Coventry Medicare

4 based on 11 Reviews*

For more information on Coventry Medicare, please call the number below to speak with a healthcare specialist:

1-800-810-1437TTY 711

Coventry Medicare Update For 2016: On May 7, 2013, Coventry Health Care was purchased by Aetna for $5.6 billion. This newly merged company formed the third-largest health benefits carrier, with an estimated membership of 22 million consumers. But even before, as an independent carrier, Coventry had earned a respectable reputation within the American healthcare system. It puts an importance on low-cost health insurance, providing necessary services and benefits at an affordable rate.

Today, Coventry sells Medicare policies and Affordable Care Act (ACA)-compliant health insurance to an estimated 5 million beneficiaries, including its national plan network and 20 states’ local health plans. It provides policies for individuals and families, as well group health plans for businesses small and large.

Coventry Medicare Plans Click Here To Get 2017 Pricing

As with many carriers, Coventry places a particular importance on Medicare. This isn’t surprising, given that the company already had an estimated 250,000 Medicare beneficiaries (and 930,000 on Medicaid) before the Aetna acquisition. According to Medicare’s Star Ratings program, Coventry Health Care received a 4-Star Overall rating for 2016. Coventry’s Medicare Advantage (MA) policies, among its most popular, offer the benefits of Original Medicare – Part A (hospital insurance) and Part B (medical insurance) – with Medicare Part D prescription drug plans (PDPs). As of March 3, 2016, Aetna (and Coventry) had 1,510,600 MA members; 8.3 percent of the nation’s 18.2 million.

But Coventry also offers stand-alone Part D plans in all states and the District of Columbia. Prior to the acquisition, the company already had more than 1.5 million Part D enrollees. In particular, Coventry’s prescription drug coverage plans have ranked among the industry’s best. They also provide Medicare Supplement plans (Medigap), which require deductibles and coinsurance costs be paid.

The Aetna Connection’s Benefits

Coventry is considered a relatively new insurer, providing coverage in 22 states. But when Aetna’s beneficiaries are included, the carrier reaches all 50 states and the District of Columbia. The company has about 15,000 employee, and its network of providers includes: more than 4,700 participating hospitals; more than 580,000 allied health care professionals; and an additional 64,000 retail pharmacy workers. Coventry’s other business lines include: worker’s compensation and behavioral health plans. They also provide managed care products and services, such as provider network access, care management services and durable medical equipment (DME).

Coventry’s acquisition by Aetna seems to have benefited both carriers, especially for the valuable Medicare audience. “It’s a deal that almost had to happen,” stated analyst Thomas Carroll. “For Aetna to really compete effectively amongst the other large, national managed-care companies, they have to do more in terms of gaining market share in the commercial business, as well as getting a bigger foothold in Medicare and Medicaid, which are the growth areas in managed care over the next decade.” Aetna gained 5 million Coventry members, including: 250,000 Medicare enrollees, 1.5 million Part D enrollees and 930,000 Medicaid enrollees. They were also able to grow two valuable audiences: smaller employers and beneficiaries who purchased individual coverage.

If you have any questions at all, don't hesitate to call and speak with one of our healthcare professionals. Available 24/7 at 1-800-810-1437TTY 711

Coventry Medicare Plans

When it comes to comparing Medicare plans, Coventry’s website makes the process simple and easy to use. Visitors can conveniently compare and contrast multiple Medicare Advantage plans and their costs, such as deductibles and copays. You’ll also find a great deal of relevant educational and tutorial information; there are Medicare-related videos, as well. The Coventry website’s plan finder allows you to compare plans by specific states; you just need to enter your ZIP code and enter specific drug information to calculate your prescription drug costs. While these costs vary by region, they’re typically lower for Medicare Advantage. In fact, the company does a very good job in providing a variety of MA plans and PDPs. Generally, enrollees can choose:

  • Health Maintenance Organization (HMO) – With this plan, you select a primary, in-network physician. For out-of-network provider and hospitals, you may have to pay out of pocket.
  • Preferred Provider Organization (PPO) – This plan offers greater flexibility, as you can visit out-of-network providers and hospitals, although they cost more.
  • HMO Point-of-Service (HMOPOS) – Specific to Coventry, this provides coverage for plan members through a network of locally contracted doctors and hospitals; you can also visit out-of-doctors and hospitals.

