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You will be able to view plan details and enroll online or download printable enrollment materials.

If you are an individual and are ready to enroll in one of our plans, you can also call 1-877-988-3589 (TTY/TDD 711 Telecommunications Relay Service) 8:00 a.m. - 8:00 p.m. local time, seven days a week.

If you receive your health care coverage through your former employer, please contact your Human Resource Department or Benefit Administrator to receive instructions on how to enroll in the Coventry Health Care plan available to you.

Notices & Disclaimers

AdvantraRx (PDP)

AdvantraRx (PDP) is a Medicare-approved Part D sponsor. The contracts with the Centers for Medicare & Medicaid Services (CMS) are renewed annually; coverage beyond the end of the current contract is not guaranteed. Our plan is authorized by law to refuse to renew its contract with CMS and CMS also may refuse to renew the contract. Termination or non-renewal may result in termination of your enrollment in our plan. AdvantraRx (PDP) may reduce its service area and no longer offer services in the area where you reside.

You must be entitled to Medicare benefits under Part A and/or enrolled in Part B, and reside in the AdvantraRx (PDP) service area. You may only enroll in one Part D Benefit Plan (PDP) at a time and only during specific times of the year. If you are enrolled in a Medicare coordinated care (HMO or PPO) plan or a Medicare Advantage (MA) Private Fee-for-Service (PFFS) plan that includes Medicare prescription drugs, you may not enroll in a PDP unless you disenroll from the HMO, PPO or MA PFFS plan. Enrollees in a PFFS plan that does not provide Medicare prescription drug coverage, or a MA Medical Savings Account (MSA) plan may enroll in a PDP. Enrollees in an 1876 Cost plan may enroll in a PDP. You must continue to pay your Medicare Part B premium if not otherwise paid for under Medicaid or by another third-party.

Medicare beneficiaries may enroll in AdvantraRx (PDP) through the Centers for Medicare & Medicaid Services Online Enrollment Center, located at www.medicare.gov. For more information contact AdvantraRx (PDP) at 1-800-882-3822 (TTY/TDD users call 1-888-788-4010), 8 a.m. to 8 p.m., seven days a week. Brokers are paid a commission upon beneficiary enrollment.

You may be able to get Extra Help to pay for your prescription drug premiums and costs. To see if you qualify for getting Extra Help, call: 1-800-MEDICARE (1-800-633-4227).  TTY users should call 1-877-486-2048, 24 hours a day, seven days a week; the Social Security Office at 1-800-772-1213 between 7 a.m. and 7 p.m., Monday–Friday. TTY users should call 1-800-325-0778; or your State Medicaid Office.

People with limited incomes may qualify for Extra Help to pay for their prescription drug costs. If eligible, Medicare could pay for seventy five (75) percent of drug costs including monthly prescription drug premiums, annual deductibles, and co-insurance. Additionally, those who qualify will not be subject to the coverage gap or a late enrollment penalty. Many people are eligible for these savings and don’t even know it. For more information about this Extra Help, contact your local Social Security office or call 1-800-MEDICARE (1-800-633-4227), 24 hours per day, 7 days per week. TTY users should call 1-877-486-2048.

If you decide to switch to premium withhold or move from premium withhold to direct billing, it could take up to three months for it to take effect and you will ultimately be held responsible for those premiums.
Eligible beneficiaries must use network pharmacies to access their prescription drug benefit, except under non-routine circumstances when they cannot reasonably use network pharmacies. In general, benefits are only available at contracted network pharmacies.

Benefits, formulary, pharmacy, network premium and/or co-payments/co-insurance may change on January 1, 2010. Please contact AdvantraRx (PDP) for details.

Documents are available in alternative formats or languages. Call AdvantraRx (PDP) at 1-800-882-3822 (TTY/TDD users call 1-888-788-4010), 8 a.m. to 8 p.m., seven days a week for information about other formats or languages.

First Health Part D (PDP)

First Health Part D (PDP) is a Medicare-approved Part D sponsor. The contracts with the Centers for Medicare & Medicaid Services (CMS) are renewed annually; coverage beyond the end of the current contract is not guaranteed. Our plan is authorized by law to refuse to renew its contract with CMS and CMS also may refuse to renew the contract. Termination or non-renewal may result in termination of your enrollment in our plan. First Health Part D (PDP) may reduce its service area and no longer offer services in the area where you reside.

You must be entitled to Medicare benefits under Part A and/or enrolled in Part B, and reside in the First Health Part D (PDP) service area. You may only enroll in one Part D Benefit Plan (PDP) at a time and only during specific times of the year. If you are enrolled in a Medicare coordinated care (HMO or PPO) plan or a Medicare Advantage (MA) Private Fee-for-Service (PFFS) plan that includes Medicare prescription drugs, you may not enroll in a PDP unless you disenroll from the HMO, PPO or MA PFFS plan. Enrollees in a PFFS plan that does not provide Medicare prescription drug coverage, or a MA Medical Savings Account (MSA) plan may enroll in a PDP. Enrollees in an 1876 Cost plan may enroll in a PDP. You must continue to pay your Medicare Part B premium if not otherwise paid for under Medicaid or by another third-party.

