Coventry One - Maryland Health Insurance Quotes - Sensible and Affordable Plans for Families and individuals in Maryland
Click to Get Multiple Company Health Insurance Quotes. Click for Group Health, Life and Dental Insurance Quotes Click for Individual and Family Dental Quotes Maryland Life Insurance Quotes Disability Income Insurance Quotes Maryland
Maryland Health Insurance Plans - Get Quotes for Families and Individuals
Maryland Instant Health Insurance Quotes   Coventry One of Bethesda
Get Group Insurance Quotes, Medical, Dental, Life and Disability   Maryland Small Business Health Insurance Quotes, Maryland Group Dental Insurance Quotes, Maryland Group Vision  Insurance Quotes | Care First Blue Cross Health Insurance for Maryland Small Businesses, United Healthcare Mamsi Health Insurance Quotes,

CoventryOne 80% Legacy PPO $500 $1000 $1500 Deductible Plans | $30 Primary Doc Visit Copay

The Legacy plans offer very robust coverage with a $2,000,000 lifetime maximum. Unlike the Choice 80% plan, the Legacy Plans do provide coverage for Specialist visit without havington meet the Deductible ( You pay a $40 Copay). Chiropractic and Home Health Care services are also covered.

Plan Design In-Network Out- of- Network 
Get Coventry Health Insurance Quote For Maryland  
Lifetime maximum (per covered individual) $2,000,000
Deductible (per contract year)
- Choice of five deductible levels
$500, $1,000, or $1,500
(2x Family)
$1,000, $2,000, or $3,000
(2x Family)
Coinsurance Coverage pays 80%
You pay 20%
Coverage pays 60%
You pay 40%
Out-of-pocket maximum (per contract year) Deductible plus $2,000 coinsurance
You Pay
You Pay
PCP office visit $30 Copay Deductible plus 40%
Specialist office visit $40 Copay Deductible plus 40%
Preventive office visit Same as PCP & Specialist office visit
Mammograms & Well-Child Visits
- Not subject to deductible
$30 PCP Copay $40 Specialist Copay 40% Coinsurance
Emergency room services $200 Copay
(waived if admitted)
$200 Copay
(waived if admitted)
Urgent care services $40 Copay $40 Copay
Ambulance (emergent)
- When medically necessary
Deductible plus 20% Deductible plus 40%
Inpatient hospital Deductible plus 20% Deductible plus 40%
Outpatient hospital / facility (X-ray, lab, diagnostic services, MRI, CAT & PET scans, surgery, anesthesia, etc.) Deductible plus 20% Deductible plus 40%
Short-term rehabilitation services ( chiropractic , physical, occupational or speech) Deductible plus 20%
(up to 24 visits per contract year per service)
Deductible plus 40%
(up to 24 visits per contract year per service)
DME and Prosthetic devices
- Max. $2,000 per contract year per Member
Deductible plus 20% Deductible plus 40%
Transplant Services Deductible plus 20% Deductible plus 40%
Home health care
- Limit of 40 visits per contract year
Deductible plus 20% Deductible plus 40%
Skilled nursing facility
- Limited to 30 days per contract year
Deductible plus 20% Deductible plus 40%
- Inpatient limited to 30 days per contract year
Deductible plus 20% Deductible plus 40%
Prescription drugs* Maximum benefit $1,500 per contract year;
$150 pharmacy deductible per contract year
- Formulary generic drugs $5 Copay $5 Copay
- Formulary (brand) drugs $25 Copay $25 Copay
- Non-formulary (brand) drugs $50 Copay $50 Copay
Mental health and substance abuse

See Appropriate Schedule of Benefits
CoventryOne 80% Legacy PPO:

$500 Deductible Plans

$1000 Deductible Plans

$1500 Deductible Plans

  Exclusions and Limitations
*Your CoventryOne PPO benefit plan provides coverage for out-of-network services. Many out-of-network services are covered ONLY if they are prior authorized. You are responsible for making sure that any services you receive from a non-participating provider are prior authorized. When you receive out-of-network covered services from a non-participating provider, you must pay applicable copayments, coinsurance, and deductibles. In addition, in most cases, the non-participating providers may bill you for charges that exceed our out-of-network rate. This amount could be substantial. Balances above the Out-of-Network Rate do NOT apply to your out-of-pocket maximum. The Out-of-Network Rate is the maximum amount covered by Us for approved out-of-network services. This rate will be derived from either
• a Medicare based fee schedule, or
• a percent of billed charges as determined by Us.
We will base the development of the rate on the following:
• Non-Participating Physicians Fees.
The Out-of-Network Rate is equivalent to 125% of the then-current Participating Provider Fee-Schedule, based on geographic region.
• Non-Participating Facility Fees.
• Inpatient facility services will be paid at the rate approved by the Health Services Cost Review Commission.
• Outpatient services rendered in a non-Hospital facility are paid at either
• Our Non-Participating non-Hospital fee schedule, which results in approximately 72% of the 2004 Medicare reimbursement schedule for ASC’s (“Ambulatory Surgical Centers”). For a copy of this fee schedule, please contact Customer Services; or
• If Medicare has not yet priced a particular code, 60% of billed charges for such code.
When We determine the Out-of-Network fee schedule, We reserve the right to apply
• proprietary reimbursement guidelines,
• claim adjudication procedures, and
• billing instructions.
This is not a contract or a definitive statement of benefits. It is intended solely to provide you with an overview of the proposed CoventryOne benefits. Complete details of benefits, terms and exclusions are governed by your CoventryOne Certificate of Insurance. The CoventryOne Certificate of Insurance may not cover all your health care expenses. Read your Certificate of Insurance carefully to determine which health care services are covered. If you have questions call us toll free at 1-800-833-7423.

* 3x for 3 month mail order supply
Coventry Home | Choice 80% PPO Plans | Coventry Legacy Plans | 80% HSA Plans | 100% HSA Plans is located at 4800 Hampden Ln Suite 200 Bethesda MD 20814 Toll Free (888)490-8782
RxMom Home | About Us | Site Map | Privacy Policy | Contact Us | ©2003-2011 | Maryland Business List | Link Directory