AvMed
Reviews and Complaints

I have an x-ray showing I have no disc left between two vertebrates and my lumbar spine. I'm in severe pain and cannot sleep at night. My doctor ordered an MRI and it was denied as unnecessary. I paid extra money to upgrading my plan so but I don't have this problem. I'm going to save myself $400 a month and go back to the basic plan. Don't spend your money on avmed it is a total ripoff. Maybe I'll get an attorney and sue them.

I went to fast care and they could not find my insurance information even with the card. I paid for the service as it was late and I wanted to go home.

When asking for the money back, I sent all documents required which got sent to me via mail saying I had the wrong address (Which is the one they still provide) I also faxed the documents but they never received them. When asking for the fax #, it was correct. I called and they told me I needed to send it again which I did, via fax and by mail, I also called and made a claim under their website.

When I called 3 weeks later, the rep told me they did not even look at my claim yet and they were going to scale it and that they were going to follow up with me. They never did so I called again and the Rep told me it was escalated but had no answer.

What does it take for someone to take care of this issue once and for all? Very disappointed of this insurance

After a stress test done by my doctor because i have difficulty breathing the test show something blocking my heart to know what is it the doctor advise me to MRI for my heart to know what is going on and to be treated but AvMed denying the request because I'm not obese, after several contact to their representative that they can't help me or do any suggesting what i have to do and in mean time I'm suffering from breathing and AvMed they do not want to approve the request from my doctor.

it's a bad service they do not care only they want to make profit from the state employees shame on you AvMed.

Since February of 2022, I have contacted Avmed member service as well as my PCP contacting provider service since last year. I am currently enrolled in the Entrust plan, My PCP is Dr Cepero, the only problem is that Avmeds provider service has not accepted him in the Entrust plan even though he shows as my pcp. I have been unable to get any referrals from his office as Avmeds system will not allow him because provider service has not or will not accept him. I have had to pay to see my PCP, as well as having to pay the other providers/specialist because I cannot get anywhere with Avmed. Avmed has been paid in full for insurance coverage, yet I am unable to get medical service under this policy. I have serious medical conditions and yet I can't get medical treatment via this policy. I am desperate to get this issue resolved. I need someone from provider service as well as member service to just add this Dr in the Entrust plan. I cannot afford to continue to pay for office visits while i have a medical plan that refuses to resolve this simple issue. I am trying my best to be patient; however, it's been well over 6 months, and nothing has been done to resolve the issue. I NEED HELP. I do not want to end up in a hospital or have my condition worsen just because they are not doing what they are supposed to do. The photo of my hand is just an example of why I need to go see my Drs, it is excruciating pain that does not allow me to sleep, it is unbearable.

Could not get rescription filled at in network pharmacies - Sams, Walmart will not fill pain meds pharmacist told me I called CVS and pharmacist told me it would be at least a week IF they could even get the meds- He suggested to fill where I had been filling for over 5 years so I would NOT run out- I called Avmed the day I came back from my monthly dr appt and asked what to do as I am disabled and without that script I will be in the Hospital I was told do what you need to do and I will send you out a Reimbursement form ( which she did) - I filled at walgreens and used my goodrx card bringing bill to $56 instead of over $100- I faxed in everything AVMED requested- few weeks went by and I received a check for $48 ( said it was the max for reimbursement) By then it was time for next month refill and the same thing happened - This time they are telling me they WILL NOT REIMBURSE ME- Still these meds are NOT available at in network pharmacies - they are strictly controlled and you can not get them just anywhere- I have called numerous times and talked to supervisor at regional office and they tell me they can NOT reimburse me - What about my rights? Also since I am disabled I am covered under the ADA laws and my rights are being violated - after 2 months of AVMED I switched to another insurer to avoid this problems and stress - PLEASE HELP ME GET MY MONEY-

I have been trying to resolve this for 2 years now. Two years ago had a mammogram at Memorial Hospital. WRONG id # was input and Avmed denied payment. After several calls to rectify the situation, I was told 5 times this will be taken care of. Two years, and a collection agency later, Avmed has still not paid. Donna, a rep with Focus Financial (a collection agaency) called me again this morning to ask if I could call Avmed AGAIN. On May 5th, Donna with Focus was told by Anna, an Avmed rep that this will be taken care of AGAIN. Donna has also been told for the past 2 years this will be taken care of.
I called Avmed and after 17 minutes I decided I dont have time to "hang" on all day. I've been "hanging" for 2 years.

