Frequently Asked Questions

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Find answers to your questions here. We included the most common questions members ask us. If you do not find the information you need here, please call Customer Service at the number on your Member ID card.

General Questions

Website Help / Navigation Questions

Logging In Questions

Claims Questions

PCP Questions

Authorizations Questions

Member ID Card Questions

Provider Search Questions





General Questions

I received a lot of written materials with my member materials. Without having to read through all the documents, is there an easier way for me to find answers to my questions?

All of the materials you receive serve a very important role in explaining your benefit coverage. We strongly urge you to review each document. You may also find the answers to your questions through My Online Services. In addition, there is always the option of calling Customer Service at the number on the back of your Member ID card with any benefit questions you may have.

Why does my benefit coverage have a deductible and coinsurance in addition to the premium I pay, rather than just straight copays?

Coventry Health Care offers a variety of employee benefit plans including plans with in- and out-of-network benefits, copays and/or deductibles, and coinsurance. Each employer chooses the plan that will be most beneficial to both their business and their employees. Talk with your employer. There may be a different benefit option available that works better for you.

Coventry Health Care needs to be more consistent in the terminology they use throughout their documents. For example: Health Plan Name vs. Group Name vs. Plan Type.

Our goal is to ensure the materials are in an easy-to-read format and are consistent in the information they provide. However, we do understand that not all of this information is easily understood, and we welcome member feedback on ways we can make our materials more clear.

Health Plan Name, Group Name, and Plan Type are not interchangeable and have three different meanings.

Website Help / Navigation Questions

What is My Online Services?

My Online Services is a password-protected area allowing you access to a variety of functions including the ability to view your policy, view your claims/authorizations, change your PCP, change your address/phone, and view/print your Member ID card. You also have access to your Personal Health Record (PHR), health news, lab results and much more.

How do I get back to the Member home page from other areas of the website?

You can return to the Member home page from any point within the website by clicking the word “Members” located on the left side of the page. If you are currently logged into My Online Services, your member home page will remain open in a window beneath the secure site.

How do I get back to My Online Services after viewing other areas of the website?

You can return to the main My Online Services page at any time by clicking the My Online Services link and logging back into the secure site.

Logging In Questions

How do I register for My Online Services on your site?

Click the My Online Services link on the top right-hand side of the public website. On the Member Login page, click Register Now. Enter your member specific information as requested on the Member Registration page.  You will need your member ID # (which can be found on the front of your Member ID card, date of birth, zip code, and email address.  Be sure to review the Terms of Use and Privacy Policy.

What is my Login ID?

During registration, you will need to create a personal, customized Login ID., It must from 6 - 20 characters in length, and cannot be your member ID number.

Are my Login ID and Password case-sensitive?

Yes. Please be sure to retain your Login ID and Password for future access to My Online Services.

I forgot my new password. How can I get a new one?

Click the “Help?” link by the username and password fields on the Login page. From the Login Help page, select “Password”.  Enter your username and answer your Secret Question when prompted. A new temporary Password will be emailed to you.  Login using your username and the temporary password.  You will be prompted to choose a new password and then to confirm it.  If you cannot answer your Secret Question, contact the Net Support Team at the number listed on the Login Help page or in the Contact Us section of the website.

I am the subscriber (carrier of the insurance) and I can’t view my spouse/dependent’s information after logging in. What do I need to do?

Any information regarding your spouse and any dependent over the age of 18 is privileged. Even though you are the subscriber, your spouse/dependent must grant you access to his or her account in order for you to view his or her information. For dependents under the age of 18, instructions on granting subscriber access can be found in the question, "How can I access My Online Services for my dependents without having to log into each dependent's account?"

How can I access My Online Services for my dependents without having to log into each dependent's account?

My Online Services enables members to view health information (such as prescriptions and claims) for other family members regardless of age, as long as permission has been granted. 

These are the steps for one family member to grant permission to another.

1. After you have registered, login.
2. Hold your mouse over Member Info, on the navigation bar at top.  Under Permissions, select Family List.
3. Choose the family member to whom you wish to grant access, then select the level of access you wish to grant.  You may choose No Access, View Only, or Full Access.

You may also grant yourself access from another family member’s account (minor child, for example) by registering them, and following the steps outlined above from their account

After you have competed these steps once, you won't have to do them again.  This will enable you to see claim info for all those family members who have granted you access.

