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Coventry Health Care

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LAST UPDATED: September 22nd, 2020

Aetna aquired Coventry Health Care in 2013. For more information about Aetna, view Best Company's Aetna profile.

Coventry Health Care was founded in 1978 under the name of Group Health Plan of Greater St. Louis. What started out as a nonprofit headquartered in Bethesda, Maryland, has since grown to help millions of customers across the United States.

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The Good

  • Types of Health Care Plans Offered
  • Additional Insurance Policies
  • Member Resources
  • Unique Features

Types of Health Care Plans Offered

One of the best things about Coventry Health Care is that it serves customers in every state of the nation. Its plans are available to anyone regardless of location. Location actually becomes important in another regard. Residents in different states may see different insurance coverage options based on what Coventry offers in their area.

Coventry offers the whole range of plans. Its individual plans include low copayments for general medications and coverage for physicals and immunizations.

Coventry also offers group plans for employers, Medicare, and Medicaid, too. Medicaid plans include CHIP, Long-Term Care, Children in State Custody, Assistance for Needy Families, and other programs. Other plans offered here include HMOs, PPOs, HSAs.

Health Savings Accounts (HSAs) are available with High Deductible Health Plans. HSAs allow you to set aside pre-tax dollars to use for health care expenses.

HMOs and PPOs offer different care provider network coverage. PPOs cover in- and out-of-network providers at different rates. In-network providers are covered at higher rates than out-of-network ones.

HMO plans only offer insurance coverage for in-network care. As you evaluate plans understand what cost-sharing payments work for medical services. Consider these out-of-pocket expenses alongside the monthly premium payment to keep your plan membership.

Additional Insurance Policies

Coventry goes beyond health insurance policy options to offer workers' compensation, fee-for-service plans for retired people, dental insurance, and vision insurance.

Through Coventry Dental, a subsidiary of Coventry Health Care, dental plans are available in 170,000 locations around the country. The coverage for these plans, of course, depends on individual health plans, though.

Vision insurance is available as well. This functions through EyeMed Vision Care and is accepted at LensCrafters, Pearle Vision, Target, JCPenney, and Sears. All Coventry members have this option, which offers discounts on glasses and Lasik if needed. The plan covers an eye exam as well, and members are expected to pay a copayment.

Member Resources

The online member portal for Coventry is called My Online Services. Even before becoming a member here, you can take a tour of this portal to see what resources it offers and whether it would be transparent and understandable enough for you. This portal offers tools to find a doctor, get an ID card, take a health assessment, chat with a nurse online, and understand more about your benefits. You can also view the status of a claim you've made and find a pharmacy.

Other member resources here include the Coventry Mobile app, which allows members to view a claim status, view or fax their ID card, find a doctor, and view your account balance-all from the convenience of a smartphone. Coventry has a member dedicated phone number as well.

One thing Coventry would help customers with would be providing a more accessible live chat tool-one that is more visible up front and easy to use in case customers or potential customers have questions that aren't answered on the website.

Unique Features

Coventry Health Care, like many other health insurance companies, provides a convenient way for you to search for a doctor or pharmacy in your plan's network and in your area. When using this tool, you narrow your search to the doctors you could use by specifying your state and the type of plan you are on (or would like to have).

Aside from this, the company has kept up technologically by providing a mobile app called Coventry Mobile. With this, you can check a claim status, find a doctor, and view various details of your account right on your phone. One thing you can't view on this app, however, is an explanation of your benefits, as this is only available on an actual computer right now.

Coventry offers many discounts for members as well. These include savings on a home fitness program, a gym membership, or a weight loss program. The member portal also offers a health assessment you can take and a place to set goals, track your health, and even benefit from a digital health coach. The Personal Health Assistant on the member portal helps with tasks like these and could provide the visual motivation to keep working toward your personal health goals.

Fitness products aren't the only discounted perks, though. You can also receive savings on spa care, vision care, chiropractic work, or massages.

