Benzinga | Oct 1, 2021 09:03AM EDT

Clover Health Debuts 2022 Medicare Advantage Plans

Today, Clover Health (NASDAQ:CLOV) ("Clover"), a technology company committed to improving health equity for America's underserved seniors, debuted its 2022 Medicare Advantage plans, which are built to increase access to affordable, high quality healthcare for Medicare eligibles across the country. Individuals eligible for Medicare in 209 counties across nine states -- Alabama, Arizona, Georgia, Mississippi, New Jersey, Pennsylvania, South Carolina, Tennessee, and Texas -- can enroll in Clover's plans. The enrollment period opens on October 15 and continues through December 7, 2021, with coverage beginning on January 1, 2022.

Clover offers highly affordable, benefit-rich health plans with low out-of-pocket costs to eliminate care barriers and encourage beneficiaries to engage with the healthcare system, and their primary care physician ("PCP") in particular. Many of Clover's plans feature $0 premiums and $0 copays for primary care visits, regardless of whether the PCP is in or out of Clover's provider network.

Clover's PPO provider networks are broad and open, enabling its members to see any clinician participating in Medicare who is willing to accept them. Several thousand PCPs within Clover's coverage areas are using Clover's clinical support technology, the Clover Assistant, to elevate the care delivered to Clover's members. Equipping PCPs with patient information from across the healthcare system and clinical recommendations at the time of the visit empowers them to deliver data-driven, personalized care, to keep patients healthier.

"We strive to offer plans with the most benefits at the lowest cost on a wide, open network because we believe these three components working in concert are essential to making high-quality, affordable care more widely available, especially for those who have historically lacked access," said Andrew Toy, President of Clover Health. "We continue to invest in market-leading plan design, while continuing to iterate to make the Clover Assistant the best possible clinical software to manage the care of our beneficiaries."

In 2022, benefits such as primary and specialty physician care, outpatient hospital services, and ambulatory surgical centers will continue to feature low member out-of-pocket costs. Enhancements to the company's Part D and supplemental benefits will increase access to resources that promote and enable healthier living.

Additional highlights of Clover's 2022 Medicare Advantage plans include:

* Over-the-Counter and Grocery Allowances. Clover members who meet certain criteria, like having an underlying health condition, such as cancer, chronic kidney disease, or hypertension, will qualify for an enhanced Over-the-Counter ("OTC") benefit that includes groceries. Depending on the plan the individual is enrolled in, eligible members will receive up to $200 in a quarterly stipend which can be used to purchase OTC and grocery items at many major retailers, local supermarkets, and regional chains.

* Dental, Vision, and Hearing. All Clover 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.

* Low Insulin Prices. Members with diabetes who are enrolled in plans participating in the Part D Senior Savings Model will pay a maximum copay of $35 for a one-month supply of their insulin prescription. While the maximum copay for each select insulin prescription is $35 per month, this cost will be $25 when members fill their prescription at preferred vendors.

* 100-Day Prescriptions and Medication Delivery. The Clover Assistant prompts doctors, when clinically appropriate, to extend members' fill lengths for Tier 1 and 2 prescription drugs from the standard 30 days to 90 or 100 days. Needing to refill a drug three or four times a year is much easier, and less expensive, than 12 times a year, which is the requirement for a standard 30-day fill, and is less likely to result in periods without any medications on hand. Prescriptions are available for delivery via Clover's partnership with CVS Caremark, enabling members to obtain critical medications without having to leave the home.

* Transportation Assistance. Clover members whose plans include transportation benefits will be able to schedule non-emergency medical transportation through Roundtrip's ride ordering app, which includes rideshare options, medical sedans, wheelchair vans, and non-emergency ambulances. By streamlining and simplifying the transportation experience, Clover aims to provide members with flexibility, autonomy and support in getting to their appointments.

* Access to Telehealth Visits. In addition to in-person office visits, Clover offers video-based visits to all members at no cost to them.

* At-Home Primary Care. Eligible members in New Jersey can enroll in Clover Home Care, Clover's in-home primary care program for medically-complex and homebound individuals. The program provides direct, 24/7 access to providers, same-day urgent visits, and collaborative care with in-network primary care physicians, all within the home.

* Fitness Classes. Clover plans include a SilverSneakers membership, which gives members access to a large network of gyms, as well as live and on-demand video classes for activities like aerobics, yoga, swimming, nutrition counseling, and senior fitness programs, free of cost.