Clover Health website screenshot

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 2 APIs on the APIs.io network: fhir-r4-formulary-api API and FHIR R4 ProviderDirectory API API. 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
43.2/100 developing ▬ flat Agent 42/100 agent ready Full breakdown ↓
scored 2026-08-10 · rubric v0.9.1
AccessSelf serve
2 APIs 1 MCP Servers
CompanyHealthcareHealth InsuranceMedicare AdvantageFHIRInteroperabilityProvider DirectoryFormularyPatient AccessPayer

Kin Score

Kin Score Kin Score How this is scored →
scored 2026-08-10 · rubric v0.9.1
Composite quality — 43.2/100 · developing
Contract Quality 13.6 / 25
Developer Ergonomics 8.6 / 20
Commercial Clarity 6.8 / 20
Operational Transparency 2.1 / 13
Governance 1.4 / 12
Discoverability 8.7 / 10
Agent readiness — 42/100 · agent ready
Machine-Readable Contract 18 / 18
Agentic Access Contract 0 / 10
MCP Server 12 / 12
Machine-Readable Auth 10 / 10
Idempotency 0 / 9
Stable Error Semantics 0 / 8
Request/Response Examples 7 / 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
A2A Agent Card 0 / 8
Dry-Run / Simulate Mode 0 / 4
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 2

Individual APIs this provider publishes, each with its own machine-readable definition.

Clover Health fhir-r4-formulary-api API

The fhir-r4-formulary-api API from Clover Health — 5 operation(s) for fhir-r4-formulary-api.

Clover Health FHIR R4 ProviderDirectory API API

The FHIR R4 ProviderDirectory API API from Clover Health — 17 operation(s) for fhir r4 providerdirectory api.

MCP Servers 1

Model Context Protocol servers that expose these APIs to AI agents.

clover-health-mcp.yml

MCP SERVER

Security Posture 3

Authentication, domain security, vulnerability disclosure, and trust-center signals.

Clover Health Authentication

apiKey/http · 2 schemes

SECURITY

Clover Health Domain Security

TLSv1.3 · HSTS · DMARC

SECURITY

Clover Health Vulnerability Disclosure

security.txt · contact published

SECURITY

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.
accessModel:
  pricing: unknown
  onboarding: self-serve
  trial: false
  try_now: false
  public: false
  label: Self-serve signup
  confidence: medium
  source:
  - authentication
  generated: '2026-07-22'
  method: derived
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:
- aid: clover-health:clover-health-fhir-r4-formulary-api-api
  name: Clover Health fhir-r4-formulary-api API
  description: The fhir-r4-formulary-api API from Clover Health — 5 operation(s) for fhir-r4-formulary-api.
  humanURL: https://www.cloverhealth.com/developers
  baseURL: https://public-api.cloverhealth.com
  tags:
  - fhir-r4-formulary-api
  properties:
  - type: OpenAPI
    url: openapi/clover-health-fhir-r4-formulary-api-api-openapi.yml
  - type: Documentation
    url: https://public-api.cloverhealth.com/swagger
- aid: clover-health:clover-health-fhir-r4-providerdirectory-api-api
  name: Clover Health FHIR R4 ProviderDirectory API API
  description: The FHIR R4 ProviderDirectory API API from Clover Health — 17 operation(s) for fhir r4 providerdirectory api.
  humanURL: https://www.cloverhealth.com/developers
  baseURL: https://public-api.cloverhealth.com
  tags:
  - FHIR R4 ProviderDirectory API
  properties:
  - type: OpenAPI
    url: openapi/clover-health-fhir-r4-providerdirectory-api-api-openapi.yml
  - type: Documentation
    url: https://public-api.cloverhealth.com/swagger
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/_original/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