Clover Medicare Advantage Keeps $0 Premium, but 2027 Out-of-Pocket Cap Rises
A 67-year-old Medicare Advantage member plans to stay in a Clover Health plan for 2027 because the monthly premium remains $0. However, the plan's average maximum out-of-pocket limit is rising by $1,144, which could matter greatly for members with serious medical needs. The article notes that enrollees still owe the Part B premium and separate drug costs, and it urges plan comparisons before the December 7, 2026 deadline.
For 2027, Clover Health's Medicare Advantage offerings keep a $0 monthly plan premium, yet their average maximum out-of-pocket ceiling reportedly increases by $1,144. Enrollees remain responsible for Medicare Part B, set at $202.90 per month in 2026 ($2,434.80 yearly), with higher-income beneficiaries paying more; 2027 Part B rates are not yet available. Prescription drug expenses are also separate, with a $2,400 cap in 2027.
A costly medical year can push someone to that ceiling. In the article's illustration, six hospital days at $350 daily cost $2,100, $40,000 of outpatient infusions at 20% coinsurance cost $8,000, and twice-monthly specialist visits at $25 each cost $600. Such totals exceed most caps, making the cap—not the premium—the key figure.
Medicare Advantage members with significant medical needs could feel the greatest effect from a higher out-of-pocket ceiling, even when the monthly premium stays at $0. Those managing chronic illness, surgery, or cancer treatment may face larger potential bills, while healthier enrollees might notice little difference. The change may prompt more beneficiaries and caregivers to compare caps, copays, and networks before the December 7, 2026 enrollment deadline, potentially shifting plan choices across this market.