Many United Healthcare HMO plans also give you access to care across the country at network costs using the UnitedHealthcare ® Medicare National Network, the nation’s largest network of top doctors and specialists. Plus, you can see out-of-network doctors and providers for certain covered services. HMO-POS (Point of Service) plans give you access to a local network of doctors and hospitals, including a PCP to coordinate your care. Many HMO plans have a low or $0 monthly premium. 3 Many plans include UnitedHealthcare Passport ®, which gives you the network costs and benefits of your plan when you travel. If you use a provider that isn't in the national network, you may have to pay for the service yourself. You'll need to get care from doctors and providers in the network and you select a PCP to help coordinate your care. You will receive notice when necessary. For sales/marketing complaints, contact Clover Health at 1-88 (TTY 711) or 1-800-MEDICARE (if possible, please be able to provide the agent or broker's name).United Healthcare HMO plans give you access to a local network of doctors and hospitals, including a primary care provider (PCP) to help coordinate your unique health care needs. The formulary, pharmacy network, and/or provider network may change at any time. Benefits, premiums, and/or copayments/coinsurance may change on January 1 of each year. Plan performance Medicare Star Ratings are assessed each year and may change from one year to the next. Limitations, copayments, and restrictions may apply. Call 1-88 (TTY 711) for more information. This information is not a complete description of benefits. Call 1-88 (TTY 711).ĪTENCIÓN: Si usted habla español, tenemos servicios de asistencia lingüística disponibles para usted sin costo alguno. ĪTTENTION: If you speak English, language assistance services, free of charge, are available to you. Medicare beneficiaries may also enroll in Clover Health through the CMS Medicare Online Enrollment Center located at. For a decision about whether we will cover an out-of-network service, we encourage you or your provider to ask us for a pre-service organization determination before you receive the service. Please call our customer service number or see your Evidence of Coverage for more information, including the cost-sharing that applies to out-of-network services. For plans that provide drug coverage, the formulary may change during the year. Out-of-network/non-contracted providers are under no obligation to treat Clover members, except in emergency situations. You must continue to pay your Medicare Part B premium. Enrollment in Clover Health depends on contract renewal. *We are open from 8 am–8 pm 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.Ĭlover Health is a Preferred Provider Organization (PPO) and a Health Maintenance Organization (HMO) with a Medicare contract. 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. If you prefer provider freedom, a PPO or PFFS plan. 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. For example, if you have a chronic health condition, an SNP Advantage plan can help with your medical costs. The choice is yours.Ĭlover knows the importance of your relationship with your primary care doctor. But you also have the freedom to go to out-of-network doctors or specialists you may have to pay higher costs. Your costs will be easy to plan for with less need to worry about unexpected medical bills. You can choose a provider from the Clover PPO network and have low copays. That’s why we give you the opportunity to make choices for greater control of your healthcare costs. To read more about out of network coverage rules, click here.Īt 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. Our PPO plans give you the freedom to choose your doctorĪs a member of a NJ HMO plan, you must use network providers to get your medical care and services.
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