South Florida HMO filter...
March 27, 2010 1:53 PM   Subscribe

Which South Florida HMO should I pick? VISTA, AVMED, United Healthcare - any reviews ones to watch out for etc...

My family (me+spouse+2 small kids) are moving to South FL. and have to leave the embrace of our socialized university health plan and enter the daunting world of HMOs. We have a choice of a BCBS plan or one of three HMOs: VISTA, AVMED, or United Healthcare. We're likely to avoid the BCBS plan since it only covers a percentage of care including hospitalization - we've had a couple of completely unpredictable hospitalization and surgery-required situations in the past few years that in that plan would have resulted in bankrupting bills for us. That said does anyone have personal experience to share about any of these three HMO plans?
posted by dorcas to Health & Fitness (2 answers total)
Best answer: I currently have AvMed HMO Open Access through my dad's local government employer. I'm 25 and live in South Florida.

I'm not sure how AvMed differs between plans purchased through work and plans purchased by an individual. (My card says AvMed Self-Funded Options, ?)

I only have great things to say about AvMed; last year I had a couple of unpredictable hospitalizations and surgery myself totaling an amount of over $80,000; AvMed covered 100% of ALL costs. Even the low $25 ER out-of-pocket fee was refunded to me because I was admitted.

I never even received a call or letter from AvMed; no paperwork, no hassle. The only bill I received was a $300 balance from the hospital because apparently there was just one procedure or doctor who saw me who was apparently out of network and was not necessarily covered by insurance; but a quick call to the hospital's billing department yielded a positive reaction from the clerk who said to me "I will send in an appeal; and AvMed will most likely cover it, they usually do." She also said that there was no need to follow up from my side, and that she would let me know if anything is still owed... I remember following up with the clerk some weeks ago and it was all covered by AvMed shortly after she appealed it last year.

Even the small things have been easy and paperwork free with AvMed. My flu shot and swine flu shot were also covered and because AvMed has electronic billing with either CVS or Walgreens (can't remember) I just had to show my card and not have to worry about later getting reimbursed.

We also had United Healthcare some time ago and while I don't remember having any issues myself with them; my dad remembers having a hard time getting an MRI approved by them.

Hope this helps and all the best to you and your family on your upcoming move!
posted by MrBCID at 6:29 PM on March 27, 2010 [1 favorite]

Response by poster: Thanks MrBCID, that's very helpful
posted by dorcas at 9:48 AM on March 29, 2010

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