Note: Each member has their own account, and the subscriber may activate accounts for any dependent under 18 years of age. Dependents 18 and over have their own account and must grant the subscriber access on their own accord.

Claims Questions

I don't understand what the status means on my claim.

The claim status codes are described below:

  • APPROVED - An approved claim that has either been – or will be – paid in full or at a determined partial amount. Refer to detailed claim information available via My Online Services -- see the “Claims” menu option.  
  • REJECTED - A rejected or denied claim. There exists a number of reasons why a claim can be rejected or denied. Please refer to your Explanation of Benefits or call the provider for further explanation. Questions may also be submitted via My Online Services.
  • PENDING - A claim that has not reached its final status and is awaiting additional internal review. Questions regarding the status of these claims may be submitted via My Online Services.

My Online Services is the secure member area accessible by way of the My Online Services link on the top right-hand side of the public website.

If you have a question about a status other than those described, please use the 'Ask a Question About This Claim' functionality after clicking on the claim in question.

I was out of area and had to obtain medical treatment. How can I submit my receipt for consideration of reimbursement?

A claim form can be requested by sending us an email or you can call Customer Service at the number listed on the back of your Member ID card.

PCP Questions

Why can’t I find my PCP's name in the provider search?

The provider may not be contracted with us or may be in the process of becoming a part of our network. Our extensive credentialing process is designed to ensure the quality of our network providers. If your provider is new to our plan, please allow us time to update our systems.

Authorizations Questions

I’m not sure what services require prior authorization. Where can I find that information?

There are a couple of places where you can go to find the prior authorization list. You will find it included in your member materials and on the website under Network Coverage. If you still have questions, you can contact Customer Service at the number listed on the back of your Member ID card or have the ordering physician contact our Health Services department for further clarification.

I have Medicare as my primary insurance coverage. Do I still need preauthorization for Coventry Health Care as my secondary insurance?

Yes. To receive the maximum benefit, you still need to obtain a preauthorization for those services that require preauthorization. You should always use a participating provider when possible.

Why isn’t my recent authorization (referral) showing up in My Online Services?

Some visits to specialists do not require an authorization "number". Only services that require a number will be shown. If the service you are going to receive requires an authorization "number", your physician may not have requested the authorization yet or the authorization may be in our review request process. Please contact the requesting physician to verify authorization has been obtained if needed.

I don't understand what the status means on my authorization.

The authorization status codes are described below:

  • APPROVED - An approved authorization.
  • REJECTED - A rejected or denied authorization. There exists a number of reasons why an authorization can be rejected or denied. Please call the provider for further explanation. Questions may also be submitted via My Online Services.
  • PENDING - An authorization that has not reached its final status and is awaiting additional internal review. Status questions may be submitted via My Online Services.

My Online Services is the secure member area accessible by way of the My Online Services link on the top right-hand side of the public website

If you have a question about a status other than those described, please use the 'Ask a Question About This Authorization' functionality after clicking on the authorization in question.

Member ID Card Questions

I need a replacement Member ID card today. Can I print a copy of my card to take with me?

Yes, a printable card is available by going to the “Member Info” menu, and choosing the View ID card link on My Online Services. A printed image of your Member ID card is an acceptable form of ID in the interim while awaiting your new card in the mail. You may request a permanent replacement card by going to the “Member Info” menu and selecting Request ID Card from the My Online Services site. My Online Services is the secure member area accessible by way of the My Online Services link on the top right-hand side of the public website.

My Member ID card is printing incorrectly to my printer. What can I do?

The issues associated with your Member ID card printing incorrectly are entirely dependent upon your "Print Setup" properties in Adobe Acrobat. If your card is being cut-off, the two choices in Acrobat are to change to landscape or more appropriately to select the "scale to fit" setting which will contract or expand to your printer's margins.

Provider Search Questions

How do I find a specialist in my area?

You can find a specialist in your area by choosing the Provider Search link from the left navigation area of your screen. Enter the Provider Search and answer the questions to find a participating provider in your area.

I am interested in a particular doctor who indicates they are a part of your network. However, I can’t find this physician on your provider search.

The physician may not be contracted with us or may be in the process of becoming a part of our network. Our extensive credentialing process is designed to ensure the quality of our network providers. If your physician is new to our plan, please allow us time to update our systems.

Do I need to log on to My Online Services (the password-protected area) to see what providers are in the plan’s network?

No, the provider search is located on the public side of the website, which is available to all users.


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