If you're burdened by stress or want to quit smoking, the Personal Health Assistant and certain discounts can motivate you to overcome these challenges as well. Individuals health plans are given through CoventryOne and on this website you can get educated about healthcare and healthcare reform, compare different health plans to get the best price and more. In this way, members of Coventry Health Care stay informed and gain a stronger understanding of a changing industry.


The Bad

  • Limited Customer Reviews and Ratings
  • Customer Service
  • Limited Mobile App

Limited Customer Reviews and Ratings

Coventry Health Care's has not received many reviews and ratings on Best Company, which makes it difficult to guage the customer experience. Unfortunately, most of Coventry Health Care's ratings are low.

Reviewers mention difficulty with claims, dissatisfaction with coverage, and bad experiences with customer service. These issues are concerning, especially since there are few positive experiences shared in Coventry reviews.

Customer Service

In some ways, the customer service resources are pretty limited at Coventry Health Care. The company doesn't offer a lot of information about its mission or philosophy on customer care, for one thing. You have to go out of your way to find very much information about the company as a whole too-such as its history, views on working with Aetna now, the way it wants customers to feel about its services, etc. These can be key factors to make customers feel more trust in a company, and Coventry is more transparent about member resources than the way it communicates with members.

Of course, customers can use the usual mediums to contact a representative at Coventry-phone, email, and mail. But it's hard to find a live chat tool if that's the way you prefer to ask questions.

In addition, Coventry provides an easy way to get a quote for an insurance plan you're interested in, and you can take a guided tour through the member portal (a major advantage, since this is the main tool you'd be using to manage your account). In these ways, Coventry has done a decent job overall of providing a few different means for customers to get a hold of someone and get more information. But the company would be even more helpful to customers if it made its website more detailed and offered a live chat tool for those who prefer it.

Limited Mobile App

The mobile app here can do a lot of things, but what it can't do is show you an explanation of your benefits. You can only view these online on a computer as the app can't yet display these. If you're out and need access to these explanations, this is pretty inconvenient.


The Bottom Line

On the whole, Coventry Health Care has a high level of industry experience and a selection of health plans.

Members have lots of resources with Coventry Health Care, and the patient portal here is intuitive to use and full of tools to track finances and even health.

Although Coventry Health Care looks good on paper and has a limited number of reviews, it's concerning that most of its reviews on Best Company are negative. We recommend exploring other health insurance companies.

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15 Reviews

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Judith Coromoto Hollywood, FL

Coventry i is a mess with the benefices and communication. Is acting in bad faith all the time. On Friday 19, 2018 I received a letter of Status of my grievance related to an emergency. The letter from Coventry was dated October 12, 2018. The letter pointed out that: “We need to hear from you by October 13, 2018. If we don’t, we’ll dismiss your grievance”. What way of resolve some one problem is that?. This letter came to my address as a regular mail, it was not an urgent or special delivered. Coventry refused to pay a bill from an urgent care facility because it was not in the networking!!!

5 years ago

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Chris Saint Louis, MO

First complaint is for prescriptions. My wife and I have had to pay $30-$50 copays for generics even though our plan says $0 copays for all tiers. We go to places like CVS and Walgreens to get them filled. How these companies are out of network I will never understand. Now, my major complaint is how painful it has been trying to add a newborn to our policy. Within 30 days of his birth we worked to add him to our policy. It took nearly a week of phone tag and email tag to get all of the proper paperwork to fill out and fax number to send in all the needed information. Why they can't accept scanned copies in pdf form I'll never understand considering a fax is essentially the same thing, but I digress. Once I had all of the proper paperwork filled out , birth cert, etc. I faxed it all in to them. My wife followed up with a phone call to make sure they received everything, which they did and even produced for us a member ID number. All well at this point and we were told his coverage would be back dated to his birthday. Now fast forward to three pediatrician visits and shots at two months. I go to check my hospital's network where I receive the bills and see that not a single doctor's visit or shot has been covered. That's $1000 worth bills Coventry has done nothing with. My wife called to get this corrected and come to find out my son is no where to be found in their system. So not only do I have to start paying on a bill I shouldn't have to to avoid bad marks on my credit we now have to go through the entire process yet again to add him to our insurance. They say it will still be back dated till his birthday but I have no idea how long that will take or if it will even cover what we've been billed. Overall, this has been the worst insurance company I've ever used. I cannot wait till open enrollment so I can dump them and move to Anthem or anyone else really.

