AvMed Medicare Choice HMO Review

AvMed Medicare Choice is a Medicare Advantage plan offered by AvMed in Florida.  It is only available in Broward and Miami-Dade counties.  AvMed is a health insurance company in Florida offering group, individual, and Medicare insurance.  They promote a large network of providers as well as providing a high level of service.  Since the plan is an HMO, you would definitely want to verify that your providers are in their network before becoming a member.  Medicare Advantage plans can be a nice alternative to having Original Medicare and a Part D Drug plan.  Let’s look at the main benefits that the plan offers:

AvMed Medicare Choice (HMO)

  • Premium – $0
  • Maximum out of Pocket – $3,400
  • Referral required for specialists
  • Hospital copay – $0/day, Days 1-5; $100/day, Days 6-23
  • Doctor’s visits – $0 – Primary; $25 – Specialists
  • Outpatient Surgery – $25 – $100 copay
  • Labs – $0 copay
  • Diagnostic Procedures and tests – $0 – $100
  • X-rays – $25  copay
  • Part D Deductible – $0
  • Part D Drugs – Tier 1 = $0; Tier 2 = $20; Tier 3 = $50; Tier 4 = 33%
  • Plan covers many generics during the coverage gap

AvMed Medicare Choice Additional Benefits

  • Dental – Exams are $0-$20 copay; Cleanings are $0-$45 copay; X-rays are $0-$35 copay; Also offers comprehensive dental benefits
  • Hearing – Routine hearing exams not covered
  • Vision – Eye exams $5 copay and glasses are $10 copay
  • No Over the Counter benefits or transportation offered
  • Silver Sneakers Gym membership included

Note:  This plan does something very unusual for Medicare Advantage plans.  Instead of charging a hospital copay for days 1-5, they charge the copay for days 6-23!  Don’t let this alarm you to much though.  In fact, I like this format.  The average hospital stay is 2-3 days which would mean in most cases you won’t have a copay for hospital stays.  Even if you ended up in the hospital for a month, keep in mind that you have a $3,400 Maximum Out of Pocket that would kick in!

Medicare Part D


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