What Medicare Plans Does Coventry Cover?

These private insurance companies offer the following:

• The exact same coverage as parts A and B of Medicare (which we’ll refer to as Original Medicare)
• Additional preventive coverage like vision and dental
• Some prescription drug coverage, which you have to purchase separately from parts A and B if you have Original Medicare
• A maximum out-of-pocket cost per year, meaning you know you won’t pay any more than a certain amount, no matter your condition

Coventry is one of the larger nationwide companies that offers Medicare plans, and it was purchased by Aetna in a $5.7 billion deal in 2012. Now, the company is known as Aetna Coventry. The move was made by Aetna to specifically “help it expand further into government-backed programs like Medicare and Medicaid,” according to The New York Times. As of late 2018, CVS was in talks to merge with Aetna for $69 billion, and Aetna Coventry would be included in the merger.

As a part of Aetna, Coventry shares 7 percent of the entire Medicare market, according to a 2017 report. As a whole, the company has more than 1 million customers Medicare Advantage.

Coventry’s Medicare Plans

Coventry was bought by Aetna to help give it a stronger hold in the Medicare market. So in addition to all the types of plans Aetna offers, it adds a number of plans to its fold by including Coventry options as well. 

Aetna Coventry Medicare Plans

PPOs

These plans allow you to use all of Aetna Coventry’s in-network doctors and services in addition to a group of many out-of-network services. This widens the range of providers you can visit for care. While it typically comes at a higher price than plans that restrict you to in-network providers, you’ll have a higher chance of your current doctor or other doctors/hospitals you prefer being covered by Aetna Coventry.

HMOs

This Aetna Coventry plan allows you to use its in-network services to get your healthcare needs. Within this plan, you pick a primary care physician, who will refer you to specialists you need. These plans are cheaper than other types because you are restricted in who you can see. However, if your healthcare needs are easily met by these restrictions, this type of plan is right for you.

HMO-POS

This version of an HMO allows for some flexibility in your choices of doctors because it allows for an out-of-network option for your care. This means that you can see a doctor or specialist who is out-of-network, but at a higher fee. You typically need to be referred to this doctor and have a reason to visit the out-of-network specialist, and you still need a primary care doctor within Aetna Coventry’s network.

SNPs

These plans are primarily for people who qualify for both Medicare and Medicaid. However, other people who get SNPs include those with chronic conditions like dementia and end-stage renal disease, or those who live in a facility such as a skilled nursing home. SNPs are required by law to include prescription drug coverage. These plans are typically made in conjunction with your state’s Medicaid programs.

Most—if not all—of these plans offer prescription drug coverage, as well.

If the Advantage plan doesn’t offer prescription drug coverage, or if you have Original Medicare and are looking for prescription coverage with Aetna Coventry, then you can get a stand-alone plan with Aetna Coventry. These plans come with premiums ranging from $0 to a couple hundred dollars per month.

The prescription plans offered by Aetna Coventry typically have a tiered system. For example, if you have more prescription drugs covered under your plan, it will cost more money. On the other hand, if you have fewer prescription drugs on your plan, it’ll cost you less money per month.

When Can I Get A Medicare Plan With Coventry?

There are three periods you can get a Medicare plan with Aetna Coventry. 

Coventry Medicare Plan Enrollment Periods

Initial Enrollment Period (IEP)

This is when you are first eligible to enroll in Medicare. This period lasts for a total of seven months: three months before your 65th birthday month, your birthday month, and then three months after your birthday month. So if you were born May 21, your IEP would last from February 1 until August 31. If you don’t obtain some Medicare coverage (Original Medicare, Medicare Advantage, Part D, or any combination of them), you may accrue penalty fees when you do eventually enroll.

OpenEnrollment Period

If you missed your IEP, you can get a Medicare plan with Aetna Coventry during the open enrollment period, which lasts from October 15 to December 7. You can also switch Medicare plans (from Original Medicare to Medicare Advantage or between two Medicare Advantage plans) during this time.

Special Enrollment Period

There are certain special situations that allow you to change your Medicare plans at varying times of the year. For instance, you can change to a Part C plan with Aetna Coventry if you move out of an area into a new one where they provide services and your old plan doesn’t. Other situations that allow special enrollment include if you move into a skilled nursing facility, were released from jail, or qualify for Medicaid while on a Medicare plan.

If Aetna Coventry ever has a Medicare plan available in your area that is rated five stars, you will able to switch from whatever Medicare Advantage plan you have to the five-star plan any time from December 8 to November 30.

How To Get A Medicare Plan With Coventry

First, you’ll want to find the Medicare Advantage or prescription drug plan that is right for you. To do this, head to the Aetna Coventry website and type in your zip code. From there, you can either let the site guide you to your decision, or you can browse all of the plan options.

Letting the site “guide you” includes entering broad information about your health status (good, fair, poor), which type of coverage you’re looking for, the drugs you’re currently taking, and the pharmacy you use. But if you’re comfortable viewing the plans on your own, you can absolutely do that, too.

The Aetna Coventry site shows different elements of their plans including:

• Monthly premium rate
• Yearly deductible
• Star rating
• If your drugs are covered in the plan
• What type of plan it is (HMO, PPO, etc.)
• The maximum out-of-pocket costs

Once you’ve settled on a plan, navigate the site’s commands for “add to cart,” and then you’ll be on your way to securing a plan.

If you have any questions regarding any Aetna Coventry plans, non-members can contact the company at 1-888-247-1051 (TTY:711). Current members can call the customer service number on their card.