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Clover Health Medicare Advantage for 2027: 5-Star PPOs, Plan Names and Where You Can Enroll

Reviewed by Russell Noga, Licensed Medicare Insurance Broker (all 50 states) — Last updated November 7, 2026

Clover Health Medicare Advantage plans for 2027 are sold in parts of New Jersey, Georgia, South Carolina, Texas and Pennsylvania, and 14 of Clover’s 16 plans are wide-network PPOs. CMS gives Clover’s PPO contract 5 stars for 2027, which lets people join it outside the usual enrollment windows, though that score rests on a court-ordered recalculation that is still under appeal.

2027 by the Numbers

16

Clover individual Medicare Advantage plans for 2027 (our analysis of CMS 2027 plan data)

203

counties where at least one Clover plan is sold (our analysis of CMS 2027 plan data)

151 of 159

Georgia counties in Clover’s 2027 service area (our analysis of CMS 2027 plan data)

5 stars

2027 CMS rating for Clover PPO contract H5141 (Clover, October 2026)

Clover Health is a younger insurer than most names in Medicare Advantage. It was founded in 2014, is based in Franklin, Tennessee, and built its business on PPO plans that let members see any doctor who accepts Medicare, with in-network and out-of-network costs that differ by plan.

This page uses our own count of the CMS 2027 plan files to show where Clover sells, which plan names appear in each state, and what the 5-star headline does and does not mean. If you live in the Garden State, our New Jersey Medicare Advantage guide lists every other insurer there too.

✔ Licensed in all 50 states
✔ Based on CMS 2027 data
✔ Free plan comparison

Key Highlights

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14 PPOs and 2 HMOs for 2027, with the HMOs sold only in New Jersey

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Georgia is now Clover’s widest footprint by county count

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Two plans carry the Giveback name, meaning a Part B premium reduction

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The PPO 5-star score would have been 4.5 stars without the court-related adjustment

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The 2027 Star Rating, Including the Fine Print

In October 2026, Clover announced that CMS had rated its PPO contract, H5141, at 5 stars for 2027 and its New Jersey HMO contract, H8010, at 4.5 stars. Only about 15 Medicare Advantage contracts in the country reached 5 stars for 2027, and H5141 is one of them.

5.0

PPO contract H5141, 2027 overall rating

4.5

HMO contract H8010, 2027 overall rating

4.5

what the PPO would have scored with the 20 removed measures included

Why the asterisk: CMS left 20 measures out of the PPO calculation after a May 2026 federal court decision in Clover’s lawsuit against the Department of Health and Human Services. The government has appealed. A different outcome could change future ratings, though the 2027 score stands for this enrollment season.

A 5-star plan opens a special enrollment period. People can switch into a 5-star Medicare Advantage plan once between December 8 and November 30, instead of waiting for the fall window.

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Our Analysis of CMS 2027 Plan Data: Clover by State

State Clover plans Counties covered Plan names in that state
New Jersey 8 20 of 21 (all but Warren) Choice, Choice Value, Choice Giveback, Valor, Classic HMO, Value HMO
Georgia 4 151 of 159 LiveHealthy, LiveHealthy Premier, LiveHealthy Giveback, Valor
South Carolina 3 22 of 46 LiveHealthy, LiveHealthy Giveback, Valor
Texas 2 7 (San Antonio area) Choice, Valor
Pennsylvania 2 3 (Bucks, Delaware, Philadelphia) Choice, Valor

Our analysis of CMS 2027 PBP and plan-county files, individual plans only. Some plans span more than one state, so state plan counts add up to more than 16.

The Georgia gaps are worth knowing. Floyd, Gordon, Lanier, Lowndes, Toombs, Towns, Walker and Whitfield counties are not in the 2027 Clover service area. Our Georgia Medicare Advantage page shows who sells in those counties instead.

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PPO or HMO: How the Two Clover Contracts Differ

Clover PPO plans (H5141)

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14 plans in all five states

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You may see out-of-network providers who accept Medicare, usually at a higher cost share

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No referral needed for specialists in a typical PPO

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2027 rating: 5 stars

Clover HMO plans (H8010)

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2 plans, New Jersey only

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Classic in 6 counties, Value in 7, mostly the northern part of the state

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You generally use the plan network except in emergencies

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2027 rating: 4.5 stars

Clover says almost all of its members, about 98 percent, are in the PPO plans. For a broader look at the trade-offs, see our guide to the best PPO Medicare Advantage plans.

What the Giveback Plans Mean

A Giveback plan pays part of your Part B premium, so more of your Social Security check stays with you. The standard Part B premium is $202.90 a month in 2026, and the Medicare Trustees project $209.50 for 2027.

