Clover Health Reports 53% Increase in Medicare Advantage Membership During AEP, Reaching 153,000 Members by January 1, 2026; Anticipates First Full Year of GAAP Net Income Profitability in 2026

Clover Health Investments Reports Strong Membership Growth in Medicare Advantage Plans

Clover Health Investments, Corp. (Nasdaq: CLOV) has made an announcement regarding a remarkable 53% year-over-year increase in membership for their Medicare Advantage (MA) PPO plans for the 2026 plan year. By the end of a successful Annual Enrollment Period (AEP), the company anticipates reaching around 153,000 members. This growth primarily reflects disciplined strategies in core markets, demonstrating strong member retention and pointing toward a path to projected profitability in GAAP net income for the entirety of 2026.

Key Highlights:

Strategic Growth: Clover has experienced a notably positive increase in Medicare Advantage membership, achieving a 53% growth rate. This success stands out against broader industry challenges, particularly in established markets where the company offers robust Clover Assistant coverage and unique home care services to enhance member care and improve overall cohort performance.

Projected Profitability: For the first time, Clover expects to achieve full-year GAAP net income profitability, thanks to effective cohort dynamics and improved efficiencies in managing selling, general, and administrative expenses.

Visibility into Economic Improvements: The company anticipates significant enhancements in both new and returning member cohorts, sustained by factors like:

4.0 Star Financial Impact for the 2026 payment year for Clover’s PPO Plan;
Favorable updates from CMS regarding rates and Part D direct subsidies;
Strong retention among returning members;
Efforts focused on expanding Clover Assistant usage and primary care physician (PCP) adoption;
Improved efficiency in managing operational expenses, yielding ongoing operating leverage.

Stable Benefits and Retention: Clover successfully maintained consistent plan benefits, leading to an impressive AEP retention rate of over 95%. This stability not only strengthens the membership base but also enhances the value the Clover Plan adds in attracting and retaining members, particularly among Medicare Advantage switchers in its core markets.

Leading Quality Metrics: As of January 1, 2026, about 97% of Clover’s MA members are enrolled in its flagship PPO plan, which has held the top ranking nationally in core HEDIS quality ratings for two consecutive years, underscoring its clinical and economic performance.

The CEO of Medicare Advantage, Jamie Reynoso, highlighted the AEP’s success as a result of their solid plan combined with the Clover Assistant’s clinical capabilities and robust community presence. He is optimistic about replicating last year’s growth strategy, having already exceeded expectations during this enrollment period.

Andrew Toy, Chief Executive Officer of Clover Health, expressed confidence in their financial trajectory entering 2026. He believes that this year will showcase the effectiveness of Clover’s approach, featuring notable membership growth alongside solid customer retention, improvements in cohort performance, and the ongoing influence of Clover Assistant. Together, these elements could lead to increased returns and margin growth over time, setting the stage for achieving first-year GAAP net income profitability in 2026.