How Can I Find Healthcare Providers That Accept Coventry Medicare Plans?
This article was updated on: 10/20/2018
If you are enrolled in certain types of Coventry Medicare plans — such as Coventry Medicare Advantage Health Maintenance Organizations (HMOs), Preferred Provider Organizations (PPOs), or Coventry Medicare Part D Prescription Drug Plans, you may need to use certain network providers or pharmacies to minimize your out-of-pocket costs and take full advantage of your benefits. Some types of Medicare plans may not cover you if you don’t follow the plan rules, so it’s important to understand how your Coventry Medicare plan works when it comes to the providers you can use.
Here’s how to find providers who accept Coventry Medicare plans.
Who are Coventry Medicare plan network providers?
Coventry, as a Medicare-approved private insurance company, contracts with various providers to provider covered services for Coventry Medicare Advantage and Coventry Medicare Part D Prescription Drug Plan members. Coventry network providers may include hospitals, doctors, specialists, hospitals, and other health-care professionals.
As part of Coventry’s network, these providers have agreed to accept a certain payment rate for their services. In addition, these providers agree to accept your plan’s cost sharing (such as copayment or coinsurance amounts) as full payment for your share; you will not be billed above contracted amounts for any covered services you receive when you use a provider contracted with your plan.
Depending on which Coventry Medicare plans you select, you may be required to get all your care from network providers (except for medically necessary emergency care), or you may have the option to use non-network providers, but save money on out-of-pocket costs by using network and/or preferred providers. For example, if you’re enrolled in a Preferred Provider Organizations (PPO) plan*, you may pay a smaller copayment or coinsurance amount for your care when you use a doctor from the plan’s preferred provider network.
You may want to confirm that the doctor or provider accepts your plan before you make an appointment or receive a medical service, even if that provider is listed in Coventry’s network, to avoid any unexpected expenses when you get care.
You can also use to access a printable version of your plan’s provider network.
If you are unable to find the information you need, or if you have questions about providers who accept your Coventry Medicare Advantage plan or Medicare Part D prescription drug coverage, you can also contact Coventry Medicare Customer Service at 1-877-988-3589 (TTY: 711) from 8:00 AM to 8:00 PM, local time, seven days a week, from October 1 through February 14, and 8:00AM to 8.00PM, and Monday through Friday, from February 15 through September 30.
As mentioned above, using providers in your plan’s provider network may save you money, depending on the rules of your plan. Would you like help finding a Coventry Medicare coverage that includes your doctor or provider in its plan network? For more information on Coventry Medicare plan options, visit the Coventry page to get started. To start browsing Medicare plan options from the convenience of your own home, use the Find Plans button to view plan options in your area.
*Out-of-network/non-contracted providers are under no obligation to treat Coventry plan members, except in emergency situations. For a decision about whether we will cover an out-of-network service, we encourage you or your provider to ask us for a pre-service organization determination before you receive the service. Please call our customer service number or see your Evidence of Coverage for more information, including the cost-sharing that applies to out-of-network services.
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