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Medicare Advantage Plan H5141-056-0 in Echols County, GA Clover Health Valor (PPO) • 2027

CMS Rating: ☆☆☆☆☆ (5.0 out of 5 stars*)

Clover Health Valor (PPO), CMS Plan-ID H5141-056-0, is a 2027 Medicare Advantage Plan (Part C), without prescription drug coverage, by Clover Health. The plan uses a Preferred Provider Organization (PPO) provider network structure.

Based on the most recent CMS data, plan enrollments topped 749 members, with 0 in Echols County, Georgia.

Last update:

Clover Health Valor Overview

2027 Medicare Advantage Plan Overview for H5141-056-0
Plan Overview for H5141-056-0
CMS Plan ID: H5141-056-0
Plan Type: PPO
Plan Year: 2027
Monthly Premium: $0.00
Plus your Medicare Part B premium.
Medical Deductible: $0.00
Maximum Out-of-Pocket: $9850.00 (In-Network)
Part B Give Back: −$140.00 reduction
Prescription Drug Coverage: Not Included
Additional Benefits: Dental, Vision, Hearing
Service Area: Echols County, GA
Enrollment (Nationwide): 749 beneficiaries
Enrollment (CMS – Local)0 beneficiaries in Echols County
Provided By: Clover Health
Frequently Asked Questions About Clover Health Valor (PPO)

Here are some of the most frequently asked questions people have about Plan ID H5141-056-0:

How much does Clover Health Valor cost per month?

Clover Health Valor has a $0.00 monthly premium for 2027. You must also continue to pay any Medicare Part B premium you owe.

What is the maximum out-of-pocket limit for Clover Health Valor?

The 2027 in-network maximum out-of-pocket (MOOP) limit is $9850.00. After you reach this limit, the plan pays covered in-network Part A and Part B costs for the remainder of the year.

What is the CMS Star Rating for Clover Health Valor?

Contract H5141, which includes this plan, has a ★5.0 out of 5 CMS Star Rating for 2027.

What type of network does Plan ID H5141-056-0 have?

Plan ID H5141-056-0 uses a Preferred Provider Organization (PPO) provider network.

How many members does Clover Health Valor have?

The most recent CMS enrollment data shows approximately 749 beneficiaries enrolled in Plan ID H5141-056-0.

Which insurance company offers Plan ID H5141-056-0?

Plan ID H5141-056-0 is offered by Clover Health.

Call 833-748-3201 (TTY 711) to speak with a licensed HealthCompare insurance agent (M-F 8AM-10PM, Sat 9AM-8PM EST) and learn more about this plan and other plans on this site. You may also Enroll Online .

Covered Services & Costs

Office Visits

This plan lists in-network cost sharing for primary care and specialist visits, along with related office-based services.

Primary care and specialist visit costs for this plan.
Covered Service In-Network Cost
Primary: In-network: $0 copay | Out-of-network: $15 copay
Specialist: In-network: $25 copay | Out-of-network: $50 copay

Preventive and Wellness Services

Preventive and wellness benefits may include routine exams, telehealth, fitness programs, health education, and other in-network services.

Preventive and wellness service costs and benefits for this plan.
Covered Service In-Network Cost
Annual wellness exam: In-network: $0 copay | Out-of-network: $0 copay, 0% coinsurance
Telehealth benefit: In-network: $0-$25 copay
Routine chiropractic: Not covered
Fitness benefits: Coming soon
Health education: Not covered
Counseling services: Not covered
Over-the-counter drug benefits: In-network: $0 copay | Out-of-network: $0 copay, 0% coinsurance
Health transportation (non-emergency): Coming soon

Diagnostic, Lab, and Imaging Services

Diagnostic coverage includes in-network cost sharing for lab tests, x-rays, radiology, and other diagnostic procedures used to evaluate health conditions.

Diagnostic, laboratory, and imaging service costs for this plan.
Covered Service In-Network Cost
Diagnostic radiology services: In-network: $50-$250 copay | Out-of-network: 30% coinsurance
Lab services: In-network: $0-$20 copay | Out-of-network: $40 copay
Outpatient x-rays: In-network: $40 copay | Out-of-network: 30% coinsurance
Diagnostic tests and procedures: In-network: $0-$250 copay | Out-of-network: 0%-30% coinsurance

Emergency and Urgent Care Services

Emergency and inpatient coverage includes cost sharing for urgent care, emergency room visits, ambulance transportation, hospital stays, and skilled nursing facility care.

