Clover Health set to triple geographic footprint in wake of membership surge

Clover Health
A startup Medicare Advantage insurer announced plans for a massive expansion. (Clover Health)

Medicare Advantage startup Clover Health announced plans to triple its geographic footprint following a massive increase in membership.

The expansion will add 74 additional counties to the insurer's reach, with 69 located in the states it already serves: Arizona, Georgia, New Jersey, Pennsylvania, South Carolina, Tennessee and Texas. In addition, Clover will add five counties in Mississippi, a new market for the 2021 plan year.

Clover currently serves 57,000 members in 34 counties across seven states. During open enrollment in 2019, the insurer's membership grew by 37%, spurring the growth ahead of enrollment this year.

The expanded footprint will put it within reach of 5 million Medicare Advantage enrollees, Clover said.

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MA is a growing business line for many insurers at both the national and regional levels. Cigna, for example, unveiled plans to significantly scale up its MA business ahead of 2019 open enrollment, and UnitedHealthcare added hundreds of thousands of MA members in the 2020 plan year.

Clover plans tout a broad PPO network and access to the insurer's Clover Assistant tool, which it calls a "GPS for healthcare." Clover Assistant uses machine learning to offer care recommendations and evidence-based guidance to primary care physicians.

“We knew that if we wanted to successfully bring great healthcare to every senior, including those in traditionally underserved communities, it was essential for us to actively provide value to the system, and we couldn’t play the same games as other insurers who shuffle risk and exploit flaws in the MA program,” Andrew Toy, president and chief technology officer of Clover Health, said in a statement.

MA open enrollment begins Oct. 15.