Clover Health expands MA plan footprint

Clover Health, a healthcare company that provides Medicare Advantage (MA) plans and a non-insurance business, has expanded its offerings to new counties in Georgia, South Carolina and Tennessee.

Clover Health, which is based in Tennessee and launched in 2014, currently offers MA plans in 209 counties, caring for 85,000 members. The expansion will bring that total up to 220 countries across Alabama, Georgia, Mississippi, New Jersey, Pennsylvania, South Carolina, Tennessee and Texas. In addition, Clover will be exiting the counties of El Paso, Texas, and Pima, Arizona, two of its smaller markets. 

Eligible customers will be able to sign up for these new plans during the MA Annual Enrollment Period (AEP), which runs from Oct. 15 to Dec. 7, with coverage starting on Jan. 1, 2023. The plans are subject to approval from the Centers for Medicare and Medicaid Services.

“We are aiming to generate industry-leading growth during this year’s AEP, as we have over the past several years, and we’re focusing our efforts on our existing footprint where we have a proven track record,” Andrew Toy, president of Clover, said in a statement. “Clover Assistant is designed to lower costs and improve outcomes, and this year’s bids demonstrate our continued focus on passing savings back to our members in the form of great benefits at affordable prices.”

The expansion comes as MA plans have gained more and more market share of Medicare recipients over the past several years. In 2021, at least 40% of Medicare recipients were enrolled in MA plans in 24 states, according to KFF. And MA share is growing in some states much faster than others. 

Clover Health tripled its membership in Georgia in 2022 by increasing its provider network throughout the state with the addition of dozens of hospitals, health systems and provider partners across the region, aligning approximately 5,000 new primary care physicians and specialists with Clover’s MA network. By 2023, Clover plans will cover 151 out of 159 counties in Georgia, representing a market opportunity of 650,000 Medicare eligibles, the company said.