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My husband's company chose a Coventry policy for 2015. I swore I would never again put myself through the stress of having them as my insurance provider (and thankfully, they are only my secondary this time).

We filled out their application including all current treatments and medications. A couple of my medications required authorization, but they were all on their approved list. We were told there would be a 30-60 day grace period where they would cover these medications while they went through their authorization process. We were also told that since I had been on these medications for years that there shouldn't be any issues with getting them approved.

2 weeks after the start of our policy (Dec 2014) I went to pick up 2 of my medications. Both went through without a problem. 1 week later, I went to pick up the rest of my prescriptions and both of my pain medications were denied. My husband called Coventry and they offered to cover 1/2 of 1 of the prescriptions (which voids out the other half) because they have a limit of how many pills I can have filled (which potentially only gave me a 2 week supply to last a month). After a lot of arguing, they approved 10 days worth of the other prescription. The prescription that they limited wasn't supposed to even need any special authorization. The other one had already been denied, so there was no grace period at all.

My doctor sent in further justification for these medications, but they were denied again. I get home to find that I have a letter from them stating that they were also denying coverage for one of the first medications I had picked up.

They sent me a laundry list of medications that I was required to try first. Any that applied to my condition I had already tried. Others simply were not appropriate for my condition or were not safe for me due to other medical issues.

This is Coventry folks! This is what they do! Read their policies closely! They have a million conditions that have to be met and even then they always leave themselves a way to get out of actually paying claims. They can deny services for any reason they want and they absolutely will deny services. Ironically, I might not have even needed to be on any of these medications had it not been for Coventry denying me every form of treatment following an injury over a decade ago! They denied both surgeries that were to hopefully prevent paralysis because there was "no proof the surgery could prevent it" (only chance I had though) and then they approved 6 physical therapy sessions for me to basically learn how to walk again before they decided I wouldn't benefit enough from PT to be worth the cost. There was no way I could afford the care I needed without insurance helping & I couldn't qualify for assistance because I had insurance!

By the end of that year I was nothing more than a drooling vegetable that couldn't even take care of myself. Once we got rid of Coventry and got with a real insurance company, I was able to see the best doctors, get my medications right and spent years in physical therapy. I can now walk normally, think clearly and have a decent quality of life even with permanent spinal cord damage. I've had Coventry again for 30 days now and they've denied everything other than 2 cheap prescriptions and they want to undo everything I've accomplished while I had great insurance. They've lied by claiming my doctor hadn't sent in the justification forms and that they had not denied my medications a second time, but I read the denials in person at the doctor's office and a few days later copies were in my mail!

Coventry has been doing this to people for well over a decade now (just from my experience) and they have obviously been rewarded financially for it. I'm fortunate to have Medicare so Coventry can't call all the shots (it won't stop them from trying though) and I can pay for my prescriptions without their help (but I shouldn't have to) while they enjoy my premiums. I would be in a world of hurt right now if this wasn't the case. All 3 of the medications that they denied are medications that you aren't supposed to just stop taking (can cause all sorts of things including death), yet they denied all 3 at once without notice and without any concern for the consequences to my health.

I liked Coventry just fine until I got hurt and needed my insurance to pay for more than a routine office visit. The things they pull should be illegal and I am checking into that as well as filing complaints with the State Insurance Commissioner's office. I'm hoping others will do the same so we can stop Coventry from continuing to treat people like this. I've never had any other insurance company even come close to being this bad. On a 5 star scale, I couldn't even fill in a single point on a single star. Coventry is worthless when you really need your insurance for something major! They don't let doctors do their job and they have nothing except excuses for covering your medical bills. In their defense: It took 1 1/2 years of fighting with them, but they did eventually pay for my surgeries, but I was responsible for payments until they finally paid their share (or my credit would have been trashed).

Reason of review: Not as described/ advertised.

Monetary Loss: $400.

Preferred solution: For them to cover my medical bills and let my doctors do their job of providing my care instead of jumping through hoops to please Coventry.

Coventry Health Care Cons: Absolute worst insurance ive had.

Location: Des Moines, Iowa

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Guest

I too have had a recent claim denied when I contracted Sepsis (sp?) from an infection. They couldn't be bothered by the fact that I could have died.

Guest

Have had multiple friends who have been denied surgery despite several specialist recommending surgery. What they are doing to maximize their profit should be criminal

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