Emergency, urgent care, hospital, ambulance, and skilled nursing costs for this plan.
Covered Service In-Network Cost
Emergency room care: $115 copay
Worldwide emergency care: Coming soon
Urgent care: $25 copay
Inpatient hospital care: In-network: | Tier 1 | $375 per day for days 1-6 | $0 per day for days 7-90 | $0 per stay | Out-of-network: | $480 per day for days 1-6 | $0 per day for days 7-90 | $0 per stay
Skilled Nursing Facility: In-network: | Tier 1 | $0 per day for days 1-20 | $221 per day for days 21-100 | Out-of-network: | 30% per stay
Ground ambulance: In-network: $350 copay | Out-of-network: $350 copay

Mental Health Services

Mental health coverage includes in-network cost sharing for outpatient individual and group therapy, as well as inpatient psychiatric hospital care.

Mental health therapy and inpatient psychiatric care costs for this plan.
Covered Service In-Network Cost
Outpatient individual therapy: In-network: $35 copay | Out-of-network: 30% coinsurance
Outpatient group therapy: In-network: $25 copay | Out-of-network: 30% coinsurance
Inpatient psychiatric hospital care: In-network: | Tier 1 | $375 per day for days 1-6 | $0 per day for days 7-90 | $0 per stay | Out-of-network: | $480 per day for days 1-6 | $0 per day for days 7-90 | $0 per stay

Rehabilitation Services

Rehabilitation coverage includes in-network cost sharing for physical therapy, speech and language therapy, and occupational therapy services.

Physical, speech, and occupational therapy costs for this plan.
Covered Service In-Network Cost
Physical therapy and speech and language therapy: In-network: $35 copay | Out-of-network: 30% coinsurance
Occupational therapy: In-network: $35 copay | Out-of-network: 30% coinsurance

Medical Equipment and Supplies

Medical equipment coverage includes in-network cost sharing for diabetes supplies, durable medical equipment, prosthetics, and related supplies.

Diabetes supplies, durable medical equipment, and prosthetic costs for this plan.
Covered Service In-Network Cost
Diabetes supplies: In-network: 20% coinsurance | Out-of-network: 20% coinsurance
Durable medical equipment: In-network: 20% coinsurance | Out-of-network: 20% coinsurance
Prosthetics: In-network: 20% coinsurance | Out-of-network: 20% coinsurance

Medicare Part B Drugs

Medicare Part B drug coverage includes in-network cost sharing for chemotherapy and other medications covered under Medicare Part B.

Chemotherapy and other Medicare Part B-covered drug costs for this plan.
Covered Service In-Network Cost
Chemotherapy: In-network: 0%-20% coinsurance | Out-of-network: 40% coinsurance
Other Part B drugs (Medicare-covered): In-network: 0%-20% coinsurance | Out-of-network: 40% coinsurance

Dental Services

Dental coverage includes in-network cost sharing for preventive care, exams, x-rays, cleanings, and comprehensive dental procedures.

Preventive and comprehensive dental service costs for this plan.
Covered Service In-Network Cost
Oral exam: In-network: $0 copay | Out-of-network: 50% coinsurance
Dental x-rays: In-network: $0 copay | Out-of-network: 50% coinsurance
Cleaning: In-network: $0 copay | Out-of-network: 50% coinsurance
Periodontics: In-network: $20 copay | Out-of-network: 50% coinsurance
Endodontics: In-network: $20 copay | Out-of-network: 50% coinsurance
Restorative services: In-network: $20 copay | Out-of-network: 50% coinsurance
Implant services: In-network: $20 copay | Out-of-network: 50% coinsurance
Orthodontics: Not covered
Oral/Maxillofacial surgery: In-network: $20 copay | Out-of-network: 50% coinsurance

Vision Services

Vision coverage includes in-network cost sharing for routine eye exams, contact lenses, eyeglass frames and lenses, and related eyewear services.

Routine eye exams, contact lenses, and eyewear costs for this plan.
Covered Service In-Network Cost
Routine eye exam: In-network: $0 copay | Out-of-network: $0 copay, 0% coinsurance
Contact lenses: In-network: $0 copay | Out-of-network: $0 copay, 0% coinsurance
Eyeglass frames only: Not covered
Eyeglass lenses only: Not covered
Eyeglasses (frames & lenses): In-network: $0 copay | Out-of-network: $0 copay, 0% coinsurance
Upgrades: Not covered

Hearing Services

Hearing coverage includes in-network cost sharing for hearing exams, fittings and evaluations, prescription hearing aids, and over-the-counter hearing aids.

