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Medicare Coventry Advantage Programs

Medicare is the federal insurance program for the elderly and disabled in the United States. While many people opt to get their coverage straight from the government, more and more are choosing to get their Medicare through private plans called Medicare Advantage plans. Coventry is a private insurance plan that sells Medicare Advantage plans. Their plans are called Coventry Advantra. They offer four different types of plans in several states across the country.

  1. Coventry Advantra HMO

    • The Coventry Advantra HMO (health maintenance organization) offers both Part A and Part B benefits. Beneficiaries in this plan are subject to a network of providers, meaning they can only see doctors and specialists who are within this network. They must also select a primary care physician, and their primary care physician will refer them to specialists as needed. If the beneficiary receives care out-of-network, the plan will not pay for it unless it was an emergency or urgent care situation.

    Coventry Advantage PPO

    • The Coventry Advantage PPO (preferred provider organization) also provides both Part A and Part B benefits. Just like an HMO, those in a PPO have a network of providers. However, unlike an HMO, those in a PPO can see doctors and specialists outside of their network at an additional cost. In a PPO, the beneficiaries do not need a primary care physician and can see any specialist that is medically necessary without a referral.

    Coventry Advantra POS

    • The Coventry Advantra POS (point of service) plan is similar to a PPO and HMO in what it covers. A POS has a network of providers, but beneficiaries can see providers outside of the network at a greater cost. However, in a POS, beneficiaries are required to select a primary care physician, and must seek out referrals when needing to see a specialist.

    Coventry Advantra Freedom

    • The Coventry Advantra Freedom plan is a private fee-for-service (PFFS) plan that covers Part A and Part B benefits. Enrollees in the Coventry Advantra Freedom plan are not subject to a network of doctors. They are not required to select a primary care physician, and they are not required to seek out referrals when seeing a specialist. Further, enrollees can see any doctor willing to accept the PFFS insurance, because there is no network limiting them.

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