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Conventry Health Care Summary
Coventry Health Care was founded in 1986 as Coventry Corporation, Inc. The company moved quickly to acquire a long list of other health care companies, and changed to the current name in 1998, setting up headquarters in Bethesda, Maryland that same year. In 2013, Coventry became a subsidiary of Aetna Healthcare.
Coventry offers health care products in most states, although not all products are available in each location, and they can differ even by county within a covered state. They provide both individual and family plans as well as group plans, including both managed care and PPO plans, and also work with Medicare and Medicaid plans in some states.
Coventry’s website has a member services portal that allows members of health plans to review claims and benefits, access health care tools, and search for providers, among other online services.
Health care products from Coventry cover a wide variety of individual and group needs.
CoventryOne Individual Plans
Individual and family plans through CoventryOne are available in 27 states, although in some of those states the plans are actually written through Coventry’s parent company, Aetna. Plans direct from Coventry can be purchased in Arkansas, Florida, Georgia, Illinois, Kansas, Louisiana, Missouri, and Utah. Availability and type of plan varies by state and county.
Plans meet the requirements set out by the Affordable Care Act and are available at varying levels of coverage and with a wide range of premiums, co-pays, and deductibles.
Group Health Plans
Coventry’s group plans allow businesses to create a benefits package and offer options to their employees for their health care needs. They offer HMO, PPO, and POS plans as well as HSA and FSA products. As with the individual plans, availability varies by state and in some cases plans are offered by Aetna.
Coventry offers Medicare Advantage and Prescription Drug Plans at a national level and across 20 states. Coverage type and options vary by state and county, but options include HMO, PPO, and POS plans.
Coventry currently offers Medicaid plans in nine states, some of which are serviced by Aetna or other subsidiaries. Medicaid plans are available in Florida, Kentucky, Missouri, Michigan, Nebraska, Pennsylvania, Virginia, and West Virginia.
Providing one of the most necessary basics of business insurance needs, Coventry’s Worker’s Comp plans include claims management systems to help provide fast services while keeping costs down.
Behavioral Health Services
Through MHNet, Coventry offers a comprehensive plan for managing and treating behavioral and mental health concerns, including depression, mood disorders, eating disorders, and addictions.
Unusual for a health care company of this size, Coventry does not offer add-on coverage such as dental or vision plans, although these may be available through affiliated companies and through the parent company, Aetna.
Coventry has a wide range of plans, each with access to a different level of provider network. Networks depend on which of the Coventry companies, either subsidiaries or parent company Aetna, the plan is written through, as well as whether it is a PPO or HMO type plan.
First Health provides PPO network services for many Coventry plans, which gives members access to a large range of providers, hospitals, and services. As with all health plans, larger provider networks are generally available at the higher premium levels, while HMO plans have more limited networks and a lower premium.
Prices and premiums from Coventry vary greatly by the type of plan, the level of coverage, the deductibles and co-pays, and of course the location. As a growing health insurance company now owned by a very large company, Coventry is likely to be able to offer competitive rates.
Quoting is available for both Coventry and plans through Aetna online, although for some products consumers should contact the company by phone for accurate quotes.
Claims submission for Coventry Health plans depend on what type of plan you have and what state the plan is in. There are different claim procedures and contact information for claims through the First Health network, for Medicare claims, and for plans written through subsidiaries or through Aetna.
Claims are handled through healthcare providers, but Coventry offers online access to statements of benefits and claims information. This allows members to track their health care costs and out of pocket spending over time.
Although Coventry is not Better Business Bureau (BBB) accredited, it carries a an A+ rating from the BBB based on their multi-factor system. In the last three years, there have been 317 complaints listed, 27 of which have been closed in the past 12 months. A large majority of the complains concern Coventry’s product and service, 230 of them to be exact. Next in line, 73 complaints, are in regards to billing and collection.
There also a large number of complaints filed against Coventry on websites such as PissedConsumer.com, resulting in a one star rating overall. Most complaints seem to revolve around issues with billing and customer service. There are also numerous complaints regarding items that were not covered as expected, although it is difficult to say whether the complaints are valid without further knowledge of the consumer’s health care plan.
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With the acquisition by Aetna, Coventry is certainly well backed financially and is likely to remain a stable insurance company for a long time to come. They have a very good range of products, it is disappointing to see that there is no option to add vision or dental plans to their health care plans, although the website does state that some Coventry Medicare Plans might offer some coverage.
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