Eligibility Requirements

You are eligible to join Advantra (PPO) if:

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

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 PPO/POS plans can go to doctors, specialists or hospitals in- or out-of-network. With the exception of emergency or urgent care, it will cost more to get care from out-of-network providers and /or that accessing services from in-network providers can cost less than using services of out-of-network providers. Your responsibility will be greater out-of-network when the out-of-network co-insurance is based on the Medicare allowed amount and the contracted amount is lower. Coventry provides reimbursement for all covered benefits regardless of whether they are received in-network, as long as they are medically necessary.

If you have any questions regarding eligibility requirements, simply call us toll-free at 1-866-784-4916 (1-866-784-4931 TTY), 8 a.m. to 8 p.m., local time, seven days a week.

You can also call 1-800-Medicare (1-800-633-4227) 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. The TTY/TDD number is 1-877-486-2048. 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.