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Referrals Required on Advantra HMO Policies

Tuesday, May 19 2015 10:58 AM

Referrals Required on Advantra HMO Policies

 

Effective January 2015, Advantra HMO policy holders must obtain a referral from their primary PCP.  According to Coventry, Chapter 3 under 2015 Evidence of Coverage for Coventry Medicare Advantage Total Care (HMO), Section 2:  "Using the plan's coverage for your medical services", the policy states a PCP must coordinate and approve in advance for certain types of covered services, requiring a referral on the following:  x-rays, laboratory tests, therapies, care from doctors who are specialists, hospital admission, and follow-up care.  For further information, please contact your local Coventry healthplan or you may follow the link below.

 

http://coventry-medicare.coventryhealthcare.com/web/groups/public/@cvty_commoncontent/documents/policyspecification/a300359.pdf

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