What Medicare Plans Does Coventry Offer?

Last Updated : 10/20/20186 min read

Whether you’re new to Medicare or have had Medicare coverage for awhile, you may have questions about Coventry Medicare plans and what your options are as a beneficiary.

Most people first enroll in Original Medicare, Part A and Part B, when they first become eligible for Medicare.

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However, certain types of coverage are only available through Medicare plan options, including Medicare Part C (Medicare Advantage) and Medicare Part D (prescription drug coverage). Medicare contracts with private insurance companies like Coventry to offer Medicare Advantage plans and Medicare Part D Prescription Drug Plans.

If you’re interested in Coventry Medicare coverage, here’s an overview of the types of plans that may be available to you.

Does Coventry offer Medicare Advantage plans?

If you currently have Original Medicare, Medicare Advantage plans (Part C) are simply another way to get your Medicare benefits; the difference is that instead of having your benefits administered through the federal program, you’ll get them through your Medicare Advantage plan.

Coventry Medicare Advantage plans are required by law to provide the same benefits as Original Medicare (Part A and Part B) at a minimum, except for hospice care, which is still covered under Medicare Part A. In addition, they may also offer additional benefits, such as routine vision care, routine dental services, and wellness program coverage. Most Coventry Medicare Advantage plans also include coverage for prescription drugs; these plans are known as Medicare Advantage Prescription Drug plans.

Medicare Advantage plans come in several plan types, with different rules for each kind of plan. Depending on where you live, you may be eligible to enroll in one of these Coventry Medicare Advantage plans:

  • Coventry MedicareAdvantage Health Maintenance Organization plans (HMOs). These plans may require you to choose a primary care provider and get all of your care, except for medically necessary emergency treatment, from providers in the plan’s network. You may also need referrals for specialist care.
  • Coventry MedicareAdvantage Preferred Provider Organization plans (PPOs)*. You have more flexibility to use both in-network and non-network providers, but you save on out-of-pocket expenses if you use doctors and hospitals within Coventry’s network of preferred providers. No referrals are necessary with this type of plan.
  • Coventry MedicareAdvantage Special Needs Plans (SNPs). These plans are similar in structure to a Health Maintenance Organization (HMO), but enrollment is limited to individuals with certain diseases and chronic conditions; those who live in an institution; or those who have both Medicare and Medicaid. You must meet the plan’s eligibility criteria to enroll. Plan benefits are tailored to meet the unique needs of its members, including specialized provider networks and coordination services.
  • Coventry MedicareAdvantage Private Fee-for-Service plans (PFFS). You can use any provider that accepts your plan’s terms and conditions, but providers, even ones that accept Medicare, are not required to treat you, unless you need emergency care. You must ask if the provider will accept your plan each time they treat you, even if they have accepted your plan in the past.

If you enroll in a Coventry Medicare Advantage plan, you must continue to pay your monthly Part B premiums, plus any other premiums your plan requires. Not all plans are available in all locations, and plan benefits and premiums may vary depending on where you live. Most of the above types of plans may include prescription drug coverage (SNPs must always include this coverage). If you’re interested in a Medicare Advantage plan with prescription drug benefits, check with the plan to make sure this coverage is included before enrolling.

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Does Coventry offer Medicare Part D Prescription Drug Plans?

Coventry offers Medicare Prescription Drug Plans, which provide stand-alone Medicare Part D prescription drug benefits for those enrolled in Original Medicare. Standard benefits for Medicare Part D prescription drug coverage are set by the Medicare program; all Coventry Medicare plans that cover prescription drugs must include these benefits at a minimum.

If you’re interested in help with your medication costs, Coventry offers stand-alone Medicare Part D Prescription Drug Plans as well as prescription drug coverage with Coventry Medicare Advantage Prescription Drug plans. Both types of plans use a formulary, which is a list of covered medications and the benefits available for each, so if you take medications on a daily basis, you may wish to check if your plan formulary includes your medications before enrolling. You may have to pay the full cost for your prescription drugs if your plan doesn’t cover your medications, so it’s important to double check. Plans may change their formularies at any time, but they must notify you in writing, usually at least 60 days in advance, prior to when the changes occur.

If you are enrolled in a Medicare Advantage plan with prescription drug coverage, you generally should not enroll in stand-alone Medicare Part D coverage; if you do, you may be automatically dropped from your Coventry Medicare Advantage plan and enrolled in Original Medicare. Certain types of Medicare Advantage plans that don’t include prescription drug coverage may allow you to enroll in a Medicare Prescription Drug Plan, but you should check with the plan first before enrolling.

It’s important to enroll in Medicare Part D coverage as soon as you are eligible, or you may pay a late-enrollment penalty along with your monthly premium for as long as you have Medicare Part D coverage; this may apply any time you go without Medicare Part D after you’re first eligible and don’t have creditable prescription drug coverage (coverage that is as good as the standard Part D benefit) for 63 days in a row or more. Not all plans are available in all locations.

Would you like help finding Coventry Medicare plans that fit your health and prescription drug needs? If you’re ready to find Coventry Medicare coverage in your area, you can visit the Coventry Medicare page to learn more and start browsing. Or, you can also click on the Find Plans button on this page to view plan options immediately.

*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.

**Aetna complies with applicable Federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, or sex. ATTENTION: If you speak a language other than English, free language assistance services are available. Visit our website at www.aetnamedicare.com or call the phone number listed in this material.
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