Hearing exams, fittings, and hearing aid costs for this plan.
Covered Service In-Network Cost
Hearing exam: In-network: $0 copay | Out-of-network: $0 copay, 0% coinsurance
Fitting/evaluation: In-network: $0 copay | Out-of-network: $0 copay, 0% coinsurance
Prescription hearing aids: In-network: $499-$999 copay | Out-of-network: $5000 copay
OTC hearing aids: Not covered

Additional and Special Needs Services

Additional benefits may include in-network services for adult day health, palliative care, personal emergency response systems, weight management, alternative therapies, and home safety needs.

Additional and special needs service costs and benefits for this plan.
Covered Service In-Network Cost
Adult day health services: Not covered
Home-based palliative care: Not covered
Personal emergency response system: Coming soon
Weight management programs: Not covered
Wigs for chemotherapy-related hair loss: Coming soon
Alternative therapies: Not covered
Massage therapy: Not covered
Home/bathroom safety devices: Not covered

Clover Health Valor covers 100% of certain preventive services as a required Part B benefit.

Prescription Drug Coverage

This plan does not include a Medicare Part D plan for prescriptions.

CMS Medicare Star Ratings

Each year, Medicare Advantage PPOs are rated by the Centers for Medicare & Medicaid Services (CMS) across nine categories using a 5-star system. These star ratings are designed to help you assess the quality of care and service offered by this Clover Health plan.

2027 Medicare Star Ratings for Contract H5141
CMS Measure Star Rating
2027 Overall Rating ☆☆☆☆☆
Staying Healthy: Screenings, Tests, Vaccines ☆☆☆☆☆
Managing Chronic (Long Term) Conditions ☆☆☆☆☆
Member Experience with Health Plan ☆☆☆☆☆
Complaints and Changes in Plans Performance ☆☆☆☆☆
Health Plan Customer Service ☆☆☆☆☆
Drug Plan Customer Service ☆☆☆☆☆
Complaints and Changes in the Drug Plan ☆☆☆☆☆
Member Experience with the Drug Plan ☆☆☆☆☆
Drug Safety and Accuracy of Drug Pricing ☆☆☆☆☆

Contact Clover Health

Call 833-748-3201 (TTY 711) to speak with a licensed HealthCompare insurance agent (M-F 8AM-10PM, Sat 9AM-8PM EST) and learn more about this plan and other plans on this site. You may also Enroll Online .

Clover Health Plan Contact Details for Clover Health Valor (PPO)
Contact Type Details
Website: Clover Health Plan Page
Opens the carrier website in a new window and enrollment information in this window.
New Members: 1-888-466-5044
Existing Members: 1-888-778-1478
Plan Address: PO Box 21164 | Eagan, MN 55121

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Medicare Plan Decision Resources
Medicare Plan Data Sources and Methodology

Medicare.org independently compiles and interprets Medicare plan information using data published by the Centers for Medicare & Medicaid Services (CMS), official plan information, and other authoritative Medicare sources. The sources used for this plan are documented below.

Medicare.org is an independent Medicare information and enrollment resource and is not affiliated with or endorsed by the U.S. Government or the federal Medicare program. Enrollment assistance is provided through HealthCompare, an Allstate company.

Primary CMS datasets used to compile information about Plan ID H5141-056-0
Data Source Publisher CMS Version
Landscape Source Files Centers for Medicare & Medicaid Services CY2027 Landscape (202609.1)
Medicare Part C & D Performance Centers for Medicare & Medicaid Services 2027 Star Ratings Data Tables
Plan Benefits Package Centers for Medicare & Medicaid Services PBP Benefits-2027
Monthly Enrollment by Contract/Plan/State/County Centers for Medicare & Medicaid Services 2026-09
Official plan information and secondary Medicare references.
Publisher Reference Last Accessed
Clover Health (official source) http://www.cloverhealth.com October 13, 2025
CMS.gov Medicare Advantage Plan Fact Sheet 25 May, 2025
Medicare.gov Joining a plan 25 May, 2025
Medicare.gov Your coverage options 25 May, 2025