Reference # [protected]
ID#A1076140400
Hospital Billed Under [protected]

I called 3 times to request doctor directory and drug formulary because I need to find new doctor since you have to request this information. Have not receive it yet. I guess I will not get it. Wanting for you to to prove me wrong. I think you see us as dollar signs and not as customers. I do not know how to get this information if you wont send it to me so you leave me no chose but contact medicare to find why.

To whom I may concern:

I'm a retired Miami Dade Police Officer who has been with Avmed for the past 30 years or so. I never had an issue with the insurance that in matter fact think is the best insurance around. My problem began after turning 65 and obtaining Medicare in December. Either I was provided wrong information which now is creating problems to me and my wife. I have been trying to reach Avmed for the past three-four days unable to do so. Every time I call, I'm placed on hold, listening to your recording specially if you're listening to it for an average hour. They always advised the wait time is an hour due to many calls. Woke up at 2:30 AM this morning to speak with someone because it said you're available 24/7. No luck, I left a message to be contacted, haven't been contacted. This morning I try to contact early in the morning, I was placed on hold for more than approximately 15 minutes time given that someone would respond. The wait lasted approximately 30 minute or so then I was disconnected from the call. Subsequently I attempted to e-mail you for assistance, no luck either they couldn't find my ID number nor my social security number in the system. My wife and I are in need of medicine for the last three/four days. CVS said which started all because I'm enrolled in Medicare I need a New cards, which I had already ordered. Somehow my prescription are not been covered. Could someone contact me please to resolve this issue. [protected]. Thank you

AVMED will not pay for my very ill husband to receive a swab test at his doctor's office. He must take the prescription and TRY to get an appointment at a drive thru testing site. In Palm Beach County, the drive-thru is booked for the foreseeable future. The Dr. office HAS THE TEST on site. Why make us wait for who knows how long for an appointment AND sit in a car for hours with someone who has symptoms? Stupid policy during a pandemic

I am disgusted by the lack of interest in providing quality customer service by a so called Linda in the intake/clinical review team. I am shocked. I have never felt so unsatisfied with an insurance company's customer service that I don't even know how to begin or what to say. I am literally shaking of how upset Mrs. Linda has made me. I called in to check/confirm that my fax has been received for a surgery scheduled on Monday for a patient and was transferred by Audrey to Linda who spoke to me in a very disrespectful tone. I understand that they are working a day behind but seriously you have to be friendly and helpful to your customers. Her attitude is unacceptable and should not be a representation of what Avmed stands for. All I wanted was a confirmation that my fax was received. She is very unhelpful. She quickly transferred me to Simone Hunter who was unavailable so I couldn't even speak with a manager about her nasty attitude and this is why I am posting this message. No one should be treated like this in any industry for following up or needing a confirmation or in any case for that matter. WE ARE YOUR CUSTOMERS! I am very disappointed. Fortunately, I called back again and spoke with Jesse. He has always been very helpful and kind and willing to go out of his way to get an answer as quickly as possible. Avmed should be proud to have him working for them. I hope something can be done about how Linda handled this situation.

very bad service takes for ever to get a rep. The rep took fo ever to get my info

He could not even provide. fax number for Dr to get authorization.
Had to look it up, than put me on hold to ask someone for it!
Never came back on the line.

I spent three days previously trying to get customer service.

The reps have little knowledge about AvMed services, and are rude.

