Sales: 800-390-9355 (TTY 711)
Current Members: 800-477-8768 (TTY 711)
Hours: Monday-Friday 9 am-8 pm
Forms
AvMed makes it easy to manage your account by providing forms and other tools for making requests. Simply print and fill out one of our pre-composed forms for quick, easy service. Certain requests can be submitted directly online.
Individuals and Families
Designated Record Set (DRS) Request
Medical Direct Member Reimbursement Form
Pharmacy Direct Member Reimbursement Form
Magellan Mental Health Direct Member Reimbursement Form - Use this form for services received on or before 12/31/2020
Optum Mental Health Direct Reimbursement Form - Use this form for services received on or after 01/01/2021