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For Providers

Access to the tools you use most

Use the links below to access information for your Coventry Medicare patients

Prior Authorization & Exception Request Forms

All forms require the doctor's signature.

2017 forms

General Prior Authorization
Tier Exception
Armodafinil
Androgel
Aranesp
Hepatitis C
Lidocaine Patch
Linezolid
Lyrica
Modafinil
Ondansetron
Procrit
Regranex
Sildenafil
Tracleer
Zolpidem IR

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Our secure website can help you manage your Coventry business. There, you can:

  • View patient eligibility and benefits
  • Check the status of claims
  • View the National Precertification List (NPL)
  • Access your remittance

Aetna Medicare is a PDP, HMO, PPO plan with a Medicare contract. Our SNPs also have contracts with State Medicaid programs. Enrollment in our plans depends on contract renewal. 

See Evidence of Coverage for a complete description of plan benefits, exclusions, limitations and conditions of coverage. Plan features and availability may vary by service area.

Aetna Medicare’s pharmacy network offers limited access to pharmacies with preferred cost sharing in: Suburban NY and Rural ME, NY and UT. The lower costs advertised in our plan materials for these pharmacies may not be available at the pharmacy you use. For up-to-date information about our network pharmacies, including pharmacies with preferred cost sharing, members please call the number on your ID card, non-members please call 1-855-338-7027 (TTY: 711) or consult the online pharmacy directory at http://www.aetnamedicare.com/pharmacyhelp.

       Y0001_4006_8306 Approved 11/04/2016

       Page last updated: Dec 21, 2016

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  • - Send a secure message to Member Services
  • - Check your claims
  • - Get an ID card
  • - And more

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