Plan year 2027 · Medicare AdvantageCMS files of Sept. 22 and Oct. 1, 2026
Clover Health Choice Value, 2027
H5141Contract007Plan
PPO · 12 counties in New Jersey
Run by Clover Insurance Company (contract H5141), sold as Clover Health, owned by Clover Health Holdings, Inc.
Clover Health Choice Value (H5141-007) costs $36.30 a month in 2027, up $5.30 from 2026, with an in-network out-of-pocket limit of $9,850 ($9,250 in 2026).
What changes from 2026 to 2027?
| What you pay or get | 2026 | 2027 | Change |
|---|---|---|---|
| Monthly premium | $31 | $36.30 | ▲up $5.30 |
| In-network out-of-pocket limit | $9,250 | $9,850 | ▲up $600 |
| Drug deductible | $220 | $440 | ▲up $220 |
| Hospital stay, in network | $399 a day for days 1–6, then $0 a day for days 7–90 | $350 a day for days 1–6, then $0 a day for days 7–90 | ▼down $245for a 5-day stay |
| Skilled nursing facility, in network | $0 a day for days 1–20, then $218 a day for days 21–100 | $0 a day for days 1–20, then $221 a day for days 21–100 | ▲up $30for a 30-day stay |
| Ground ambulance, in network | $350 copay | $300 copay | ▼down $50 |
| Eyewear, yearly limit | $200 a year | $300 a year | ▲up $100 |
| Over-the-counter items, yearly | $680 a year | $580 a year | ▼down $100 |
| Drug tier 2, generic | $5 | $8 | ▲up $3 |
| Drug tier 4, non-preferred drug | 35% of the cost | 34% of the cost | ▼down 1 point |
| Drug tier 5, specialty tier | 30% of the cost | 28% of the cost | ▼down 2 points |
| 10 lines do not change | |||
| Part B premium reduction, monthly | none | none | no change |
| Primary care visit | $0 copay | $0 copay | no change |
| Specialist visit | $2 copay | $2 copay | no change |
| Emergency room | $115 copay | $115 copay | no change |
| Medical deductible, in network | none | none | no change |
| Comprehensive dental, yearly limit | not offered | not offered | no change |
| Hearing aids, yearly limit for both ears | not offered | not offered | no change |
| Counties served | 12 | 12 | no change |
| Drug tier 1, preferred generic | $0 | $0 | no change |
| Drug tier 3, preferred brand | $47 | $47 | no change |
Source: CMS Medicare Advantage and Part D landscape files for 2027 (Sept. 22, 2026, revised Sept. 30) and 2026 (Sept. 2, 2026 revision); CMS plan benefit package files, 2027 and 2026; CMS plan crosswalk from 2026 to 2027 (Oct. 1, 2026). Plan details can change during the year; confirm on Medicare Plan Finder.
What will prescriptions cost?
| Tier | What the tier holds | 2026 | 2027 |
|---|---|---|---|
| Tier 1 | Preferred Generic | $0 | $0 |
| Tier 2 | Generic | $5 | $8 |
| Tier 3 | Preferred Brand | $47 | $47 |
| Tier 4 | Non-Preferred Drug | 35% of the cost | 34% of the cost |
| Tier 5 | Specialty Tier | 30% of the cost | 28% of the cost |
Source: CMS plan benefit package files, 2027 and 2026. Insulin is capped at $35 a month by law. A drug's tier is set by the plan's formulary.
How does it compare with plans sold where it is?
In the counties it serves, 49 plans open to everyone are sold for 2027, this one included. Against the others, 25 plans have a lower out-of-pocket limit, 23 the same. On the premium, 32 plans have a lower premium, 2 the same, 14 a higher one.
Out-of-pocket limits of the 49 plans open to everyone
Source: CMS Medicare Advantage and Part D landscape files for 2027 (Sept. 22, 2026, revised Sept. 30) and 2026 (Sept. 2, 2026 revision).
Where is it sold, and what does it cost there?
The premium and the out-of-pocket limit are the same in all 12 counties: $36.30 a month and $9,850.
New Jersey
Source: CMS Medicare Advantage and Part D landscape files for 2027 (Sept. 22, 2026, revised Sept. 30) and 2026 (Sept. 2, 2026 revision).
Who runs this plan?
- Plan ID
- H5141-007
- Legal name of the contract
- Clover Insurance Company
- Sold as
- Clover Health
- Parent company
- Clover Health Holdings, Inc.
- Plan type
- PPO
- 2026 star rating of the contract
- 4.5 of 5 overall; health plan 3.5 of 5, drug plan 3 of 5
- Members, September 2026
- 35,366
- Plan website, as filed with CMS
- www.cloverhealth.com
Source: CMS Medicare Advantage and Part D landscape files for 2027 (Sept. 22, 2026, revised Sept. 30) and 2026 (Sept. 2, 2026 revision); CMS 2026 Star Ratings (October 2025); CMS monthly enrollment by plan and by county, September 2026 (CMS hides counts under 11). CMS publishes the 2027 Star Ratings in October 2026.
What else should you check?
- Other 2027 plans in Hudson, NJWhere most of its members live; premiums and limits side by side
- Every Clover Health plan for 2027Its contracts, counties and plans that end
- The other 13 plans of contract H5141Same company, same contract
- Is your prescription covered?Coverage share and tier for 2,259 drugs
Data, not advice. These are the plan's filed amounts, not a quote for you; confirm on Medicare Plan Finder or call the plan before you enroll.