Extra Benefits and Programs

Regular dental visits are important to your health and well-being. That’s why we have partnered with DentaQuest to provide your dental benefits. With preventive coverage included in the plan, your dentist will be able to find dental problems early, when they’re easier to fix. This can help save you money and unwanted additional treatments.

Most plans cover preventive and comprehensive services.

Preventive Dental Coverage

These routine dental services are covered at low costs to you:

• Cleanings
• X-ray
• Fluoride treatments
• Oral exam

For Medicare-covered dental services, like diseases, or injuries that are treated in a hospital, refer to your Evidence of Coverage.

If you call to ask if a dentist accepts your insurance, please refer to your dental plan as “DentaQuest,” not “Clover Health,” to avoid confusion.

Comprehensive Dental Coverage

Comprehensive dental includes most services that are not listed as preventive services.

Plans that include comprehensive dental coverage have a low copay and also give you an annual allowance to help pay for services. The allowance can be used to cover the dental services listed below. (Limitations may apply.) Once your allowance is used, you will be responsible to pay for any additional dental costs for the rest of the year.

Comprehensive dental services include:

• Extractions
• Root canals
• Crowns
• Bridges and fillings
• And more

How to Find an In-Network Dentist

Use our online Find a Dentist tool to find an in-network dentist that is close to you. Here’s a step-by-step guide:

1. Go to dentaquest.com/en/find-a-dentist.
2. Enter your zip code.
3. Type of Plan: Select “Medicare”
4. Choose Your Plan: Select “Clover Medicare”. You have the option to search for dentists by name, specialty, or location. You can also perform an advanced search to further filter your search results, or search for all.

HMO plan members: You must see a dentist who is contracted with DentaQuest to use your dental coverage. If you visit a dentist who is outside of the DentaQuest network, you will be responsible for the full cost of the service.

PPO plan members: Reimbursement for Services

We encourage you to see a dentist who accepts DentaQuest. In most cases, the provider will simply bill DentaQuest. Just present your DentaQuest/EyeQuest ID card at the time of service.

In the event that you prefer to see a non-DentaQuest dentist you will have to first pay out of pocket. You can then submit a Reimbursement Form to DentaQuest. The form is located at cloverhealth.com/dmr.

For covered and approved services, you should receive payment up to your annual benefit allowance minus applicable copay. To help you understand your financial responsibility for dental services, please refer to your Evidence of Coverage.

We want to help you to move and feel as strong as possible. The free SilverSneakers® membership included in your Clover plan offers live and on-demand video classes for times when you can’t go to a class in person. Try the online classes if you enjoy learning at home, or choose from over 17,000 fitness locations if you prefer to take classes in-person.

Access a broad selection of healthy lifestyle offerings. Some in-person classes even meet outside at local parks and include group walks so you can enjoy that fresh air and sunshine! Just go to silversneakers.com to access classes and the many other benefits available on the site.

SilverSneakers Tuition Rewards

As a SilverSneakers member, you can save thousands on tuition for your loved ones. The program is easy to use and it’s free. Imagine helping your grandkids or other students in your life pay for school while you’re staying fit. Your workouts can add up to big savings. (Note: This program is not managed by Clover.)

For more information, visit silversneakers.tuitionrewards.com

Clover Health partners with TruHearing to provide hearing aid services at a low cost ($699 or $999 per aid). Your plan offers one routine hearing exam and two hearing aids (one for each ear) per year.

Healthy activities should be rewarded! With our rewards program, we give you the opportunity to earn up to $400 a year on healthy activities you’re probably already doing.

• Get $100 for answering simple questions in our 2024 Getting to Know You form.
  • Answering these questions, on the survey, will help us to personalize your healthcare experience.
• Get up to $50 for receiving certain preventive care services.
  • Getting select preventive services can help you detect or prevent serious illnesses.
• Get $150 for completing a LiveHealthy Visit.
  • This wellness visit gives a preferred doctor more time to take a comprehensive look at your health, your lifestyle, and your meds.
• Get up to $25 per quarter for getting active.
  • These healthy activities are designed to help you stay or get active.
• Get an additional $50 gift card reward for a PCP visit between November 1, 2024 and December 31, 2024**.
  • All members are eligible for the reward.
  • This reward is independent from the LiveHealthy Visit reward.
  • To earn the additional reward you must either call us before or soon after the visit at 1-888-921-0774 (TTY 711), 8am - 6pm ET, Monday - Friday, for a consultation regarding the visit.

LiveHealthy Flex Plus Card—1 Card for 2 Great Programs

The Flex Plus card is used for both your OTC benefit and your rewards earned through the LiveHealthy Rewards program.

Spending your OTC allowance and reward dollars is easy.

