Hey there! If you’re scrolling through a sea of Medicare options and wondering whether Clear Spring Medicare Advantage might be the right fit for you, you’ve landed in the right spot. I’m going to lay out everything you need to know—no fluff, no jargon, just straight‑to‑the‑point information that helps you decide with confidence.
Quick Answer Snapshot
Here’s the TL;DR you can read in a glance:
- What it is: A private‑insurance Medicare Advantage (Part C) plan that bundles hospital (A), medical (B) and often drug (D) coverage, plus extra cash‑back perks.
- Where you can get it: Colorado, Georgia, Illinois, South Carolina and Virginia.
- Key extra benefits (2025): $75‑$95 /month OTC allowance, $100‑$125 /month grocery stipend, $75 /month utility credit.
- Star rating status: 2024 – “Not enough data”; 2025 – No rating published yet.
That’s the gist. Now let’s dive deeper, because a quick glance never hurts, but a solid understanding does.
Ideal Member Profile
Who tends to love Clear Spring’s plans? Picture this: you’re a senior who lives in one of the five covered states, you have a chronic condition like diabetes or heart disease, and you enjoy snagging a little extra cash each month for groceries or over‑the‑counter meds. If that sounds like you—or someone you know—keep reading.
Eligibility basics are simple. You must already have Medicare Part A and Part B, and you’ll need to complete a health‑risk assessment that shows a qualifying chronic condition. The assessment isn’t a medical exam; it’s a questionnaire that helps Clear Spring tailor benefits to your health needs.
Real‑world example: Mrs. Lopez, a 68‑year‑old retired teacher from Georgia, switched to Clear Spring’s MAPD plan last year. She saves about $1,200 a year on groceries and OTC items, and she says the extra utility credit helped her keep the heat on during a chilly winter. Stories like hers show the tangible impact of the “cash‑back” side of the plan.
Plan Types Overview
Clear Spring offers three main flavors of Medicare Advantage. Knowing the difference helps you match a plan to your situation.
| Plan Type | What’s Included | Best For |
|---|---|---|
| MAPD (Medical & Prescription Drug) | Hospital, medical, and prescription drug coverage in one package. | Seniors who want a single plan for all core services. |
| CSNP (Chronic‑Condition Specialized) | All MAPD benefits plus disease‑specific programs (e.g., diabetes care). | People with a documented chronic condition who need extra support. |
| DSNP (Dual‑Eligible Special Needs) | MAPD features tailored for those who qualify for both Medicare and Medicaid. | Low‑income beneficiaries who need extra financial help. |
Across all three, you’ll enjoy the standard Medicare benefits—hospital stays, doctor visits, preventive care—and the optional extras that set Clear Spring apart.
Star Ratings Review
Star ratings are the Medicare way of giving you a quick “quality score.” For Clear Spring, the story is a bit unusual.
2024: The CMS star‑rating PDF shows “Not enough data” for overall, health, and drug services. This usually means the plan is relatively new or has a small enrollment pool, not that it’s bad.
2025: The latest PDF lists “Service not offered” for health services, which simply indicates that CMS hasn’t released a rating yet. The bottom line? You’ll want to keep an eye on the official Medicare.gov “Plan Compare” tool during open enrollment to see if a rating appears.
Why do star ratings matter? They’re built from beneficiary surveys, complaint rates, and clinical outcomes. Even if Clear Spring’s rating is pending, you can still gauge quality by checking:
- Member satisfaction scores on the carrier’s site.
- Complaints logged with Medicare (available on Medicare.gov).
- Network size and hospital affiliations.
Compare Plans Quickly
When you’re weighing Clear Spring against other Medicare Advantage carriers, a side‑by‑side view helps. Below is a snapshot of how Clear Spring’s cash‑back perks stack up against a few national players.
| Carrier | States Covered | Monthly Premium | OTC / Grocery / Utility Credits | 2024 Star Rating |
|---|---|---|---|---|
| Clear Spring | CO, GA, IL, SC, VA | $0‑$10 (varies) | $75‑$125 /mo (varies) | Not enough data |
| UnitedHealthcare | 35+ states | $0‑$30 | $0‑$15 /mo (varies) | 4.5 |
| Humana | 30+ states | $0‑$20 | $0‑$10 /mo (varies) | 4.0 |
| Aetna | 20+ states | $0‑$25 | $0‑$12 /mo (varies) | 3.8 |
If you care most about extra monthly cash that can be used at the grocery store or for over‑the‑counter meds, Clear Spring stands out. If a high star rating is your top priority, you might gravitate toward UnitedHealthcare or Humana.