Clover’s two Giveback plans for 2027

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Clover Health Choice Giveback (PPO): sold in all 20 Clover counties in New Jersey

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Clover Health LiveHealthy Giveback (PPO): sold across Clover’s Georgia and South Carolina counties

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The exact reduction amount is set by plan and county, so check the plan’s Summary of Benefits

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If Medicaid or a savings program already pays your Part B premium, a Giveback adds nothing for you

Trade-off: Giveback plans often carry higher copays or a higher out-of-pocket limit than the same insurer’s other plans. Compare the full yearly cost, not only the premium reduction.

Extras and Benefits to Confirm

Clover’s 2027 plans may include dental, vision, hearing and over-the-counter allowances, depending on the plan and area. Not all plans offer all benefits, and amounts can differ between, say, a LiveHealthy plan in Georgia and a Choice plan in New Jersey.

Read these lines in each plan’s Evidence of Coverage

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In-network and combined out-of-pocket maximums

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Out-of-network cost share for specialists and hospital stays

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Part D drug tiers for your current prescriptions

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Dental annual maximum and whether it covers crowns or only cleanings

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Clover Health's Background

Vivek Garipalli and Kris Gale started Clover in 2014. The company went public through a merger with a special-purpose acquisition company and began trading on Nasdaq in January 2021. Andrew Toy became chief executive in 2023.

Points that matter for members

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Clover credits its own clinical software, Counterpart Assistant, which doctors in its network use, with supporting its quality scores

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Clover reported more than 157,000 Medicare Advantage members in mid-2026, up about 48 percent from a year earlier

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Clover says its PPO scored 4.82 out of 5 on core HEDIS quality measures, first among non-SNP PPOs with more than 2,000 members

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Clover is a newer, publicly traded company, so membership and finances can move more than at older insurers

Before You Enroll in a Clover Plan

1

Confirm your county Use the state table above. Warren County, New Jersey, and eight Georgia counties are outside the 2027 service area.

2

Pick PPO or HMO Outside New Jersey, every Clover plan is a PPO, so the choice there is between plan names, not plan types.

3

Price your drugs The 2027 Part D out-of-pocket cap is $2,400, but your cost before reaching it depends on the plan’s formulary.

4

Use the right window The Annual Enrollment Period runs October 15 to December 7, 2026. Because the PPO contract holds 5 stars, the 5-star special enrollment period also applies to it. Details are on our 2027 enrollment period page.

Bottom Line

The Bottom Line

Clover Health Medicare Advantage is mostly a PPO story for 2027: 14 of 16 plans, sold across 203 counties in five states, with a 5-star PPO rating that comes with a court-related footnote. Check your county, compare a Giveback plan against a standard one, and price your drugs before you pick.

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Frequently Asked Questions

➤ Is Clover Health rated 5 stars for 2027?

Its PPO contract, H5141, received 5 stars for 2027, and its New Jersey HMO contract received 4.5 stars. The PPO score excludes 20 measures removed after a 2026 court decision that is under appeal; with them, the PPO would have scored 4.5.

➤ Which states have Clover Medicare Advantage in 2027?

New Jersey, Georgia, South Carolina, Texas and Pennsylvania. In Texas the plans cover seven counties around San Antonio, and in Pennsylvania they cover Bucks, Delaware and Philadelphia counties.

➤ Can I join a Clover PPO after December 7?

Yes, once. Because the PPO contract has 5 stars, you can use the 5-star special enrollment period to move into it between December 8 and November 30.

➤ Does Clover sell HMO plans?

Yes, two: Clover Health Classic and Clover Health Value, both sold only in northern and central New Jersey counties.

➤ What is a Clover Giveback plan?

It is a PPO that lowers the Part B premium you pay. Clover offers Choice Giveback in New Jersey and LiveHealthy Giveback in Georgia and South Carolina.

➤ Who owns Clover Health?

Clover Health Investments is a public company traded on Nasdaq under the symbol CLOV. Its Medicare Advantage plans are issued by Clover Insurance Company and, for the HMOs, Clover HMO of New Jersey.

➤ Is Clover available everywhere in Georgia?

Almost. Our count of CMS 2027 plan data shows Clover in 151 of Georgia’s 159 counties, with Floyd, Gordon, Lanier, Lowndes, Toombs, Towns, Walker and Whitfield left out.

➤ Do Clover plans include dental and vision?

Many Clover plans may include dental, vision and hearing extras for 2027, depending on the plan and county. Benefit amounts vary, so read each plan’s Summary of Benefits.

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Compare 2027 Medicare Advantage plans with drug coverage from several insurance companies in one call.

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TTY users 711  |  Mon–Fri: 5am–7pm, Sat–Sun: 7am–4pm CT

No obligation to enroll

Find & Compare Plans Online

Speak with a licensed insurance agent

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Mon-Fri: 8am-9pm ET

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