You should know that for certain areas, there will only be MA plans or PDPs available. And despite the partnership with Aetna (and Humana), some extras included with those plans may not be offered with Coventry policies. You still receive these plans’ basic coverage, but they may be combined with prescription drug coverage. Individual plan benefits may also differ by state. For the plans below, all have the same benefits, but there may be different costs for copays:

  • Doctor office visits
  • Specialist office visits
  • Inpatient hospital care
  • Skilled nursing facility
  • Home healthcare
  • Outpatient mental healthcare
  • Prescription drug coverage


Advantra Silver PPO

While this plan has no in-network deductible, you may have to pay out-of-network costs. And, there are no discounts for plan extras, like dental, vision, hearing or wellness services. Prescription drug coverage is available, and a one-month supply of drugs will have different tiers for copays. However, you must visit Coventry-preferred pharmacies to qualify; visiting in-network pharmacies that are not preferred or out-of-network will cost more. Enrollees can also choose two other PPOs: Advantra Silver Plus (PPO; has a $67 monthly premium) and Advantra Gold (PPO; $116 monthly premium); these two plans have no in-network deductibles, as well.


Advantra Silver HMO

Similar to the Advantra Silver PPO plan, this Coventry HMO provides no extra services (dental, vision, hearing, fitness programs). And, visiting out-of-network pharmacies and using mail order may cost more.


Advantra Elite PPO

For members who want lower inpatient costs, this plan is a good choice, although it has more expensive copays than Advantra Silver. Out-of-network pharmacy and mail order prescriptions also cost more.


Stand-Alone Coventry Medicare Prescription Drug Plans

These individual PDPs are available and affordable, although you should have an Original Medicare plan, as well.

Among these plans are:
  1. First Health Part D Value Plus – This plan has a monthly premium, but no deductible. When used with preferred retail pharmacies, you pay a set price for different prescription drug tiers (prices increase with each tier).
  2. First Health Part D Essentials – This plan requires a higher premium and deductible than the Value Plus plan. But you only pay a $1 copay for generic drugs.
  3. First Health Part D Premier Plus D – This plan has the highest monthly premium, but no deductible. With this PDP, those who take different medications and want to save money at the pharmacy, may benefit. For preferred pharmacies, there is only a $1 copay preferred generic drugs.

Coventry Health Care started somewhat recently in 22 states. As a relatively new and young company, it provides mostly low-cost health insurance. If you are looking for basic coverage, these plans offer all of the services and benefits you’re looking for, at an affordable rate. However, there aren’t a lot of extras, like dental, vision or hearing discounts.

That doesn’t mean that Coventry doesn’t do a good job of providing different health plans for prescription drugs. In fact, Coventry Medicare plans have some of the very best coverage options available for 2015 enrollment.

The quantity of plans is also impressive, but in certain areas, Coventry only supplies prescription drug plans or PDPs. The costs of the plans vary, based on region; generally, they’re much lower for those who qualify for Medicare Part C. For Medicare Advantage, plan costs are a bit lower, but you won’t find a lot of wiggle room when it comes to coinsurance and copay costs.

The best part about Coventry is the easy plan comparison for their different Medicare Advantage plans. You can look up all of Coventry Medicare Advantage plans online and see the differences in copays and other costs.

Overview of Coventry Medicare Advantage

Coventry Health Care does a good job of providing various types of Medicare Advantage and prescription drug plans. You can choose between PPO, HMO and POS plans in most regions where Coventry is offered.

With HMO plans, you must see in-network providers and hospitals unless it’s an emergency situation. PPO offers some more flexibility, allowing you to go out-of-network, but you will have to pay for some of the out-of-pocket costs. The HMO Point-of-Service plans or HMOPOS, allows you to work with a network of local doctors and hospitals. You can also use a provider who isn’t in the network for some specific services.

Getting Medicare with Coventry

Coventry has a pretty easy-to-use system when it comes to finding Medicare Advantage plans online. Their website also provides a lot of education and tutorial information, as well as videos to explain different aspects of Medicare.

The site is designed to give you more general information about what types of Medicare plans they offer. Then, you can use the plan finder for your state to see specific plans available to you.

To view plans and make comparisons, you’ll have to specify your ZIP code to get started with Coventry’s Medicare plan finder. It will also ask you to specify drug information in order to calculate your prescription drug costs.

