Member Resources

All of your bills can be viewed and paid from the dashboard of the Member Portal. Not registered yet? Learn How to Register for the AvMed Member Portal and get other New Member Tips.

Alert: Effective, November 1, 2023 PCP to specialist referrals will resume for the following plans:

• AvMed’s Engage and Entrust Individual and Family plans
• AvMed’s Medicare Advantage Plans Choice, Circle and Premium Saver plans

AvMed’s Engage and Entrust Individual and Family plan Members are required to obtain a referral from their PCPs for most Specialist appointments. View the list of specialties requiring a referral.

When you receive services from an in-network provider, your provider will generally file claims for you. If your provider does not file your claim for you, you can call our AvMed Member Engagement Center at the number on the back of your ID card and ask for a claim form of the right type:

• Medical Claim
• Dental Claim
• Pharmacy Claim

Claims must be submitted and received by us within 12 months after the service is provided to be eligible for benefits.

Medical Claims

AvMed
Attn: Member Reimbursement
PO Box 569008
Miami, FL 33256

Download Medical Claim Form

Dental Claims

Delta Dental
PO Box 1809
Alpharetta, GA 30023-1809

Download Dental Claim Form

Pharmacy Claims

AvMed
PO Box 569008
Miami, FL 33256

Fax: 352-337-8737

Download Pharmacy Claim Form

Find a list of covered medications on our Prescriptions page, or log in to the Member Portal to find details specific to your plan.

To order a new card and also print a temporary one, log in to your Member Portal. Your new card will take 7-10 business days to arrive.

Log In to the Member Portal.

Before you can start using your Member rewards or take advantage of our discount program, you must take a Personalized Health Assessment (PHA), a short questionnaire that evaluates your nutrition, physical activity and overall health.

It takes 10-20 minutes to complete and can be found in the Member Portal.

Log In or Register at the Member Portal.

AvMed Members enjoy the highly personal touches of a regionally focused health plan without the sacrifices you might expect. AvMed has consistently rated above our statewide competitors for overall satisfaction with health plans, according to the National Committee for Quality Assurance (NCQA).*

• AvMed provides personalized Member Engagement and 24/7 Nurse On Call support.
• AvMed’s focus on service excellence is appreciated by clients, some of whom have been with us for decades.

*Highest overall rating of statewide plans reporting Health Maintenance Organization (HMO) and Point of Service (POS) product data to the National Committee for Quality Assurance (NCQA) for the Consumer Assessment of Healthcare Providers and Systems (CAHPS). CAHPS® is a registered trademark of the Agency of Healthcare Research and Quality (AHRQ).

We help our Members to live a healthy, more active life. WELLfluent™ is our holistic approach to overall wellbeing. Empowering Members with the resources and tools to improve and maintain personal health is a priority for AvMed.

• Members receive education and incentives to participate in a wide range of wellness and prevention programs, as well as complementary and alternative medicine programs.
• We provide our Members with decision-support tools to help them make better healthcare choices and save money.
• For members with chronic conditions, such as asthma, diabetes and heart disease, our highly trained care team offers individualized attention and education information to help Members manage their health.

Regardless of service area, our Members have access to a broad network of doctors and a wide array of comprehensive Care Management programs for those living with chronic diseases and complex medical issues.

• We have a broad network of specialists, flexible authorization policies and plans without referral requirements. We make it easy for Members to access this fine network of doctors.
• AvMed continually evaluates service and network providers to offer the highest quality healthcare.
• We emphasize efficiencies that help control healthcare costs for Members and society at large.

Find a Doctor

To learn more about the authorization and appeals processes, view the Empowering You to Secure Services Under Your Benefit Plan document.