Customer ReviewsforAvMed, Inc.

My precious healthy baby daughter had Avmed all her life, paid bi-weekly through a family plan. Unfortunately there was an issue with her health and the Avmed insurance refused to pay for necessary medications prescribed by the endocrinologist, stating she did not meet the criteria. Even had a peer to peer review with a medical director who is supposed to be a "medical doctor". I had to end up paying $1000/m. After a few months we switched to another insurance ... who did cover her medications with a $75 copayment in just the 1st of January as a new member without hesitation or appeals. Insurances should be "get what you pay" but after years of payments for a healthy person, once you need it, they don't cover anything. It is a shame. I am so glad I never spent another dime paying Avmed for nothing.

I’m so disappointed from Avmed, I’m a state of Florida employee I have a heart issue after I done a heart stress test the doctor want to know what is the real issue to treat me he send me to do some further test for my heart, Avmed denies the test in ground that I’m not obese I do not meet the their approval for the test it seem to me like if you are average wait and you have a heart issue you should die I still waiting I do not know what I have to and I’m suffering every second I feel I’m out of breath and any minute I’m going to die that company has no customers service when I call like it’s tough luck we stress not going to approve it they need me to pay for it and I can’t effort it shame on you Avmed very bad service you can contact me any time if you need more information

I have chosen AvMed through the Market place last year July 2021. In January 2022 I started to received bills from my doctor that AvMed refused to pay the invoice. I have used my tax credit plus making payments for the Gold plus. plan. Now AvMed says I was shorting paying my portion of my monthly bills. and the insurance was canceled since September 2021. As such I have been calling from January to present for a refund of $500 x 6 = $3000. And every time I am told that they will get back to me after putting me on Hold for hours. To this day this matter cannot be resolved.. Please I needed help.... Because all my doctors bills are piling up..

I would give AvMed a zero but the lowest is a one star. Where can I start (rhetorical question). First, if you have any choice at all, don't get AvMed. In plain English, they ****. They subcontract their authorization to a third party called eviCore. Their specialty is to deny outright, and them put you through their meat grinder. You're in pain, need authorization, and they delay and delay. They only accept medical records and orders from doctors via facsimile (fax) machine. And if you don't spell out all the redundant information in a certain format, they keep denying. They probably get bonuses for how many people die while waiting for their authorization. Out of the kindness of their heart, they offer a peer-to-peer interview. Meaning your doctor needs to talk with one of the butchers - I mean doctors, try to convince them why you need a test or procedure. This literally takes weeks, sometimes they can stretch it to months. If your doctor was kind enough to entertain them, they will argue with your doctor until he/she gets so tired they will just say, look, I spent almost half hour and I have other patients to see. No mater what, it's a dead end. And because AvMed contracted with eviCore, on purpose. I can go on, but I'm still waiting for authorization so I don't want to be any higher on their s*** list than I am already, and I'm running out of room here. So avoid AvMed at all cost, and ask whatever company to pick, if they sub out to eviCore.

Being denied Doctor required diagnostic test from Cardiologist. Due to ******* guidelines. Peer to Peer review has been done with the doctors office however doing CT scan only puts me at risk for more exposure. I would listen to the Cardiologist who has an all over view of my health rather than one person behind a desk.

I am unable to use the AvMed's $25 monthly OTC allowance. I spent nearly 2 hours on the phone and online last week trying to use this benefit. The representative promised to call me back after researching the problem. She did not. Today I called again at the number listed o AvMed's website and was disconnected twice without explanation.

Abolutely horrendous insurance company. I changed my family of 3 to this company just this year and boy do I regret it. It's March, and we've been members since January. In February, my 18 month old got a very basic prescription filled, no problem. In March, they tell the pharmacy it's not covered. I call that day, Monday, and they say no it's not covered and we need to get the pharmacy group to recommend a different medicine. "You should hear back by mid-day tomorrow" - and of course I didn't. Call #2 on Tuesday they say oh no the issue is that we never received your daughter's birth certificate. Was never notified that was an issue. Have been using the insurance for 2 months. I immediately send in the certificate over the messaging center and write VERY URGENT as instructed. "You should hear back by mid-day tomorrow" - and of course I never hear back. Now it's Wednesday, my daughter has been out of her prescription with the company I pay almost $1000 a month to for coverage for 2 days because "she's not cleared as eligible" - and we have filled THIS EXACT PRESCTIPTION in the last month. Call #3, I explain the whole situation and it gets escalated. "You should hear in an hour" - 4 hours go by before I make call #4. They say they can't help me as "it takes time." I finally get to a manager and she can immediately do the override - temporarily until midnight and if midnight comes I have to start this all over again. I ask her why the employees from 3 other calls don't know about this or even how to find what the real problem is - "hahah, I don't know!" she says. Wow. My kid's simple issue has now escalated to more extreme issue that may become infected because Avmed has sat on their hands for 2 extra days instead of pushing one button in their computer system. This is exactly why people hate insurance companies.

DO NOT TAKE THEIR INSURANCE! The first 2-to 3 months were amazing! My prescription never cost more than $10, my copays were under $10, free mental health and psychiatry visits. I set up Autopay, and all of a sudden their system "malfunctioned" and no payments were coming out. No one sent a letter, no one sent an email, no called me. I called in November because of a weird doctor's office statement, they said my account was great, called in December, because my doctors said my insurance wasn't working, and nope the rep said everything was great. January comes and now my prescription are getting denied! Called and two reps said my account was terminated and they can't do anything about it. I sent emails, no answer, I sent more emails, no response. Then I called again and the new rep said that their autopay had malfunctioned and EVERYONE was having that issue and IF I had called earlier I wouldn't be going through this. I informed her I did call earlier, and the reps never told me any of this. She said if I paid her for the month of January, all would be fixed. So I made a phone payment, got an Avemed receipt and she told me to wait about a week and it will be fixed. Wasn't fixed. Called again and the new agent said I owed 4 months of payment and that why didn't I set up autopay to remember. I DID HAVE AUTOPAY SET UP. I showed her the proof and she felt bad and said if I made a payment for the missing months then all could be reinstated and fixed. maybe the payment. A week later my doctors are calling me telling me Avmed wants all their money back and harassing me. I CALLED AGAIN RIGHT NOW, and they are saying it's too bad I paid because they can't do anything. I finally broke down crying and threatened lawyers and all of a sudden they are trying to help. AN ABSOLUTE HEADACHE. It is not the customers' fault if they were responsible, set up autopay, avmeds system crashed, and NO ONE informed customers, I learned I am not the only one. STAY AWAY, not worth the stress!