Clover Health’s Texas Medicare Advantage plans take Medicare coverage to the next level with low or $0 premiums and a cap on yearly out-of-pocket costs to protect your finances.
Original Medicare covers Part A, like hospitalization, and Part B, like doctor appointments. However, there is a Part A deductible, and it only covers 80% of your Part B expenses. You are responsible for the remaining 20%, which can add up.
Our Texas Medicare Advantage plans have many advantages over Original Medicare, such as:
Peace of mind with a Clover Health Medicare Advantage plan
The Clover Health Medicare Advantage plans with prescription drug coverage gives Texas County residents some of the best benefits in the area, including:
$0 monthly plan premium
$0 copay for unlimited primary care visits
$20 for unlimited specialist visits**
$0 copay for many generic drugs, including shingles vaccine
$0 to $10 copay for outpatient lab services**
$0 copay for preventive services**
$0 copay for SilverSneakers® fitness membership
When you’re a Clover Health member, your copays for urgent care, emergency care, inpatient hospital stays, outpatient surgery, ambulance services, and prescription costs are reasonable and affordable.
**In-network copay only. Out-of-network has a higher cost share.
At Clover Health, we understand that your relationship with your doctor is very important and we believe you have the right to receive care where you are most comfortable. That’s why we give you the opportunity to make choices for greater control of your healthcare costs.
You can choose a provider from the Clover PPO network and have low copays. Your costs will be easy to plan for with less need to worry about unexpected medical bills. But you also have the freedom to go to out-of-network doctors or specialists; you may have to pay higher costs. The choice is yours.
Clover knows the importance of your relationship with your primary care doctor. That’s why, for most Clover PPO plans, you’ll have $0 or low copays for either in-or out-of-network primary care visits.
If you’d like to see a list of providers in your area who are in the Clover Health network, please use Find a Provider.
Find a ProviderAnother advantage of the Clover Health plans in Texas is that we offer supplemental benefits not offered with Original Medicare.
Clover Health plans cover important dental, vision, and hearing services to support your wellness. Texas Medicare plan members get routine dental exams, cleanings, and an annual x-ray. Most plans include comprehensive dental coverage with a minimum of $1,000 yearly allowance for dentures, crowns, fillings, and other dental services.
With Clover Health, you also get one routine vision exam per year, plus some of our plans offer a $100 yearly allowance for routine contacts or glasses. One annual routine hearing exam is also included with a $0 copay in our Texas Medicare Advantage plan when you visit a TruHearing audiologist, along with hearing aids with affordable copays.
Our Texas plan also include an allowance for frequently used over-the-counter products like vitamins, aspirin, cold and flu medicines, digestive aids, and much more.
Texas Choice PPO plan members receive $45 every quarter, or $180 a year, to spend on these items which helps keep more money in your pocket. Benefits vary by plan.
In addition to visiting your doctor’s office, you can now see your doctor from the comfort of your home. Clover Health Medicare Advantage plans provide a telehealth solution to all doctors so they can offer video or phone appointments. If your personal doctor isn’t available, Clover Health can connect you with a doctor or nurse practitioner via video or phone.
Staying fit and active is much easier when you have the Clover Health Medicare Advantage plan, which includes a SilverSneakers® membership. Sign up for a Clover Health plan and you’ll have access to over 16,000 fitness centers nationwide as well as on-demand video fitness and nutrition classes through SilverSneakers®.
Unlike Original Medicare, many of Clover’s Medicare Advantage plans offer prescription drug coverage. Clover gives you the very lowest copays on prescriptions, including many chronic medications. With our Texas plans, Tier 1 prescriptions from a preferred pharmacy have a $0 copay. We allow extended (up to 100-day) supplies, which is convenient and may be easier on your wallet. Find a complete list of drugs covered by your Clover plan at cloverhealth.com/formulary. You can go to any pharmacy in our network, but your costs for some drugs may be less at our preferred pharmacies, like CVS, Walgreens, Walmart, Costco, and many other pharmacy locations. Visit cloverhealth.com/find-pharmacy to find a preferred pharmacy near you.
Important Message About What You Pay for Insulin - You won’t pay more than $35 for a one-month supply of each insulin product covered by our plan, no matter what cost-sharing tier it’s on, even if you haven’t paid your deductible (if applicable).
In addition for 2023, our LiveHealthy PPO plan includes our Insulin Savings Program, where members with diabetes will have predictable copays for insulin. Members in the program may pay $35/month for covered select insulins with no deductible. This will help you save about $325 in out-of-pocket costs for the year.
You do healthy things, we give you rewards.
Lots of them.
With our LiveHealthy Rewards, it pays to be healthy! We give you reward dollars just for doing some easy health-related tasks!
When you enroll in your Clover Medicare Advantage plan, you get a LiveHealthy Flex Plus Visa card. Then, we add reward dollars to your card as you complete each task.
Your rewards and OTC dollars are easy to use.
Your LiveHealthy Flex Plus Visa card will contain both your rewards and OTC funds. You can use your OTC benefits at a number of approved locations. And you can spend your reward dollars on just about any products or services! †
†LiveHealthy reward dollars may not be used to purchase alcohol, tobacco products, or firearms. Not redeemable for cash. Other limitations may apply; please call Clover for detail
Most Texas residents are looking to lower their out-of-pocket healthcare costs, stretch their budget, have the freedom to choose their doctor, and even have yearly allowances for dental care, eyewear, and over-the-counter items. Clover Health’s Medicare Advantage plans can help you get all that and more.
We're available to talk 8am to 8pm, 7 days a week.*