Enroll Step by Step
Ready to see if Clear Spring fits your life? Here’s the simple path to enrollment.
- Mark the open‑enrollment window. For 2025, it runs from October 15 to December 7.
- Confirm you’re eligible. Verify you have Medicare Part A & B and complete the health‑risk assessment if your plan requires it.
- Choose a plan type. MAPD is the most common, but CSNP or DSNP may be better if you have a chronic condition or dual eligibility.
- Compare costs and benefits. Use Clear Spring’s online plan‑finder to see premium, out‑of‑pocket maximum, and extra cash credits for your zip code.
- Enroll. You can sign up online, call the toll‑free number 877‑364‑4566 (available Mon‑Fri 8 am‑8 pm ET), or work with a licensed Medicare agent.
- Gather paperwork. Have your Medicare card, a list of current prescriptions, and your preferred doctors or pharmacies handy.
Pro tip: If you’re already working with an agent from Ritter Insurance or another brokerage, let them know you’re interested in Clear Spring—they often have tools that pre‑populate forms and can answer questions about network doctors.
Risks & Considerations
No plan is perfect, and it’s wise to look at the possible downsides before you click “Enroll.”
- Star‑rating uncertainty. As mentioned, Clear Spring currently lacks a public star rating. While that doesn’t automatically mean poor quality, it does make it harder to gauge performance compared to carriers with established scores.
- Network restrictions. Some Clear Spring plans have narrower provider networks. Always double‑check that your primary doctor and local hospital are in‑network using the “Find a Provider” tool.
- Potential changes in 2025. The Centers for Medicare & Medicaid Services (CMS) recently sanctioned Clear Spring’s Part D contracts, which could affect future prescription‑drug coverage. Keep an eye on CMS announcements and be prepared to switch plans if needed.
- Geographic limitation. If you move out of the five states where Clear Spring operates, you’ll need to select a new Medicare Advantage plan during the next enrollment period.
How can you mitigate these risks? Keep a short list of alternative carriers in your state, regularly review your “Evidence of Coverage” PDF (usually mailed each year), and set a reminder to check the Medicare.gov plan‑compare site before each enrollment window.
Helpful Resources Guide
When you’re navigating the Medicare maze, a handful of reliable tools can make life a lot easier.
- Clear Spring’s provider search. Find doctors, hospitals, and pharmacies that accept your plan.
- Medicare Plan Compare. The official Medicare.gov tool lets you filter by star rating, premium, and extra benefits.
- State Health Insurance Assistance Programs (SHIP). Free counseling from trained professionals in every state.
- Member Services phone line. 877‑364‑4566 (TTY 711) is open 7 days a week during the enrollment season.
- CMS Star‑Rating PDFs. The 2024 and 2025 PDFs (linked earlier) show the most recent quality data.
These resources are your safety net—use them to double‑check facts, ask questions, and stay informed.
Final Takeaway Summary
Clear Spring Medicare Advantage offers a modest‑premium, cash‑back‑rich option for seniors living in Colorado, Georgia, Illinois, South Carolina, or Virginia. The extra monthly allowances for OTC items, groceries, and utilities can shave hundreds of dollars off your out‑of‑pocket expenses, especially if you have a chronic condition that qualifies you for MAPD, CSNP, or DSNP coverage.
On the flip side, the lack of a current star rating and recent Part D sanctions mean you should stay vigilant, compare network providers, and have a backup plan ready. If you’re comfortable tracking those moving parts, the financial perks and comprehensive coverage could make Clear Spring a great fit.
What do you think? Does the balance of extra cash benefits and pending quality data feel right for you, or are you leaning toward a carrier with a higher star rating? Feel free to drop a comment below or reach out to a Medicare counselor—your next health‑care decision is just a conversation away.
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