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Optima Health provides health plan coverage to members throughout Virginia. We offer a full suite of commercial products, including employee-owned and employer-sponsored plans, as well as individual and family health plans, employee assistance plans and plans serving Medicare and Medicaid enrollees. Our Optima Medicare plans offer four choices that include over 25,000 providers and 17,000 pharmacies in our network.

Optima Medicare offers Medicare Advantage plans that include all of the benefits offered by Original Medicare, plus a $0 monthly premium option, low out-of-pocket maximums, and extra benefits like Part D prescription drug coverage, dental, vision, transportation and more, so you can enjoy better value and more predictable costs.

Our service area includes most counties and cities throughout Virginia and includes over 25,000 in-network providers and 17,000 in-network pharmacies.

Below are the plan offerings from Optima Medicare:

  • Optima Medicare Value (HMO) offers a $0 monthly premium
  • Optima Medicare Prime (HMO) provides enhanced coverage
  • Optima Community Complete (HMO D-SNP) is a Dual Eligible Special Needs Plan that works with your Medicaid Plan.
  • Optima Medicare Classic (HMO) is a Medicare Advantage plan without drug coverage, often referred to as an MA-only plan, which is an excellent choice for those who have drug coverage through the VA, CHAMPVA, or TRICARE for Life and want to see non-VA health care providers.

When can you join? The Annual Election Period for Medicare Advantage plans is October 15th through December 7th each year. However, if you are aging into Medicare, meaning you are three months from your 65th birthday, are in the month of your 65th birthday, or are within three months after your 65th birthday you can enroll now. Your coverage is effective the first of the month you turn 65, or the first of the month after you turn 65 if you enroll past your 65th birthday.

3 Month before and 3 months after 65th birthday enrollment period

You can also qualify for a Special Election Period when you move out of your service area, your current Medicare plan terminates, or you become qualified for Low Income Subsidy payment for Part D (prescription) premiums.

Our Optima Community Complete plan, which is for individuals that have both Medicare and Medicaid coverage, is open for enrollment for eligible enrollees once every quarter and then, in the fourth quarter, you can enroll with an effective date of January 1.

Call one of our Licensed Plan Advisors today to learn more!

 

Optima Medicare is an HMO with a Medicare contract. Enrollment in Optima Medicare depends on contract renewal.

 

Optima Health

(800) 211-5417 TTY: 711 Website 4417 Corporation Lane
Virginia Beach , VA 23462