The time to sign-up for your 2026 Schwab Insurance Medicare plan is October 15–December 7.
Find downloadable guides, authorization tools, claims tools, request forms & more.
see Prior Auth details.
Online Authorization Tool User Guide
Continuity of Care Provider Notice
April 6,2024 Utilization Management Update
January 1, 2024 Utilization Management Update
Peripheral Vascular Intervention – Utilization Management Update
Clover Health Vascular Intervention Frequently Asked Questions
Clover Health Peripheral Vascular Intervention Provider Orientation
Clover Health Provider Orientation Invitation
UM Prior Authorization List
eviCore Prior Authorization Guidelines
Novologix Provider Support
Novologix NCCN Provider User Authorization Guide
Novologix NCCN Provider Support
Novologix NCCN Provider Notification
Clover Novologix NCCN Guidelines
Prior Authorization Request Form
Medicare Part B RX Prior Authorization Form
Clover Clinical Update Form
Medical Review Criteria Policies
Provider Quick Reference Guide
Guía de referencia rápida
Clover Health Policies
Care Connection Newsletter
Find Clover providers for referrals
270 and 271 Requirement
National Coverage Determination on PrEP for HIV Prevention
Novologix Part B PA Policies
Step Therapy for Part B Drugs
Formulary (Pharmacy and Part D)
Part D Coverage Determinations, Exceptions, Grievances, and Appeals
HEDIS Provider Cheat Sheet
Clinical Informational Resources
Claims and Appeal Dispute Form
Waiver of Liability Statement
Guide to Covered Formulary Drug Alternatives
We partner with a network of pharmacies to ensure our plan members can easily access their medications. In most cases, your prescriptions are covered only if they are filled at an in-network pharmacy or through our mail-order pharmacy service. We will fill prescriptions at non-network pharmacies under certain circumstances.
The formulary is a list of Part D drugs that Clover Health covers for medically necessary purposes. Our comprehensive formulary includes both brand-name and generic drugs that are covered by Clover Health.
You can easily find out if your medication is included and see which Tier it is in. See the plan benefit details for copay details. Please keep in mind that we may update our formulary throughout the year.
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