If you have AvMed coverage and heard the company is “going out of business,” you are not alone in that worry. But the full picture is more specific — and less alarming — than the rumors suggest.
AvMed is not shutting down. What is actually happening is a mix of a major product exit, some lost contracts, and real financial pressure. Those things together can sound like a collapse, but they are not the same thing. This article breaks down exactly what is changing, what the numbers show, and what you should do depending on your plan type.
AvMed Is Not Closing — But It Is Restructuring
Let’s answer the main question directly: AvMed is not going out of business. It is a Florida-based nonprofit health insurer that is still selling individual and family health plans, still signing provider contracts, and still operating under state regulatory oversight.
In December 2022, Sentara Healthcare — a Virginia-based health system — completed its acquisition of AvMed. Since then, AvMed has continued normal commercial operations as a Sentara subsidiary. Its individual plan lineup (Entrust, Engage, Empower, and others) is still actively listed and available.
So where is the confusion coming from? A few places: a major exit from Medicare Advantage, the loss of some large public contracts, and reported net losses. Each of those sounds bad in isolation. Combined, they can easily be mistaken for a company in its final days. But “exiting a product line” and “going out of business” are two very different things.
AvMed Is Leaving Medicare Advantage in Florida — Here Is What That Means
This is the single biggest source of the rumors, and it directly affects roughly 12,555 people.
AvMed will discontinue all of its Medicare Advantage plans in Florida by December 31, 2025. Starting in 2026, it will have no Medicare Advantage products in the state at all. A Sentara spokesperson described these plans as “no longer financially sustainable in the current environment.” That is a strategic pullback, not a company collapse.
If you are one of the roughly 12,555 Medicare Advantage members affected, here is what you need to do: use the Annual Election Period — October 15 through December 7, 2025 — to pick a new Medicare Advantage plan. Your new coverage would start January 1, 2026.
To put this in plain terms: a retiree in Broward County with an AvMed Medicare Advantage plan is not losing all their insurance options. They are losing one specific product and need to shop for a replacement. That is a real inconvenience, but it is not the same as AvMed disappearing.
Think of it like a large retailer closing one unprofitable department while keeping the rest of the store open. AvMed and Sentara are making a similar call — exit one product line that is losing money, but keep other insurance offerings running.
What About the Lost Contracts?
Two significant contract losses have added to the perception that AvMed is in trouble.
First, Miami-Dade County voted to move more than 31,000 county employees from AvMed to Aetna. AvMed lost a long-standing role as the county’s health plan administrator. Second, Florida state worker HMO and PPO contracts for 2025–2028 went to other carriers. AvMed — a company that had served roughly 250,000 Floridians for about 50 years — was shut out of those contracts entirely.
Those are serious competitive setbacks. They reduce revenue and put pressure on the business. But they are purchasing decisions made by government agencies in competitive bidding, not signs that AvMed is collapsing. The losing carrier in a government contract bid does not become insolvent because of it — they just lose that book of business.
A Florida state employee who sees their coverage shift from AvMed to a different carrier might reasonably wonder if AvMed is “done.” But AvMed continues to cover other employers, individuals, and families. The state simply chose a different vendor for its workers.
What the Financial Data Actually Shows
Here is where honesty matters. AvMed is under real financial pressure. But financial stress and insolvency are not the same thing.
For the fiscal year ending December 2024, AvMed reported revenue of about $616.6 million against expenses of about $800.7 million — a net loss of roughly $184 million. That is a significant gap. A Q3 2024 managed care report also showed a year-to-date net loss of about $55.3 million.
Those numbers are not good. But here is the part that matters for members: AvMed still holds positive net assets and is above the capital thresholds Florida law requires.
Florida’s Office of Insurance Regulation conducted a full-scope examination of AvMed as of December 31, 2024. It found capital and surplus of approximately $70.4 million — above the state’s minimum requirement of roughly $31.3 million. Regulators required no adjustments to surplus. That is a meaningful distinction. It means AvMed is not in a solvency crisis as of that review.
A Q3 2024 managed care report showed net admitted assets of about $341.9 million and a positive surplus of about $80.5 million. The Weiss Ratings snapshot supports a similar picture — losses, but ongoing operations and positive capital.
Here is a simple analogy: a small business can have a loss-making year and still have positive equity and enough cash to keep the lights on. AvMed’s current position is something like that. The losses are real and unsustainable if they continue long-term, but they have not triggered regulatory intervention or insolvency proceedings.
True insolvency looks different. That is when a company’s capital falls below required thresholds and regulators step in to seize or liquidate it. That has not happened with AvMed.
What Should Current AvMed Members Do Right Now?
The answer depends on your plan type.
If You Have a Medicare Advantage Plan
Act before December 7, 2025. That is the end of the Annual Election Period. Use that window to compare and select a new Medicare Advantage plan for 2026. Medicare’s plan finder at medicare.gov is the most reliable tool for comparing options in your county. Do not wait until the last minute — plan availability and networks vary by location.
If You Have a Commercial or Individual Plan Through AvMed
There is no announced exit from these markets. AvMed is still selling individual and family plans and recently ranked number one for customer satisfaction in Florida in the J.D. Power 2024 Commercial Member Health Plan Study. That does not mean the financial pressures are gone, but there is no current signal that these products are being discontinued.
It is still reasonable to keep an eye on any notices AvMed sends you and check the Florida OIR’s website for any regulatory updates. Staying informed is always smart, but there is no need to panic-switch your plan today.
If You Are a Public-Sector Employee
If your employer — a state agency or county government — has moved or is moving to a different carrier, that is a procurement decision. Your benefits office will notify you of new plan options and enrollment periods. AvMed losing that contract does not affect your right to coverage; it just changes who provides it.
How to Verify AvMed’s Status Yourself
You do not have to rely on rumors. Here are the places to check directly:
- Florida Office of Insurance Regulation (floir.gov): Publishes examination reports and managed care summaries. The 2024 exam report for AvMed is publicly available and confirms capital levels above the statutory minimum.
- AvMed’s official website (avmed.org): The news and media spotlight pages are updated regularly with announcements, rankings, and contract activity.
- Medicare.gov: If you are a Medicare Advantage member, this is where you compare plans in your area for 2026.
- ProPublica Nonprofit Explorer: AvMed files as a nonprofit. You can view its Form 990 financials there for a clear look at revenue, expenses, and net assets.
For more coverage of business developments like this, Index Business Magazine tracks company news and industry shifts across a range of sectors.
The Bottom Line
AvMed is not going out of business. It is a company under financial pressure that is making strategic cuts — most notably, exiting Medicare Advantage in Florida by end of 2025. It has also lost significant government contracts, which reduces its revenue base.
But it continues to operate, sell individual and family plans, meet Florida’s regulatory capital requirements, and function as a going concern. The Florida OIR’s most recent examination found no solvency violations and required no surplus adjustments.
If you are a Medicare Advantage member, take the exit seriously and act during this year’s election period. If you are on a commercial or individual plan, watch for updates but there is no immediate action required.
The difference between a restructuring company and a failing one matters. Based on the current evidence, AvMed falls into the first category — stressed, shrinking in some areas, but still operating and regulated.
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