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Clover Health Medicare Advantage 2024-2025 Review: Pros & Cons
Clover Health Medicare Advantage plans are available in five states and get average star ratings from CMS.
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Kate Ashford, CSA® Lead Writer | Medicare, retirement, personal finance
Kate Ashford is a writer and NerdWallet authority on Medicare. She is a certified senior advisor (CSA)® and has more than 20 years of experience writing about personal finance. Previously, she was a freelance writer for both consumer and business publications, and her work has been published by the BBC, Forbes, Money, AARP, LearnVest and Parents, among others. She has a degree from the University of Virginia and a master’s degree in journalism from Northwestern’s Medill School of Journalism. Kate has appeared as a Medicare expert on the PennyWise podcast by Lee Enterprises, and she's been quoted in national publications including Healthline, Real Simple and SingleCare. She is based in New York.
Holly Carey joined NerdWallet in 2021 as an editor on the team responsible for expanding content to additional topics within personal finance. She currently leads the Medicare team. Previously, Holly wrote and edited content and developed digital media strategies as a public affairs officer for the U.S. Navy. She is based in Virginia Beach, Virginia.
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
3.98
CMS Star RatingAverage Medicare star rating, weighted by enrollment. Star ratings are determined by the Centers for Medicare & Medicaid Services (CMS).
We will connect you with Medicare companies based on the information you provide. They will help you find a plan that suits your needs. If you prefer to speak to a licensed insurance agent right away, please call the number listed below.
M-F 9AM-9PM, Sat 10AM-6PM ET
Speak to a licensed insurance agent on askchapter.org
M-F 9AM-9PM, Sat 10AM-6PM ET
Speak to a licensed insurance agent on askchapter.org
Plan availability is determined by ZIP code. While a plan may be available in your state, it may not be offered in your specific county. Please verify plan availability with a licensed insurance agent.
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
3.93
CMS Star RatingAverage Medicare star rating, weighted by enrollment. Star ratings are determined by the Centers for Medicare & Medicaid Services (CMS).
Plan availability is determined by ZIP code. While a plan may be available in your state, it may not be offered in your specific county. Please verify plan availability with a licensed insurance agent.
CMS Star RatingAverage Medicare star rating, weighted by enrollment. Star ratings are determined by the Centers for Medicare & Medicaid Services (CMS).
We will connect you with Medicare companies based on the information you provide. They will help you find a plan that suits your needs. If you prefer to speak to a licensed insurance agent right away, please call the number listed below.
M-F 9AM-9PM, Sat 10AM-6PM ET
Speak to a licensed insurance agent on askchapter.org
M-F 9AM-9PM, Sat 10AM-6PM ET
Speak to a licensed insurance agent on askchapter.org
Plan availability is determined by ZIP code. While a plan may be available in your state, it may not be offered in your specific county. Please verify plan availability with a licensed insurance agent.
CMS Star RatingAverage Medicare star rating, weighted by enrollment. Star ratings are determined by the Centers for Medicare & Medicaid Services (CMS).
We will connect you with Medicare companies based on the information you provide. They will help you find a plan that suits your needs. If you prefer to speak to a licensed insurance agent right away, please call the number listed below.
M-F 9AM-9PM, Sat 10AM-6PM ET
Speak to a licensed insurance agent on askchapter.org
M-F 9AM-9PM, Sat 10AM-6PM ET
Speak to a licensed insurance agent on askchapter.org
Plan availability is determined by ZIP code. While a plan may be available in your state, it may not be offered in your specific county. Please verify plan availability with a licensed insurance agent.
CMS Star RatingAverage Medicare star rating, weighted by enrollment. Star ratings are determined by the Centers for Medicare & Medicaid Services (CMS).
We will connect you with Medicare companies based on the information you provide. They will help you find a plan that suits your needs. If you prefer to speak to a licensed insurance agent right away, please call the number listed below.
M-F 9AM-9PM, Sat 10AM-6PM ET
Speak to a licensed insurance agent on askchapter.org
M-F 9AM-9PM, Sat 10AM-6PM ET
Speak to a licensed insurance agent on askchapter.org
Plan availability is determined by ZIP code. While a plan may be available in your state, it may not be offered in your specific county. Please verify plan availability with a licensed insurance agent.
CMS Star RatingAverage Medicare star rating, weighted by enrollment. Star ratings are determined by the Centers for Medicare & Medicaid Services (CMS).
Plan availability is determined by ZIP code. While a plan may be available in your state, it may not be offered in your specific county. Please verify plan availability with a licensed insurance agent.
CMS Star RatingAverage Medicare star rating, weighted by enrollment. Star ratings are determined by the Centers for Medicare & Medicaid Services (CMS).
We will connect you with Medicare companies based on the information you provide. They will help you find a plan that suits your needs. If you prefer to speak to a licensed insurance agent right away, please call the number listed below.
M-F 9AM-9PM, Sat 10AM-6PM ET
Speak to a licensed insurance agent on askchapter.org
M-F 9AM-9PM, Sat 10AM-6PM ET
Speak to a licensed insurance agent on askchapter.org
Plan availability is determined by ZIP code. While a plan may be available in your state, it may not be offered in your specific county. Please verify plan availability with a licensed insurance agent.
NerdWallet’s Medicare content, including articles, reviews and recommendations, is produced by a team of writers and editors who specialize in Medicare. Their work has appeared in The Associated Press, Washington Post, Nasdaq, MSN, MarketWatch, Yahoo! Finance and other national and regional media outlets. They have been cited in publications including Healthline, and appeared on NerdWallet's "Smart Money" podcast.
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 3.95.
Of Clover Health members who are in Medicare Advantage plans with a star rating, 96% 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.
. 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 $174.70 per month in 2024 ($185 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 just over 80,000 Medicare Advantage beneficiaries
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.
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).
Clover Health
3.98
CMS Star RatingAverage Medicare star rating, weighted by enrollment. Star ratings are determined by the Centers for Medicare & Medicaid Services (CMS).
Clover Health offers mostly PPO plans, and more than half of its plans have $0 premiums, but they're only available in five states.
We will connect you with Medicare companies based on the information you provide. They will help you find a plan that suits your needs. If you prefer to speak to a licensed insurance agent right away, please call the number listed below.
States available
5 states
Members in high-rated plansPercentage of members who are in rated contracts with a Medicare star rating of 4 or higher.
High (85% to 100%)
Member experienceThe average of CMS' star ratings for quality measures in the domain "Member Experience with the Health Plan," weighted by contract enrollment.
3.12 (Below average)
IS THIS PROVIDER AVAILABLE IN MY STATE?
Plan availability is determined by ZIP code. While a plan may be available in your state, it may not be offered in your specific county. Please verify plan availability with a licensed insurance agent.
Pros
PPO plans offer more flexibility than HMOs.
More than half of plans have $0 premiums.
Cons
Out-of-pocket maximums can be high.
Available only in five states.
States available
5 states
Members in high-rated plansPercentage of members who are in rated contracts with a Medicare star rating of 4 or higher.
High (85% to 100%)
Member experienceThe average of CMS' star ratings for quality measures in the domain "Member Experience with the Health Plan," weighted by contract enrollment.
3.12 (Below average)
IS THIS PROVIDER AVAILABLE IN MY STATE?
Plan availability is determined by ZIP code. While a plan may be available in your state, it may not be offered in your specific county. Please verify plan availability with a licensed insurance agent.