7 years ago

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Linda Kay Rutledge Dallas, TX

When I spoke to an agent I explained my two pre-existing conditions, one of which required me to wear CPAP machine. I was assured it was covered. I found out it was not until after 12-24 month waiting period. I'll be medicare age by then. My doctors took the plan which was good. I was very specific re my CPAP and my doctors and took meticulous notes. I feel I was given falsified information and could get no satisfaction to remedy the situation.

3 years ago

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Richard H Boynton Beach, FL

Coventry is not transparent about the true nature of their association with Aetna. They claim to be "under the Aetna umbrella" but are avoided like the plague by providers. Every customer service representative tells a different story and doesn't explain that Coventry and Aetna are not the same. You will not get clear explanations of coverage or options. Customer service simply isn't.

4 years ago

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Kelly Burkemper Elsberry, MO

My dad has been in the hospital for a month now after heart surgery, the surgery went well but the after care that the Coventry insurance has allowed is stupid, they want to keep him in the ICU instead of moving him to the ltech, so he can get off the vent (trach). they say he has to be on the trach for 21 days before they think he needs help weaning him off of it, He could be taking off of it so much earlie, but the wont allow it. Why would you keep someone on it longer then they need ??? I would not recommend this insurance to anyone !!!

5 years ago

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Joyce Kansas City, MO

Coventry is the worst! The doctor and hospital recommended a particular care. The hospital worked diligently to get Coventry to approve the same level of care that Medicare would easily approve. However, Coventry insisted my mother accept a lower level of care in a facility in another state. Coventry is despicable. I will certainly cancel but unfortunately my mother is denied the chance to recover thanks to Coventry.

6 years ago

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F. Teresa Walsh Allentown, PA

They do not provide the services they tell customers they are entitled to under their plans. They don't know what they are doing. Three weeks waiting for a DIME that is a covered item under my plan. Non weight bearing customer can't walk and still waiting! ! Very bad customer service have very little knowledge of their own insurance coverage. Won't get insurance with them again!

7 years ago

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KitKat1900 Blue Springs, MO

This has got to be the worse insurance company out there. How they are not under investigation, I'll never know. The way they treat customers, especially seniors, is deplorable. Wait time to even talk to someone is unacceptable. Find yourself another company. You'll be much better off if you ever have to use your medical benefits.

3 years ago

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Jeff Young Imperial, MO

This insurance company is terrible! Don't use them. They will charge you $1800 per month for family insurance and deny everything. When they do make a payment... Their payment will be less than half the payment that you will be making!!!

4 years ago

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allison Hiram, GA

We paid $24,000 and we received NO HEALTH CARE COVERAGE. What a rip off!!! There was NO value for our money. We PAID $1,200 per month. We received nothing in return. What a scam! Run for your life!!!!! What a joke: "Best Company". So if you name yourself that it must be true?

5 years ago

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Keith McCracken Washington, MO

This company keeps changing their coverage. When we called to inquire why the coverage was changed and we were not notified the representative stated they are not required to notify us of any changes. We received a letter today stating they will not offer the same plan we have now after December 1,2016.

7 years ago

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Poor communication. Poor resources for member. Denied level of care authorization due to pneumonia unstable and 24 hours later denied level of care authorization due to pneumonia cleared.

5 years ago

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Elizabeth Grindstaff Joplin, MO

Can not get what you needed when you're in needed I would not recommend for anybody with mental health issues or diabetes

6 years ago Edited September 14, 2021

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Taylor Chicago, IL

They do not approve 100% needed health care related to safety and wellbeing. They are an awful awful company who are killing people.

6 years ago

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Dalek Miami, FL

Customer service is the worst. They do not answer phone calls.

4 years ago