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HMO/PPO/POS Plans from Coventry Health Care
HMO/PPO/POS plans from Coventry Health Care combine your Part A (hospital), Part B (medical) and Part D (prescription drug) coverage into one source of coverage.
In addition to medical and prescription drug coverage, these plans offer many added benefits* like dental, vision, hearing, over-the-counter drug coverage and no-cost health club memberships.
Best of all, most of our plans offer coverage options for no or low monthly plan premiums.
Members in our HMO plans must use plan providers (sometimes called “in network” providers), except in emergency or urgent care situations or for out-of-area renal dialysis. If you obtain routine care from out-of-network 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 may 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 coinsurance 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.
HMO/PPO/POS plans from Coventry Health Care are available to beneficiaries in select counties in: Arkansas, Florida, Georgia, Illinois, Iowa, Kansas, Missouri, Nebraska, North Carolina, Ohio, Pennsylvania, South Dakota, Texas, Utah, and Wyoming.
*benefits may vary by plans and/or by county