Eligibility Requirements

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Eligibility Requirements

You are eligible to join Coventry if:

  • You are entitled to Medicare Parts A and B benefits due either to age or disability. With Coventry, you must continue to pay your Medicare Part B premium. If you do not have Medicare Part B, you are not eligible for Coventry and must contact your nearest Social Security office and sign up for Part B.
  • You live in the service area.
  • You have not been diagnosed with End-Stage Renal (kidney) Disease, unless you are already a member of Coventry or had a successful kidney transplant.
  • You must be eligible for both Medicare and Medicaid to enroll in our Dual-eligible Special Needs Plans.

Medicare Prescription Drug benefits are only available to beneficiaries with Part D Prescription Drug coverage or members of a Medicare Advantage Prescription Drug plan. You cannot enroll in this plan if your current or former employer helps pay for your drugs.

Members in our HMO plans must use plan providers except in emergency or urgent care situations or for out-of-area renal dialysis or other services. If you obtain non-emergent, routine care from out-of-network providers, neither Medicare nor Coventry will be responsible for the costs.

Dual-eligible Special Needs Plans are available to anyone who has both Medical Assistance from the state and Medicare. Premiums, copays, coinsurance and deductibles may vary based on the level of Extra Help that you receive. Please contact the plan for details.

If you have any questions regarding eligibility requirements, simply call us toll-free at 1-855-338-9551 (TTY: 711), 8 a.m. to 8 p.m., local time, seven days a week from October 1 - February 14 and Monday through Friday,  February 15 - September 30.

You can also call 1-800-Medicare (1-800-633-4227) (TTY: 711) to ask questions or get free information booklets from Medicare. You can call this national Medicare helpline 24 hours a day, seven days a week. Domain names, trademarks and copyrights of other websites or of, or contained in, information on this website are the sole property of their respective owners.

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Y0022_PDPCCP_2013_4006_1202b Approved
CMS Approved Date: 02/08/2013
Page Last Updated: 03/09/2016

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Aetna Medicare is a PDP, HMO, PPO plan with a Medicare contract. Our SNPs also have contracts with State Medicaid programs. Enrollment in our plans depends on contract renewal.