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
Medication Exception Request Form
Optum Exchange of Information Form
Optum Mental Health Direct Reimbursement Form
PCP-Behavioral Health Communication Form
Pharmacy Member Reimbursement Form - AvMed pharmacy reimbursements are processed by CVS Caremark.
Rx - Mail Order Form - Spanish
Interoperability
Filing a Complaint - How to file a complaint with the Office of Civil Rights or the Federal Trade Commission.
Member FAQs - Information related to the factors enrollees should consider in selecting a health information management application.
Privacy - Strategies enrollees may use to safeguard the privacy and security of their data.