Medicare beneficiaries may enroll in First Health Part D (PDP) through the Centers for Medicare & Medicaid Services Online Enrollment Center, located at www.medicare.gov. For more information contact First Health Part D (PDP) at 1-800-588-3322 (TTY/TDD users call 1-888-788-4010), 8 a.m. to 8 p.m., seven days a week. Brokers are paid a commission upon beneficiary enrollment.

People with limited incomes may qualify for Extra Help to pay for their prescription drug costs. If eligible, Medicare could pay for seventy five (75) percent of drug costs including monthly prescription drug premiums, annual deductibles, and coinsurance. Additionally, those who qualify will not be subject to the coverage gap or a late enrollment penalty. Many people are eligible for these savings and don’t even know it. For more information about this Extra Help, contact your local Social Security office or call 1-800-MEDICARE (1-800-633-4227), 24 hours per day, 7 days per week. TTY users should call 1-877-486-2048.

Eligible beneficiaries must use network pharmacies to access their prescription drug benefit, except under non-routine circumstances when they cannot reasonably use network pharmacies. In general, benefits are only available at contracted network pharmacies.

Benefits, formulary, pharmacy, network premium and/or copayments/coinsurance may change on January 1, 2010. Please contact First Health Part D (PDP) for details.

If you decide to switch to premium withhold or move from premium withhold to direct billing, it could take up to three months for it to take effect and you will ultimately be held responsible for those premiums.

Coordinated Care Plans (HMO/PPO/POS)

Advantra (HMO/PPO/POS) is a Coordinated Care plan with a Medicare Advantage contract. This contract with the Centers for Medicare & Medicaid Services (CMS) is renewed annually; coverage beyond the end of the current contract year is not guaranteed.  By law, Coventry can choose not to renew its contract with CMS and CMS may also refuse to renew the contract, thus resulting in a termination or non-renewal. This may result in termination of your enrollment in the plan. In addition, the plan sponsor may reduce its service area and no longer offer services in the area where the beneficiary resides.

Our Medicare Advantage plans are open to all Medicare beneficiaries eligible by age or disability and living in the plan’s service area. You must be entitled to Medicare benefits under Part A and be enrolled in Part B. You must continue to pay your Medicare Part B premium if not otherwise paid for under Medicaid or by another third party. If you switch to premium withhold or move from premium withhold to direct bill, it can take up to three months for the switch to take effect. You will be held responsible for those premiums.  You may enroll during specific times of the year. You cannot enroll in this plan if your current or former employer helps pay for your drugs.  For information on enrollment periods and for full information on Coventry benefits, please click here to contact our Customer Service Department.

Benefits, formulary, pharmacy network, premium and/or co-payments/co-insurance may change on January 1, 2010. Please contact Coventry for details.

Members in our HMO plans must use plan providers except in emergency or urgent care situations or for out-of-area renal dialysis. If you obtain routine care from out-of-plan providers, neither Medicare nor Coventry Health Care (and all subsidiaries) will be responsible for the costs.

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.  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 coinsurance in-network is based on the contracted amount which is probably lower. Coventry provides reimbursement for all covered benefits regardless of whether they are received in-network, as long as they are medically necessary.

Some of our health plans offer Dual-eligible Special Needs Plans that are available to anyone in select service areas who has both Medical Assistance from the state and Medicare. Premiums, copays, coinsurance and deductibles may vary based on the level of help that you receive. Please contact the plan for details.

Medicare Prescription Drug Benefit is only available to members of the Medicare Advantage Prescription Drug (MAPD) plan; if a beneficiary is already enrolled in an MAPD plan, the enrollee must receive their Medicare Prescription Drug Benefit through that plan.  Eligible beneficiaries must use network pharmacies to access their prescription drug benefits, except under non-routine circumstances when they cannot reasonably use network pharmacies.

You may be able to get extra help to pay for your prescription drug premiums and costs. To see if you qualify for getting extra help, call:

• 1-800-MEDICARE (1-800-633-4227).  TTY users should call 1-877-486-2048, 24 hours a day, seven days a week; 
• The Social Security Office at 1-800-772-1213 between 7 a.m. and 7 p.m., Monday–Friday. TTY users should call 1-800-325-0778; or
• Your State Medicaid Office.

People with limited incomes may qualify for extra help to pay for their prescription drug costs. If eligible, Medicare could pay for 75% of drug costs including monthly prescription drug premiums, annual deductibles, and co-insurance. Additionally, those who qualify will not be subject to the coverage gap or a late enrollment penalty. Many people are eligible for these savings and don’t even know it. For more information about this extra help, contact your local Social Security office or call 1-800-MEDICARE (1-800-633-4227), 24 hours per day, 7 days per week. TTY/TDD users should call 1-877-486-2048.

The benefit information provided herein is a brief summary, but not a comprehensive description of available benefits. Additional information about benefits is available to assist you in making a decision about your coverage. This is an advertisement; for more information contact the plan.

Medicare beneficiaries may also enroll through the Centers for Medicare & Medicaid Services Online Enrollment Center, located at www.medicare.gov.  You can also find plan rating information on this site.  For more information, contact Coventry at 1-877-988-3589 (TTY/TDD: 1-888-788-4010 for the hearing impaired), 8 a.m. to 8 p.m., seven days a week.

Plan documents are available in other formats.  For information about other formats, please click here to contact our Customer Service Department.