5

5 out of 5 stars* for plan year 2024

Plan ID: H8010-002

What You Need to Know:

  • Clover Health Classic (HMO) is a Medicare Advantage Health Maintenance Organization Local HMO plan.
  • It must provide all of the same hospital and medical benefits as Medicare Part A and Part B, however, costs may be different.
  • It has additional benefits not included in Medicare Part A and Part B, including prescription drug coverage.
  • The plan's monthly premium is $0, which does not include your monthly Medicare Part B premium.
  • The annual deductible for this health plan is .
  • The plan includes an out-of-pocket maximum of $7,550 per year (in-network).
  • Clover Health Classic (HMO) includes a Part D prescription drug plan for prescription medication coverage. The annual deductible is .
  • This plan's Part D Initial Coverage Limit is $0.

* Every year, the Centers for Medicare & Medicaid Services (CMS) evaluates plans based on a 5-star rating system.

$0

Monthly Premium

Medicare Plan Features
Monthly Premium: $0
Part C Premium: $0
Monthly Premium: Part C Premium: Part D Drug Premium: Part D Supplemental Premium: Total Part D Premium: Drug Deductible: Tiers with No Deductible:
$0 $0 $0 $0 $0 $0 0.0
Gap Coverage: No
Benchmark: not below the regional benchmark
Type of Medicare Health: Enhanced Alternative
Health Plan Type: Local HMO
Similar Plan: H8010-003
Special Needs Type: NULL
Chronic Condition: NULL
Additional Gap Coverage: No additional gap coverage, only the Donut Hole Discount
Maximum Out-of-Pocket Limit for Parts A & B (Moop): $7,550
Annual Deductible: NULL
Annual Initial Coverage Limit ICL: $4,130
Number of Members enrolled in this plan in Bergen, New Jersey: Plans Summary Star Rating: Customer Service Rating: Drug Cost Rating:
479 members New plan - No summary rating as of yet. 5 out of 5 Stars. 3 out of 5 Stars.
Plan Offers Mail Order: Yes
Plan Health Benefits
Total # of Formulary Drugs: 3,421 drugs
Number of Members Enrolled in this Plan in Bergen, New Jersey: NULL
Number of Drugs Per Tier: NULL
Preferred Pharmacy Cost Sharing During Initial Coverage Phase: NULL
Special Needs Plan SNP Eligibility Requirement: NULL
Monthly Premium Split as Follows:
Part C Premium Part D Base Premium Part D Supplemental Premium Total Premium
$0.00 $0.00 $0.00 $0.00
Monthly Premium with Extra Help Low Income Subsidy:
LIS100 Subsidy Total Monthly Premium with LIS Parts CD LIS25 Subsidy Monthly PartD Premium with LIS LIS25 Subsidy Total Monthly Premium with LIS Parts CD LIS50 Monthly PartD Premium with LIS LIS50 Subsidy Total Monthly Premium with LIS Parts CD LIS75 Monthly PartD Premium with LIS LIS75 Subsidy Total Monthly Premium with LIS Parts CD
$0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00
Formulary Drug Details:
Tier 1 # of Drugs per Tier Tier 1 Preferred Pharmacy Cost Sharing (initial coverage phase) Tier 2 # of Drugs per Tier Tier 2 Preferred Pharmacy Cost Sharing (initial coverage phase) Tier 3 # of Drugs per Tier Tier 3 Preferred Pharmacy Cost Sharing (initial coverage phase) Tier 4 # of Drugs per Tier Tier 4 Preferred Pharmacy Cost Sharing (initial coverage phase) Tier 5 # of Drugs per Tier Tier 6 Preferred Pharmacy Cost Sharing (initial coverage phase)
365 $2.00 462 $10.00 1032 $40.00 886 $95.00 676 33%

Other Medicare Advantage Plans in Bergen, New Jersey

Plan Name Type Premium MOOP Rx Deduct. Rating
Aetna Medicare Explorer Premier Plus (PPO) (2023)Local PPO$7,550$200
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Aetna Medicare Premier (Regional PPO) (2023)Regional PPO$7,550$100
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Amerivantage Balance (HMO) (2023)Local HMO$7,550$445
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Amerivantage Classic (HMO) (2023)Local HMO$6,950$200
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WellCare Value (HMO-POS) (2023)Local HMO$7,550$0
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WellCare Focus (HMO) (2023)Local HMO$5,900$0
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WellCare Premier (PPO) (2023)Local PPO$7,550$150
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WellCare Absolute (PPO) (2023)Local PPO$7,550$200
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WellCare Compass (HMO) (2023)Local HMO$6,700$445
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Clover Health Choice (PPO) (2023)Local PPO$7,550$175
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Clover Health Choice Value (PPO) (2023)Local PPO$7,550$445
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Clover Health Value (HMO) (2023)Local HMO$7,550$445
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AARP Medicare Advantage Plan 3 (HMO) (2023)Local HMO$6,700$200
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AARP Medicare Advantage Plan 4 (HMO) (2023)Local HMO$6,700$150
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AARP Medicare Advantage Choice (PPO) (2023)Local PPO$6,700$240
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Aetna Medicare Explorer Premier Plus (HMO) (2023)Local HMO$7,550$100
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Aetna Medicare Prime Value (HMO) (2023)Local HMO$7,550$195
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Aetna Medicare Explorer Elite (HMO) (2023)Local HMO$7,550$100
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Aetna Medicare Value 2 (HMO) (2023)Local HMO$7,550$300
5
Aetna Medicare Eagle (HMO) (2023)Local HMO *$7,550$-
5
Aetna Medicare Explorer Elite 2 (HMO) (2023)Local HMO$7,550$250
5
Aetna Medicare Explorer Premier (PPO) (2023)Local PPO$7,550$100
5
Humana Honor (PPO) (2023)Local PPO *$4,500$-
4
Braven Medicare Choice (PPO) (2023)Local PPO$6,700$150
New plan - not yet rated.
Aetna Medicare Prime Premier (PPO) (2023)Local PPO$7,550$250
5
Braven Medicare Freedom (PPO) (2023)Local PPO$6,500$100
New plan - not yet rated.
Aetna Medicare Prime Credit (PPO) (2023)Local PPO$7,550$300
5
Braven Medicare Plus (HMO) (2023)Local HMO$6,500$0
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HumanaChoice H5216-172 (PPO) (2023)Local PPO$7,550$295
4
Humana Gold Plus H6622-063 (HMO) (2023)Local HMO$7,200$275
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HumanaChoice H5216-169 (PPO) (2023)Local PPO$7,400$275
4
HumanaChoice H5216-170 (PPO) (2023)Local PPO$6,500$250
4
Horizon Medicare Blue Advantage (HMO) (2023)Local HMO$6,700$250
5
AARP Medicare Advantage Plan 1 (HMO) (2023)Local HMO$6,700$240
5
AARP Medicare Advantage Patriot (HMO) (2023)Local HMO *$6,700$-
5
Medicare Advantage Plans by Clover Health
Clover Health Choice (PPO) (2023)Local PPO$7,550$175
4
Clover Health Choice Value (PPO) (2023)Local PPO$7,550$445
4
Clover Health Value (HMO) (2023)Local HMO$7,550$445
5

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