Date: 10/17/2017

I called 2 times and held for over 10 minutes each time. I spoke with a representative by the name of Carla in the provider services department who would ask what I was calling about and then rudely directed me to the website. Upon trying to navigate through the website Carla hung up on me to talk to another representative. The second time Carla hung up on me she asked me what I needed and put me on a soft hold or in other words muted her phone. I said hello 5 times before Carla hung up on me again. I called back and followed the prompts to a different department to receive help form representative Pam L. Who was wonderful and did all she could to help. I would really like for Carla to be reprimanded for job negligence. I do not appreciate being hung up on when I am trying to help service a patient.

I have been going to this office for years. Have seen two different doctors who have both left. I called to make my annual appointment, which I need in order to get prescription filled. Was told no other doctors left except Dr. Santiago so I made an appointment with her. The appointment was cancelled due to Hurricane Irma (understandable). When I called to reschedule the office staff advised she only had hours a few days over the next two weeks and I would have to wait until October. I asked if they could call in a one-month prescription until I could get in. Absolutely refused. Office manager reiterated refusal and Dr. Santiago refused to speak to me. Left a message with Director of Operations, M. Pulan and received a message back at approximately 6:00pm. Called her back for two days and never heard back. Refusing patients medication due to circumstances beyond my control. This is the WORST experience with a Dr. I have had with AvMED.

A1077888800 On May 9, 2017, I paid $25 because Doctor Marvin Stein of Margate, Florida detected blood in my urine and he wanted me to have my kidneys and bladder examined with an Ultrasound.I contacted Doctor Stein repeatedly and he and his staff failed to notify me of the test results that were done at Cardio Nuclear in Margate, Florida.I repeatedly contacted AvMed and they have failed to help me out in a timely manner(I spoke to a lady named Ana). I notified AvMed the third week of May 2017 of my problem and I have continued to do so several times.I plan to go to a different Medicare health provider starting in January, 2018 and hopefully I will be treated with greater respect. Sincerely, Barry Isaac [protected]@hotmail.com

Our group has been a loyal client for years with AvMed. For the first time our payment was received late and they canceled our policy. Even after receiving our payment and posting the payment for 2 weeks they refuse to activate our policy until they received a wire transfer! We showed proof of another payment that was sent out and still they refuse to help us. I wrote numerous emails begging for help with explanations that we had a toddler needing medical attention and a member seeking prescribed medication and premium services did nothing. So much for being a loyal client and actually paying on time the other 11 months of the year. Thanks AvMed Premium Services for actually taking any of our emails into consideration.

I've been with AvMed since November of 2015. They have never paid for any of my visits to my PCP or specialists. They also never paid for a liver scan I had this year. The excuse they give is that I have a primary insurance that should be covering those visits. If that is their reasoning, why are they paying for my prescriptions and blood work?
My spouse and I have contacted them about non-payment at least 5 or 6 times. Every time except once, they told us they would fix the problem. The one exception was when a male told me they needed proof that I didn't have a primary insurance. He also told me they had no record of ever contacting them.
The last time my spouse contacted them, he was told that we have Humana as our primary. He informed them that was through ACA and we discontinued that when we got AvMed through his employer. They said they would fix the problem and pay our outstanding bills.
That was two weeks ago and we are still getting bills.

AvMed is discriminating against my son. He had the HPV vaccine back in February and April, the next one is August and AvMed is declining payment for them because according to them they only pay for girls not boys. These vaccines are preventive medicine and it should be cover under the policy for both boys and girls. Girls do not get std's by themselves!

Due to a job change we have AVMED, I went to the pharmacy to renew a prescription and AVMED refused to cover it. They say I need a form filled out by the doctor. I have run out of the medicine and in pain. I called AVMED and asked for help and what I should do. They recomended I go to the ER.

It is insane to not authorize a needed prescription, to contain costs, then recomend the ER which will be thousands of dollars. Likewise my condition is worsening which may infact cost more.

This company does not care about it's clients, I recomend to stay away if you can.