Health & Wellness
Our preventive health benefits are designed to give you access to a variety of resources to help you be healthy and independent.
Enhanced Case Management
You may join our Enhanced Case Management programs if you have a serious health problem that requires a high level of care management. , Our registered nurses will coordinate your medical services with your primary care provider (PCP). Call the Customer Service number on your Member ID for more information.
Examples of health problems that may qualify for enhanced case management include:
If you have a chronic disease such as:
- Coronary Artery Disease (CAD)
- Chronic Obstructive Pulmonary Disease (COPD)
- Heart Failure (HF)
We can help you manage your health by suggesting ways to help your symptoms and reminding you when tests are due.
Utilization Management (UM)
Utilization management (UM) is the evaluation of the medical necessity, appropriateness, and efficiency of the use of health care services, procedures, and facilities under the provisions of the applicable health benefits plan, sometimes called “utilization review.”
Quality Improvement Program (QI)
The Quality Improvement Program is designed to help us make sure our services meet the highest standards for safety and quality. We help you take care of your health and get the best service possible, and every year, we do our best to improve your:
- Access to providers
Our goals are to:
- Make sure we use reliable ways to measure our services
- Have staff to support the quality improvement process
- Focus on important quality issues
- Be aware of our members’ cultural and language needs to improve how you receive health care
- Ensure we meet all state and federal requirements
- Meet all requirements of health care quality accreditation
All providers and staff in the QI program must keep your information private. The program is reviewed every year to be sure it meets accreditation guidelines, and the results help us create the work plan for the following year. Call the Customer Service number on your Member ID card for more information.
You can find out more about Coventry's Quality Improvement program here.
SilverSneakers® Fitness Program
Offered at nearly 10,000 participating locations nationwide, enjoy a no-cost membership, as well as fitness classes specifically designed for older adults and taught by certified instructors. Locations also offer amenities such as exercise equipment and have on-site staff available to help you meet your personal fitness goals. Or, for those who don’t have convenient access to a SilverSneakers location, take advantage of SilverSneakers® Steps, which provides a kit of wellness tools to help you get fit. To support your success, you’ll also have access to the SilverSneakers website, a comprehensive, easy-to-use wellness resource. Here, you can create exercise and nutrition plans, track your fitness progress, find health articles and recipes and more!
Check your Summary of Benefits or Evidence Of Coverage to see if you have fitness benefits
Dental, Hearing and Vision Benefits
Our plans include coverage to help you take care of your teeth, your hearing and your sight. Benefit options vary by plan, but may include routine check-ups as well as coverage for hearing aids and glasses. Please visit My Online Services, call us at the toll-free number on your member ID card, or review your Evidence of Coverage to determine which options are available through your particular plan.
Coventry's provider search function is updated regularly. While it is our goal to provide accurate information, the composition of our provider network is subject to change without notice. The participation of a particular provider is never guaranteed, even if you are referred by your physician to the provider.
Coventry continually negotiates with additional physicians and hospitals, and changes to our network list are made as appropriate. It is important to know when you enroll in this plan, services are provided through the plan's delivery system, but continued participation of any one doctor, hospital, or other provider cannot be guaranteed.
You should always verify that the provider you choose is participating in our network before you receive services.
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