Request an Information Kit

Complete the form below to get an information kit for . Please allow 7 to 15 business days for delivery.

All fields marked with an asterisk ( * ) are required.

This page requires you to select a plan on the previous step. Return to the plan page and select a plan.

*First Name

*Last Name

*Home Address (enter the permanent address of the applicant)

*City

*State

*ZIP Code

By giving us your email address or telephone number, you agree to allow us to contact you. We'll give you details about our health plans, services and/or educational information related to health care.

If you enter your phone number, we'll call you in a few weeks during regular business hours. The reason for the call is to see if you have any questions or need help selecting a plan.

Phone Number

Re-enter Phone Number

Email Address

Re-enter Email Address

Do you want the information sent to another person or address?

Check the box to add that information

*First Name of Recipient

*Last Name of Recipient

*Address of Recipient

*City

*State

*ZIP code

Let us help you

Email us or call a Coventry representative at (TTY: 711), Monday - Friday, 8 a.m. to 8 p.m.

Have us call you

Schedule an in-home visit

Disclaimers

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.

Compare Plans & Enroll

How Medicare Plans Work

Find Doctors & Hospitals

Prescription Drugs

Live Well

For Members

Let us help you

You are now leaving the Coventry Medicare website.

You are now leaving the Coventry Medicare website.

You are now leaving our Medicare website.

What 2016 coverage do you need?

Select your plan to request a directory

What coverage do you have?

What 2017 coverage do you have?

Doctors & Hospitals

Mental Health Providers

What coverage do you need?

Choose a 2017 plan to enroll

Choose a 2018 plan to enroll

Choose a plan to enroll

Doctors, Hospitals & Facilities

Dental Providers

What plan do you have?