Below you will find valuable membership information. If you are not able to find the information you are looking for, please contact us.

Please also review the materials available on our Wellness Documents page.

Other plan documents may be applicable. See your plan administrator or contact Customer Service for details.

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The special notices below are applicable to employer group members. With the exception of the Special Enrollment Rights notice, the special notices below are also applicable to CoventryOne individual members.

Complaints and Appeals

Complaint and appeal policies are in place to ensure that we have effective procedures for addressing, documenting, and resolving complaints or appeals.

The complaint procedure gives a member the right to express dissatisfaction with any aspect of the organization and to request review of any matter related to:

• The quality of health care service received 
• General inquiries about covered services 
• Member rights and responsibilities

The appeals procedures give members the opportunity to ask us to review any matter related to:

• Issues about the scope of coverage for health care services
• Medical necessity of services requested
• Denial of care/services/claim
• Other adverse benefit determinations

Financial Reimbursement Disclosure

See the link below for a summary of Coventry's financial arrangements with our contracted (in-network) providers.

Special Notices for Members

While you will find special notices to members throughout the website, click on the links below to read more about our Consumer Choice Option, Women's Health and Cancer Rights Act, and Special Enrollment Rights.

Member Rights and Responsibilities

To ensure that our members are treated fairly, we have a list of member rights and responsibilities. We encourage you to become familiar with them.

Your Privacy Matters

Coventry Health Care works hard to keep your personal and health information secure and private.

We need information about you to manage your benefits. We collect your information from many sources. And keeping your information safe is one of our most important jobs. We make sure that only people who need to use your information have access to it. We may use and share your information for:

• Treatment
• Payment
• Health care operations

These uses are covered under state and federal laws. Our policies will reflect the most protective laws that apply to you.