Networks change. We verify your specific AvMed plan before your first visit; call with your member ID and we will confirm benefits, copay and any referral or authorization requirements.
Also appears on cards as: AvMed Health Plans, AvMed Commercial. Offered in Florida.
AvMed is a Florida-based nonprofit health plan founded in Miami in 1969 that serves employer groups, individuals and Medicare beneficiaries, with its strongest presence in South Florida, the Treasure Coast and Central Florida. AvMed offers HMO, POS and PPO products, and its Medicare Advantage plans are available in Miami-Dade, Broward and Palm Beach counties. Behavioral health is covered under parity rules, and AvMed does not require a primary care referral for in-network outpatient mental health visits, even on HMO plans. A psychiatry visit is typically a specialist copay, often $30 to $60 for commercial plans and $0 to $45 for Medicare Advantage, or coinsurance after the deductible on high-deductible designs. Telehealth psychiatry is covered at parity for members located in Florida.
AvMed's medical policy for transcranial magnetic stimulation covers TMS for major depressive disorder when you have had an inadequate response to at least two antidepressant trials and psychotherapy, with prior authorization required and an initial course approved based on documented severity. Medicare Advantage members are covered under Medicare's criteria with plan authorization. Spravato requires prior authorization for treatment-resistant depression, with a concurrent oral antidepressant and REMS-certified administration. AvMed's local presence usually means responsive authorization staff, and Stedfast Psychiatry's Palm Beach County offices work with them regularly.
What we check before your visit
- Whether your plan is in network at the office you chose and for telehealth
- Your copay or coinsurance for an evaluation and for follow-ups
- Whether a primary-care referral is required (common with HMO plans)
- Prior-authorization criteria for Deep TMS and Spravato, if those are being considered
Frequently asked questions
Is Stedfast Psychiatry in AvMed's network?
Stedfast Psychiatry accepts AvMed commercial and Medicare Advantage plans at our Florida offices, with the strongest overlap in Palm Beach and Broward counties where AvMed has the most members. Networks differ between AvMed HMO, POS and PPO products, so confirm your plan with AvMed member services or ask our front desk to verify.
What is my copay for a psychiatry visit with AvMed?
Most AvMed commercial plans charge a specialist copay, commonly $30 to $60, for outpatient mental health visits. AvMed Medicare Advantage plans set a fixed mental health copay, often $0 to $45. High-deductible plans charge the contracted rate until the deductible is met. Your plan summary lists the outpatient behavioral health cost share.
Does AvMed cover telehealth with a psychiatrist?
Yes. AvMed covers video psychiatry visits with in-network providers at the same cost share as office visits for members physically located in Florida during the appointment. Telehealth is appropriate for evaluations and medication follow-ups. Deep TMS and Spravato must be delivered in person at the offices that offer them.
Will AvMed pay for Deep TMS at Palm Beach Gardens?
AvMed covers TMS for major depressive disorder with prior authorization when you have documented failure of at least two antidepressants, a psychotherapy trial and current severity scores. Our TMS coordinator submits your records and follows up with AvMed's utilization management team, which is based in Florida and typically responds within one to two weeks.
Does AvMed cover Spravato?
AvMed covers Spravato for treatment-resistant depression with prior authorization, provided you are taking an oral antidepressant and receive treatment at a REMS-certified clinic. The drug and the monitoring visit are billed separately, so there may be two cost shares. We offer Spravato at Boynton Beach, Palm Beach Gardens and Royal Palm Beach and coordinate the approval.