Coventry Health Care was a managed health care company that sold medical insurance, Medicare and Medicaid plans, and workers’ compensation coverage in 27 states before Aetna bought it in 2013. Aetna itself was acquired by CVS Health in a $69 billion deal that closed in late 2018.1U.S. Securities and Exchange Commission. Form 425 – Aetna Inc. Acquisition of Coventry Health Care, Inc. Coventry-branded policies no longer exist. If you’re holding an old Coventry card or paperwork, the coverage now sits with Aetna under CVS Health.
The Company and What It Sold
Coventry was founded in 1986 and headquartered in Bethesda, Maryland. At its peak it covered roughly five million members through local health plans concentrated in the Mid-Atlantic, Midwest, Mountain West, and Southeast.
It was a diversified insurer rather than a single-product company. Its portfolio included individual and group health insurance, Medicare Advantage, Medicare Part D prescription drug plans, Medicaid managed care, workers’ compensation coverage, and network rental services sold to other payers.1U.S. Securities and Exchange Commission. Form 425 – Aetna Inc. Acquisition of Coventry Health Care, Inc. So a Coventry policy could be almost anything: an ACA marketplace plan bought by an individual, an HMO or PPO offered through an employer, a Medicare Advantage plan bundling hospital and medical benefits, a state Medicaid managed care plan, or a workers’ comp arrangement through a job.
Individual and Employer Plans
Coventry sold ACA-compliant individual plans in the standard Bronze, Silver, Gold, and Platinum tiers, and it wrote group coverage for businesses in both fully insured and self-funded arrangements. In the fully insured form, Coventry took the financial risk for employee claims; in self-funded arrangements, the employer paid claims directly and Coventry handled administration and network access.
Medicare and Medicaid
Coventry ran Medicaid managed care plans in select states and offered Medicare Advantage, the private alternative to Original Medicare that bundles Part A and Part B, usually with Part D drug coverage and extras like dental and vision.2U.S. Department of Health and Human Services. What is Medicare Part C?
Workers’ Compensation
Coventry also had a workers’ comp business that served employers. This line did not stay with Aetna after the acquisitions. It now operates under a separate company called Enlyte.
Who Owns Coventry Now
Aetna announced the Coventry deal in August 2012 and completed it in May 2013.1U.S. Securities and Exchange Commission. Form 425 – Aetna Inc. Acquisition of Coventry Health Care, Inc. The merger gave Aetna a larger Medicare and Medicaid footprint and expanded its reach into states where it had been thin. The Coventry brand was retired as policies renewed under the Aetna name, and most product lines were folded into Aetna’s existing offerings.
In November 2018, CVS Health completed its $69 billion acquisition of Aetna. As part of that deal, Aetna divested its standalone Medicare Part D prescription drug business to address antitrust concerns about overlap with CVS’s pharmacy benefit management operations. Aetna now operates as a subsidiary of CVS Health, so any former Coventry coverage that survived the first merger sits under the CVS Health corporate umbrella today.
The transition wasn’t seamless for every member. Some Coventry provider networks were merged into Aetna’s contracts, and some were renegotiated. Doctors and hospitals that accepted Coventry weren’t always part of Aetna’s networks, which meant some members had to switch providers or change plans. Individual policies were either discontinued or converted to Aetna-branded ACA offerings, and many policyholders had to re-enroll through Aetna at the next open enrollment to keep coverage. Medicare and Medicaid enrollees saw a mix: some rolled over automatically to corresponding Aetna plans, while others had to review new plan details to confirm their doctors and medications were still covered.
If You Still Have a Coventry Card or Records
Start with Aetna. It absorbed Coventry’s membership records, and its member services line can locate old policy information, confirm how a Coventry-era claim was processed, or direct you to your current plan if your coverage was transitioned automatically.
If your Coventry policy was workers’ compensation through an employer, Aetna is not the right contact. That business now runs under Enlyte. Your employer’s benefits administrator should be able to confirm who currently manages the claim.
If you have a dispute about how a Coventry-era claim was handled, or you believe coverage was wrongfully denied during the transition, you can file a complaint with your state’s department of insurance at no cost. Every state has an insurance regulator that investigates consumer complaints against insurers, including complaints about acquired companies. The National Association of Insurance Commissioners maintains a directory of state insurance departments.