensed insurance agent on askchapter.orgon NerdWallet | |||||
(855) 432-0512 / TTY 711 M-F 9AM-9PM, Sat 10AM-6PM ETSpeak to a licensed insurance agent on askchapter.orgon NerdWallet | 3.97 | 3.97/5 | 29 states and Washington, D.C. | Medium (50% to 84%) | 3.82 (Above average) |