Clover Health

Clover Health is a Medicare Advantage health insurer that runs a public developer program built on healthcare interoperability standards. Its public FHIR R4 API exposes a Formulary service (covered drugs, tiers, and utilization management) and a Provider Directory service (practitioners, organizations, locations, healthcare services, and insurance plans), and a separate consent-based Patient Access API delivers a member's clinical and claims data in FHIR-native format via CareEvolution. The APIs implement the CMS Interoperability and Patient Access final rule (CMS-9115-F); Clover was the first payer to go live on a CMS-aligned/TEFCA network. Developers register for approved credentials and authenticate with HTTP Basic or a session cookie.

Clover Health publishes 1 API on the APIs.io network: FHIR API (Formulary & Provider Directory). Tagged areas include Company, Healthcare, Health Insurance, Medicare Advantage, and FHIR.

Clover Health’s developer surface includes documentation, API reference, signup flow, support, authentication, and 19 more developer resources.

🌐 Visit website 📡 Source on GitHub
41.2/100 thin Agent 50/100 agent ready Full breakdown ↓
scored 2026-07-20 · rubric v0.4
1 APIs 1 MCP Servers 0 Features
CompanyHealthcareHealth InsuranceMedicare AdvantageFHIRInteroperabilityProvider DirectoryFormularyPatient AccessPayer

API Rating

API Evangelist API Evangelist Rating How this is scored →
scored 2026-07-20 · rubric v0.4
Composite quality — 41.2/100 · thin
Contract Quality 12.2 / 25
Developer Ergonomics 10.9 / 20
Commercial Clarity 6.8 / 20
Operational Transparency 2.1 / 13
Governance 0.0 / 12
Discoverability 9.3 / 10
Agent readiness — 50/100 · agent ready
Machine-Readable Contract 18 / 18
Agentic Access Contract 0 / 15
MCP Server 12 / 12
Machine-Readable Auth 10 / 10
Idempotency 0 / 9
Stable Error Semantics 0 / 8
Request/Response Examples 0 / 7
Rate-Limit Signaling 0 / 7
Typed Event Surface 0 / 6
Agent Skills 5 / 5
Well-Known Catalog 4 / 4
Consent & Bot Identity 3 / 3
Improve this rating by publishing the missing artifacts — every area above can be raised, and the full rubric is at apis.io/rating/. This rating is computed from github.com/api-evangelist/clover-health: open an issue to ask a question, or submit a pull request to add artifacts. Want it done for you? Prioritized profiling — $2,500 →

APIs

Clover Health FHIR API (Formulary & Provider Directory)

Public FHIR R4 read API exposing the Clover Health drug formulary (covered medications, tiers, utilization management) and provider directory (practitioners, organizations, loca...

MCP Servers

clover-health-mcp.yml

MCP SERVER

Resources

Get Started 2

Portal, sign-up, and the first successful call

DeveloperPortal
DeveloperPortal
 SignUp
SignUp

Documentation 3

Reference material describing how the API behaves

Documentation
Documentation
 APIReference
APIReference
 OpenAPI
OpenAPI

Agent Surfaces 4

MCP servers, agent skills, and machine-readable catalogs

MCPServer
MCPServer
 LLMsTxt
LLMsTxt
 AgentSkill
AgentSkill
 WellKnown
WellKnown

Design & Contract 4

Pagination, idempotency, versioning, errors, and events

Conventions
Conventions
 DataModel
DataModel
 Conformance
Conformance
 Lifecycle
Lifecycle

Build 1

SDKs, sample code, and the tooling you integrate with

GitHubOrganization
GitHubOrganization

Access & Security 5

Authentication, authorization, and security posture

Authentication
Authentication
 SecurityTxt
SecurityTxt
 VulnerabilityDisclosure
VulnerabilityDisclosure
 Security
Security
 DomainSecurity
DomainSecurity

