As an AvMed Medicare Member, you have the right to important information about your plan, including our financial condition. You have the right to have information about AvMed’s participating health care Providers and their qualifications, our Network Pharmacies, and how AvMed compares to other health plans. You also have the right to find out from us how we pay our Providers. Finally, you have the right under law to have a written coverage pre-determination for any service, even if you obtain this service from a Provider not participating with our organization.
For your convenience, please click on any of the items below to see more information. For items not listed here, please call AvMed's Member Engagement Center at 800-782-8633 (TTY 711).
- Provider Compensation Arrangement - Information regarding payment to participating Providers
- Appeals & Grievances - General report on AvMed’s appeal and grievances. For more specific information about how to file a grievance or an appeal, please call our Member Engagement Center at 800-782-8633 (TTY 711).
- Member Rights and Responsibilities - Your rights and responsibilities as an AvMed Member.
- Utilization Management - Information regarding AvMed’s medical management process, including services requiring authorization, the utilization management process, and establishing medical necessity for services.