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AvMed
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15 complaints
2 resolved 13 unresolved
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S
1:23 pm EDT
Verified customer This complaint was posted by a verified customer. Learn more

AvMed - Prescription reimbursement

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-

Desired outcome: just want to get reimbursed and help others going through this problem with their prescriptions - AVMED also got paid for my policy premium over $1700 for 2 months - there is no excuse for this

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M
11:20 am EDT

AvMed - Failure to pay Memorial Hospital from 2019

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 # 00540060
ID#A1076140400
Hospital Billed Under 005016187249

Desired outcome: Pay what is owed to Memorial Hospital

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D
1:24 am EDT

AvMed - Doctor directory and drug formulary

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.

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B
12:22 pm EST
Verified customer This complaint was posted by a verified customer. Learn more
Featured review
This review was chosen algorithmically as the most valued customer feedback.

I have been trying to reach your customer service, a person/human to talk to and get assistance about my benefits for the last 4 days and all I get was the same recorded message of the wait is "an hour and use our online".. No matter what time of the day I call.. After 4 days of trying, I had to call the headquarters of avmed hoping to speak with a person...

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A
6:26 pm EST
Featured review
This review was chosen algorithmically as the most valued customer feedback.

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...

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K
5:56 pm EDT

AvMed - Lack of covid-19 support

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

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L
12:47 pm EST
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This review was chosen algorithmically as the most valued customer feedback.

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...

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B
2:09 pm EDT
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This review was chosen algorithmically as the most valued customer feedback.

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.

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C
3:18 pm EDT

AvMed - unprofessional customer service representative

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.

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2 comments
E
Oct 04, 2018 6:17 pm EDT

terrible customer service, , asked if my plan was being re breed could not tell me. got letter in the mail. they had the info. worthless rep to lazy to look it up.
Terrible web site

E
Apr 13, 2018 2:32 pm EDT

terrible customer service. The web site is difficult to log into. It took months to set up log in. one one could help me. has constant issues.
I called on 4/13/2-18. rep could not understand me. repeated all info several times.
been with av med 1 1/2 yrs dissatisfied with customer service.

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P
8:07 am EDT

AvMed - dr santiago - florida hospital physicians group - tampa

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.

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B
2:22 pm EDT

AvMed - failure to notify patient of medical test results

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 [email protected]

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L
11:30 am EST

AvMed - Group policy

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.

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J
9:48 pm EDT
Featured review
This review was chosen algorithmically as the most valued customer feedback.

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...

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C
9:12 pm EDT
Resolved
The complaint has been investigated and resolved to the customer’s satisfaction.

AvMed - services not paid

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!

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Resolved

The complaint has been investigated and resolved to the customer’s satisfaction.

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7:05 pm EDT
Resolved
The complaint has been investigated and resolved to the customer’s satisfaction.

AvMed - Refused to cover prescription

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.

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Resolved

The complaint has been investigated and resolved to the customer’s satisfaction.

1 comment
B
Sep 02, 2018 1:01 am EDT

the number phone has too many prompts. always hard to get through.
Reps do not listen. Have to repeat many times. very frustrating.
I find the reps do not listen to customers

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+1 800 882 8633 +1 800 782 8633 More phone numbers

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www.avmed.org
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