• If you are a current member and have a 2023 LiveHealthy Flex Plus card, you will NOT receive a new card automatically. Your old card will continue to be active for 2024.
• If you are a new member, your LiveHealthy Flex Plus card will arrive in the mail activated and ready to use.
• The card can be used almost anywhere Visa is accepted.
• Use your Flex Plus card to spend your OTC allowance on qualifying items and your reward dollars on just about any product—except for alcohol, tobacco products, and firearms.*
• Your HealthyBenefits+ welcome kit will include instructions on how and where to shop.
• To check your rewards balance, visit cloverhealth.com/livehealthy.***

*Note: These funds cannot be converted to cash. Other limitations may apply. Please contact Clover Health for details.

*The $50 gift card reward can be earned by completing a primary care visit with any primary care provider (including a LiveHealthy Visit with one of our preferred providers) between November 1, 2024 and December 31, 2024 and completing the consultation discussed above.  You will receive your gift card in a separate mailer within 90 days of Clover receiving record of you completing your appointment. The $50 reward will not be loaded onto your LiveHealthy Rewards Visa Card.
***The gift card balance cannot be checked through cloverhealth.com/livehealthy

We give you an allowance of at least $120 per year* to shop a selection of thousands of approved over-the-counter (OTC) items. Things like bandages, cough medicine, and vitamins are just a few of the OTC purchases you can make with your allowance. Plus, you have the convenience of getting your OTC items at leading retail locations like CVS, Walgreens, and Walmart, or by phone or online.

*The allowance is distributed quarterly and expires at the end of each quarter (March 31, June 30, September 30, and December 31). Refer to your Evidence of Coverage to find your quarterly allowance amount.

Check your balance, find a store, and more!

Head to my.cloverhealth.com or download the Healthy Benefits+ mobile app—or both!

Use the website or app to:

• Get more details on using your OTC benefit
• Check your account balance for both your OTC allowance and rewards earned (see below)
• Find participating stores

For a sample selection of covered items, view the 2024 LiveHealthy Item Catalog.

Need to see a doctor outside of normal business hours? We know how important this has become recently. All Clover members have the option to see a doctor for non-emergency health issues by video or on the phone. Appointments are available 24 hours a day, 365 days per year, with no referral or prior authorization required.

For more information, see your Evidence of Coverage.

Clover Health partners with EyeQuest to cover one routine eye exam and an annual allowance for one pair of eyeglasses or contact lenses per year.

To find an in-network vision provider, click here.

HMO plan members: You must see an eye doctor who is contracted with EyeQuest to use your routine vision coverage. If you visit an eye doctor who is outside of the EyeQuest network, you will be responsible for the full cost of the service.

PPO plan members: Reimbursement for Services
We encourage you to see an eye doctor who accepts EyeQuest. In most cases, the provider will simply bill EyeQuest. Just present your DentaQuest/EyeQuest ID card at the time of service.

In the event that you prefer to see a non-EyeQuest eye doctor you will have to first pay out of pocket. You can then submit a Reimbursement Form to EyeQuest. The form is located at cloverhealth.com/dmr.

For covered and approved services, you should receive payment up to your annual benefit allowance minus applicable copay. Your Clover Health plan also covers medical vision care, such as diabetic retinal exams, cataract surgeries, and other treatments that fall under your medical benefits. For more information, see your Evidence of Coverage.

Regular dental visits are important to your health and well-being. That’s why we have partnered with DentaQuest to provide your dental benefits. With preventive coverage included in the plan, your dentist will be able to find dental problems early, when they’re easier to fix. This can help save you money and unwanted additional treatments.

Most plans cover preventive and comprehensive services.

Preventive Dental Coverage

These routine dental services are covered at low costs to you:

• Cleanings
• X-ray
• Fluoride treatments
• Oral exam

For Medicare-covered dental services, like diseases, or injuries that are treated in a hospital, refer to your Evidence of Coverage.

If you call to ask if a dentist accepts your insurance, please refer to your dental plan as “DentaQuest,” not “Clover Health,” to avoid confusion.

Comprehensive Dental Coverage

Comprehensive dental includes most services that are not listed as preventive services.

Plans that include comprehensive dental coverage have a low copay and also give you an annual allowance to help pay for services. The allowance can be used to cover the dental services listed below. (Limitations may apply.) Once your allowance is used, you will be responsible to pay for any additional dental costs for the rest of the year.

Comprehensive dental services include:

• Extractions
• Root canals
• Crowns
• Bridges and fillings
• And more

How to Find an In-Network Dentist

Use our online Find a Dentist tool to find an in-network dentist that is close to you. Here’s a step-by-step guide:

1. Go to dentaquest.com/en/find-a-dentist.
2. Enter your zip code.
3. Type of Plan: Select “Medicare”
4. Choose Your Plan: Select “Clover Medicare”. You have the option to search for dentists by name, specialty, or location. You can also perform an advanced search to further filter your search results, or search for all.

HMO plan members: You must see a dentist who is contracted with DentaQuest to use your dental coverage. If you visit a dentist who is outside of the DentaQuest network, you will be responsible for the full cost of the service.

