Clover Health Formulary Directory
Important Message About What You Pay for Vaccines - Our plan covers most Part D vaccines at no cost to you, even if you haven’t paid your deductible (if applicable). Call Member Services for more information. Clover Health Member Services: 1-888- 778-1478 (TTY 711), 8am-8pm local time, 7 days a week. From April 1st through September 30th, alternate technologies (for example, voicemail) will be used on the weekends and holidays.
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). Drugs noted as "Select Insulin" are covered under the Part D Senior Savings Model Program for participating plans only. During the deductible, initial coverage and coverage gap or "donut hole" stages of your benefit, Clover Health offers up to one month supply of select insulins at $35 copay. During the catastrophic phase, the member will pay the greater of 5% of the total cost of the drug, OR $10.35 copayment. Members with a Low-Income Subsidy or "Extra Help" are excluded from the Senior Savings Model. For complete coverage details on these select insulins see Chapter 6 of your Evidence of Coverage booklet. The following Clover Health Plans participate in the Senior Savings Model Program:
Clover Health Non Discrimination Notice
Clover Health LiveHealthy (PPO) (052) – AL
Clover Health Live Health (PPO) (026) – GA
Clover Health LiveHealthy (PPO) (050) – MS
Clover Health Choice (PPO) (038) - PA
Clover Health Live Healthy (PPO) (036) – SC
Clover Health Live Healthy Value (PPO) (037) – SC
Clover Health Choice (PPO) (033) – TN
Clover Health Choice (PPO) (025) - TX