Clover Health plans to expand into 101 new markets

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Clover Health, a technology company focused on health equity for underserved seniors, recently announced plans to nearly double its geographic footprint. The expansion, subject to approval from the Centers for Medicare and Medicaid Services, will make Clover’s Medicare Advantage plans available to eligible individuals in a total of 209 counties across nine states.

Medicare-eligible people in these new counties can enroll in Clover’s plans during the annual election period, which runs from Oct. 15 through Dec. 7, with coverage beginning Jan. 1, 2022.

WHAT IS THE IMPACT

Clover currently offers its Medicare Advantage plans in 108 counties where it serves approximately 66,300 members. The planned expansion will cover 101 additional counties, 94 of which are in the existing Clover states of Georgia, New Jersey, South Carolina and Texas, and seven of which are in Alabama, marking the company’s first foray into this state. Clover also has plans available in Arizona, Mississippi, Pennsylvania, and Tennessee.

The expansion opens Clover’s plans primarily to seniors living in rural areas, who are more likely to face health disparities than those in more urban settings. By tapping into Cover Assistant’s network of primary care physicians, the company seeks to improve care coordination, close gaps in care, and reduce overall medical expenses for those eligible for Medicare.

Beginning in 2022, all of the company’s plans will operate solely under the Clover brand, and as such, Clover will end its current co-branding agreement with Walmart in eight Georgia counties. There will be no material changes to the benefits of these plans, and Clover expects there will be no disruption to its members.

Additionally, Clover intends to introduce a number of new benefits, some of which may be launched to existing Clover members as early as Q3 of this year. For many of its plans, Clover intends to expand its over-the-counter benefit and add a grocery benefit, which would be available at many major retailers (including Walmart), additional local supermarkets and regional channels.

THE GREAT TREND

Clover’s arrangement with Walmart was short-lived, as the companies teamed up to offer MA plans to eligible seniors in Georgia just in October 2020.

This marked Walmart’s first steps into the insurance market and followed other recent moves to expand into healthcare. It first remodeled 500 stores in two dozen states to include updated pharmacy areas equipped with private consulting rooms. From there, Walmart Health opened its first physical location in Dallas, Georgia, where patients could get primary care, dental care, counseling, lab services, X-rays, audiology and more. .

For its part, Clover’s workforce, based in Nashville, is distributed in the United States and also includes a team of technologists based in Hong Kong. The company manages the care of Medicare beneficiaries in 11 states, including Arizona, Georgia, Kansas, Mississippi, New Jersey, New York, Pennsylvania, South Carolina, Tennessee, Texas and Vermont .

Twitter: @JELagasse
Email the author: jeff.lagasse@himssmedia.com

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