PPO plan members: Reimbursement for Services

We encourage you to see a dentist who accepts DentaQuest. In most cases, the provider will simply bill DentaQuest. Just present your DentaQuest/EyeQuest ID card at the time of service.

In the event that you prefer to see a non-DentaQuest dentist you will have to first pay out of pocket. You can then submit a Reimbursement Form to DentaQuest. The form is located at cloverhealth.com/dmr.

For covered and approved services, you should receive payment up to your annual benefit allowance minus applicable copay. To help you understand your financial responsibility for dental services, please refer to your Evidence of Coverage.

We want to help you to move and feel as strong as possible. That’s why we include a membership to One Pass® with your Clover Health plan at no cost to you. You will have access to the largest nationwide network of gyms and fitness locations. Plus, you can join over 20,000 online fitness classes live, on-demand, in the comfort of your home. The program also offers personalized online brain training games to help you improve your memory and focus.

One Pass is a voluntary program. The One Pass program varies by plan/area. Information provided is not medical advice. Consult a health care professional before beginning any exercise program.

Clover Health partners with TruHearing to provide hearing aid services at a low cost ($699 or $999 per aid). Your plan offers one routine hearing exam and two hearing aids (one for each ear) per year.

Healthy activities should be rewarded! With our rewards program, we give you the opportunity to earn up to $400 a year on healthy activities you’re probably already doing.

• Get $80 for answering simple questions in our 2025 Getting to Know You form.
  • Answering these questions, on the survey, will help us to personalize your healthcare experience.
• Get up to $50 for receiving certain preventive care services.
  • Getting select preventive services can help you detect or prevent serious illnesses.
• Get $150 for completing a LiveHealthy Visit.
  • This wellness visit gives a preferred doctor more time to take a comprehensive look at your health, your lifestyle, and your meds.
• Get up to $30 per quarter for getting active.
  • These healthy activities are designed to help you stay or get active.

LiveHealthy Flex Plus Card—1 Card for 2 Great Programs

The Flex Plus card is used for both your OTC benefit and your rewards earned through the LiveHealthy Rewards program.

Spending your OTC allowance and reward dollars is easy.

• If you are a current member and have a LiveHealthy Flex Plus card, you will NOT receive a new card automatically. Your old card will continue to be active for 2025.
• If you are a new member, your LiveHealthy Flex Plus card will arrive in the mail activated and ready to use.
• The card can be used almost anywhere Visa is accepted.
• Use your Flex Plus card to spend your OTC allowance on qualifying items and your reward dollars on just about any product—except for alcohol, tobacco products, and firearms.*
• Your HealthyBenefits+ welcome kit will include instructions on how and where to shop.
• To check your rewards balance, visit cloverhealth.com/livehealthy.

*Note: These funds cannot be converted to cash. Other limitations may apply. Please contact Clover Health for details.

We give you an allowance of at least $200 per year* to shop a selection of thousands of approved over-the-counter (OTC) items. Things like bandages, cough medicine, and vitamins are just a few of the OTC purchases you can make with your allowance. Plus, you have the convenience of getting your OTC items at leading retail locations like CVS, Walgreens, and Walmart, or by phone or online.

*The allowance is distributed quarterly and expires at the end of each quarter (March 31, June 30, September 30, and December 31). Refer to your Evidence of Coverage to find your quarterly allowance amount.

Check your balance, find a store, and more!

Head to my.cloverhealth.com or download the Healthy Benefits+ mobile app—or both!

Use the website or app to:

• Get more details on using your OTC benefit
• Check your account balance for both your OTC allowance and rewards earned (see below)
• Find participating stores

For a sample selection of covered items, view the 2025 LiveHealthy Item Catalog.

Need to see a doctor outside of normal business hours? We know how important this has become recently. All Clover members have the option to see a doctor for non-emergency health issues by video or on the phone. Appointments are available 24 hours a day, 365 days per year, with no referral or prior authorization required.

For more information, see your Evidence of Coverage.

Clover Health partners with EyeQuest to cover one routine eye exam and an annual allowance for one pair of eyeglasses or contact lenses per year.

To find an in-network vision provider, click here.

HMO plan members: You must see an eye doctor who is contracted with EyeQuest to use your routine vision coverage. If you visit an eye doctor who is outside of the EyeQuest network, you will be responsible for the full cost of the service.

PPO plan members: Reimbursement for Services
We encourage you to see an eye doctor who accepts EyeQuest. In most cases, the provider will simply bill EyeQuest. Just present your DentaQuest/EyeQuest ID card at the time of service.

In the event that you prefer to see a non-EyeQuest eye doctor you will have to first pay out of pocket. You can then submit a Reimbursement Form to EyeQuest. The form is located at cloverhealth.com/dmr.

For covered and approved services, you should receive payment up to your annual benefit allowance minus applicable copay. Your Clover Health plan also covers medical vision care, such as diabetic retinal exams, cataract surgeries, and other treatments that fall under your medical benefits. For more information, see your Evidence of Coverage.