1- On a maternity rider, is the waiting period 12 months from the date of conception or delivery ? The 12-month waiting period is from the effective date of the policy , or from the effective date of the addition of the Maternity Benefit Rider, if added at a later date
2- Are referrals required for office visits with an in-network participating specialist? No .Members have direct access , with no referrals , to any participating specialist
3- When are authorizations required ? Prior authorization is required for some services including all inpatient care ,complex diagnostic testing ,dialysis and transplant services ,certain drugs and non-emergency transport services
4- Does AvMed offer Individual Health members access to a national network of providers? The national network consists of a separate network ,provided by Private Healthcare Systems ,Inc.(PHCS) ,that members can access when seeking care outside the AvMed service area, either in Florida or nationwide .Covered services will be paid at the in-network level of plan benefits
5- Is there a co-payment saving with Rx mail order ? Yes .A 90 day supply for two months of co-payments is available
6- Does AvMed offer emergency worldwide coverage? Yes. AvMed will ensure traslation and processing of claim
7- Will each dependent covered in a family plan receive an AvMed ID card? Yes .Each enrolled member will receive a separete ID card
8- Are credit cards accepted for initial and ongoing premium payments? Yes, credit/debit cards are accepted for initial and ongoing premium payments .To make a payment by phone (bank draft or credit/debit card)
9- Will members receive electronic billing statements ? Yes AvMed Individual Health members will receive , via e-mail, an electronic invoice by the 20th of the month before the due date .Premiums are due on the Ist of the month .However ,members can contact Member Solution and request paper billing statements .When filling out an application ,the member can now request paper billing date from the Ist to 15th786-259-0067
source: avmed agent guide