Operate 1

Status, limits, changes, and where to get help

Support
Support

Commercial 2

Pricing, plans, and the legal terms of use

TermsOfService
TermsOfService
 PrivacyPolicy
PrivacyPolicy

Company 1

The organization behind the API

Website
Website

Other 1

Properties that don't map to a standard resource type

Overlay
Overlay

Source (apis.yml)

apis.yml Raw ↑ 
aid: clover-health
name: Clover Health
description: Clover Health is a Medicare Advantage health insurer that runs a public developer program built on healthcare
  interoperability standards. Its public FHIR R4 API exposes a Formulary service (covered drugs, tiers, and utilization management)
  and a Provider Directory service (practitioners, organizations, locations, healthcare services, and insurance plans), and
  a separate consent-based Patient Access API delivers a member's clinical and claims data in FHIR-native format via CareEvolution.
  The APIs implement the CMS Interoperability and Patient Access final rule (CMS-9115-F); Clover was the first payer to go
  live on a CMS-aligned/TEFCA network. Developers register for approved credentials and authenticate with HTTP Basic or a
  session cookie.
image: https://cdn.cloverhealth.com/filer_cloudrun_public/img/live-tile-large-310x310.png
url: https://raw.githubusercontent.com/api-evangelist/clover-health/refs/heads/main/apis.yml
x-type: company
x-source: vc-portfolio
x-backed-by:
- first-round-capital
- gv
- social-capital
x-tier: stub
x-tier-reason: portfolio-lead
specificationVersion: '0.20'
created: '2026-07-17'
modified: '2026-07-18'
tags:
- Company
- Healthcare
- Health Insurance
- Medicare Advantage
- FHIR
- Interoperability
- Provider Directory
- Formulary
- Patient Access
- Payer
apis:
- name: Clover Health FHIR API (Formulary & Provider Directory)
  description: Public FHIR R4 read API exposing the Clover Health drug formulary (covered medications, tiers, utilization
    management) and provider directory (practitioners, organizations, locations, healthcare services, and insurance plans).
    22 read operations across two services.
  humanURL: https://www.cloverhealth.com/developers
  baseURL: https://public-api.cloverhealth.com
  tags:
  - FHIR
  - Provider Directory
  - Formulary
  - Healthcare
  properties:
  - type: OpenAPI
    url: openapi/clover-health-fhir-openapi-original.yml
  - type: Documentation
    url: https://public-api.cloverhealth.com/swagger
  - type: Overlay
    url: overlays/clover-health-fhir-overlay.yaml
maintainers:
- FN: Kin Lane
  email: kin@apievangelist.com
- FN: APIs.json
  email: info@apis.io
common:
- type: DeveloperPortal
  url: https://www.cloverhealth.com/developers
- type: Documentation
  url: https://public-api.cloverhealth.com/swagger
- type: APIReference
  url: https://public-api.cloverhealth.com/swagger
- type: SignUp
  url: https://docs.google.com/forms/d/1qhbMWXYYn3lpBg8026mW20rxGHE9SL2sHNLzVoyOS0g/edit
- type: TermsOfService
  url: https://www.cloverhealth.com/developers/termsofuse
- type: PrivacyPolicy
  url: https://www.cloverhealth.com/privacy-policy
- type: Support
  url: mailto:api-support@cloverhealth.com
- type: GitHubOrganization
  url: https://github.com/CloverHealth
- type: OpenAPI
  url: openapi/clover-health-fhir-openapi-original.yml
- type: Overlay
  url: overlays/clover-health-fhir-overlay.yaml
- type: Authentication
  url: authentication/clover-health-authentication.yml
- type: Conventions
  url: conventions/clover-health-conventions.yml
- type: DataModel
  url: data-model/clover-health-data-model.yml
- type: Conformance
  url: conformance/clover-health-conformance.yml
- type: Lifecycle
  url: lifecycle/clover-health-lifecycle.yml
- type: MCPServer
  url: mcp/clover-health-mcp.yml
- type: LLMsTxt
  url: llms/clover-health-llms.txt
- type: AgentSkill
  url: skills/_index.yml
- type: WellKnown
  url: well-known/clover-health-well-known.yml
- type: SecurityTxt
  url: well-known/clover-health-security.txt
- type: VulnerabilityDisclosure
  url: security/clover-health-vulnerability-disclosure.yml
- type: Security
  url: https://www.cloverhealth.com/.well-known/security.txt
- type: DomainSecurity
  url: security/clover-health-domain-security.yml
- type: Website
  url: https://www.cloverhealth.com
x-enrichment:
  date: '2026-07-19'
  status: backfilled
  pass: local-v1
  note: backfilled from .gitignore signal + verified work evidence