Plans are different in each state, but in general, Coventry offers the following types of Medicare plans:
  • HMO (Health Maintenance Organization) – These plans require that you pick a primary physician and stay within your network. If you go outside of the network, you will likely pay out-of-pocket.
  • PPO (Preferred Provider Organization) – You have more flexibility to see doctors outside of your network. But you still pay a higher cost to see doctors and hospitals if they are not in your network.
  • HMOPOS (HMO Point-of-Service) – HMOPOS provides coverage for plan members through network of locally contracted doctors and hospitals. Members who use a POS plan can use providers and hospitals that are not in the network.

These plans have different levels of flexibility for patients. The HMOPOS plans are particular to Coventry. The company is praised for offering lower prices on their plans. However, some of the prices seem a bit high for what is offered through competitor health insurance providers.

What does Medicare Advantage Cost in Your Area?

Benefits and Costs of Coventry Medicare

The following plans are available to some states and may not be the same in every state. Some areas do not have Medicare Advantage plans and search results will only come back with Part D or prescription drug plans.

Benefits for each plan is the same, but with different costs for copays:
  • Doctor office visits
  • Specialist office visits
  • Inpatient hospital care
  • Skilled nursing facility
  • Home health care
  • Outpatient mental health care
  • Prescription drug coverage

Some of the extras that are included in other plans with Humana and AETNA are not available for these plans. You will get the base coverage for these plans, but they bundle with prescription drug coverage.

Advantra Silver (PPO)

For this plan, there is no deductible for in-network. But you may have out-of-network costs if you choose to see doctors or specialists not covered under Coventry.

There aren’t any extra services or discounts included with this plan for dental, vision, hearing or wellness. However, prescription drug coverage is available. For a one-month supply of drugs, you’ll pay different copays for each tier. These prices are only available if you go to a Coventry-preferred pharmacy. Prices are higher for going to in-network pharmacies that are not preferred or out-of-network pharmacies.

Advantra Silver (HMO)

The HMO plan is similar to the Advantra Silver PPO plan. There aren’t any extra services, like dental, vision, hearing or fitness programs, with this plan. Prices are higher for going to retail pharmacies out of network or choosing mail order.

Advantra Silver Plus (PPO)

With the Silver Plus, the copays are the lowest.

Advantra Elite (PPO)

This is a good plan for those who want a lower cost for inpatient hospital care. The copays are a little bit more expensive than Advantra Silver. Prescriptions are more expensive at out-of-network retail pharmacies and mail order.

Stand-Alone Coventry Prescription Drug Plans

You can get stand-alone prescription drug coverage to go along with your Original Medicare plans through Coventry, as well. These are more popular with Coventry and generally, are available for affordable rates in most states.

Among these plans are:

  • First Health Part D Value Plus
    For this plan, you pay a monthly premium, there is no deductible and when used with preferred retail pharmacy, you pay a set price per different tier of prescription drugs. The prices go up for each tier.
  • First Health Part D Essentials
    For the Part D Essentials plan with Coventry, you will pay a higher premium and a higher deductible than the Value Plus plan. The benefit to these plan is that you pay a nominal copay of $1 for generic drugs.
  • First Health Part D Premier Plus D
    Coventry offers the Premier Plus Part D plan as well. This plan has the highest monthly premium, but there is no deductible. This is the best plan for someone who needs different medications and wants to save money every time they go to the pharmacy. When you visit a preferred pharmacy, you’ll spend only $1 per preferred generic drugs.

If you have any questions at all, don't hesitate to call and speak with one of our healthcare professionals. Available 24/7 at 1-800-810-1437TTY 711

Coventry Medicare Rating

Coventry plans have a high Medicare program rating. These ratings are based on customer satisfaction, long-term care, customer surveys, prescription drug coverage and customer service. For many of Coventry’s Medicare Advantage plans, they received a 4 out of 5-star rating, with multiple plans also receiving 4.5 stars. These plans aren’t available in all states, so the rating will likely depend on where you live.

For prescription drug plans, Medicare program rated Coventry lower, with only 3 out of 5 stars. In general, the costs are low for the prescription drug coverage. But Coventry has a smaller network of doctors, pharmacies and facilities than other major health insurance providers.

Overall, if you are looking for some of the extras, like fitness programs, dental, vision and hearing, you won’t find those services with Coventry. Their coverage mimics Original Medicare almost completely, except that they include prescription drug coverage for a rather cheap price. If you do decide to buy stand-alone prescription drug coverage, then you will likely spend more per month.

*Star Rating
The star rating listed above is reflective of results of consumer polling from individuals who have used in the past and or currently use that carriers medicare plan. These do not reflect star ratings that have been assigned to each individual carriers plan by CMS. For detailed information about each plans CMS star rating please visit

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