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1-866-806-0333

TTY/TTD 1-800-225-7784)

 

Why Optima Medicare

 

Are You About to Turn 65?

 

Are You Exploring Medicare Options?

 

Are You Losing Your Medicare Advantage Coverage?

 

 

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You Need

 

Compare Our 2010 Plans

 

Compare Our 2009 Plans

 

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You Need

 

2010 Plan Information

 

2009 Plan Information

 

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Find a Pharmacy

 

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Introduction to Medicare

 

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Request an Enrollment Kit and Decision Guide

 

Out-of-network Pharmacy Coverage

 

Help with Prescription Drug Costs

 

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Common Questions

 

 

Medicare Required Information

 

Grievance, Coverage Determination and Appeals Processes

 

Disclaimers for Optima Medicare Plans

 

Pharmacy Access Guidelines

 

Member Rights and Responsibilities

 

Notice of Privacy Practices

Optima Medicare (PPO)
2009 Plans


 

Compare Our 2009 Medicare Plans

 

Please use the charts below to compare 2009 Optima Medicare Plans.

 

Download a printable version of these charts

 

Adobe Reader is required to download and print this document – get Adobe Reader.

 

 

Optima Medicare Value Plans -- $0 Monthly Premium*

Optima Medicare
Value
Optima Medicare
Value Plus
Monthly Premium $0 $0
Annual Medical Out-Of-Pocket Limit $3,250 $3,250
Benefits Network Out-Of-Network Network Out-Of-Network
Inpatient Hospital Care $125 per day (1-5) $125 per day (1-5) $185 per day (1-5) $185 per day (1-5)
Doctor Office Visits $10 per visit 20% $10 per visit 30%
Physical Exams $10 per annual exam 20% Not Covered Not Covered
Emergency Care $50 per visit $50 per visit $50 per visit $50 per visit
Urgent Care $10 per visit $10 per visit $10 per visit $10 per visit
Part D Prescription Drugs Not Covered Not Covered $4/$30/$60/30% $4/$30/$60/30%

You must continue to pay your Medicare Part B premium if not otherwise paid for under Medicaid or by another third party.

 

H4908_SEN_COMPARE09_CMS Approved 072808

 

 

Optima Medicare Preferred Plans*

Optima Medicare
Preferred
Optima Medicare
Preferred Plus
Monthly Premium $84 $116
Annual Medical Out-Of-Pocket Limit $3,000 $3,000
Benefits Network Out-Of-Network Network Out-Of-Network
Inpatient Hospital Care $0 $500 per admission $0 $500 per admission
Doctor Office Visits $10 per visit $15 per visit $10 per visit $15 per visit
Physical Exams $0 per annual exam $15 per annual exam $0 per annual exam $15 per annual exam
Emergency Care $50 per visit $50 per visit $50 per visit $50 per visit
Urgent Care $10 per visit $10 per visit $10 per visit $10 per visit
Part D Prescription Drugs Not Covered Not Covered $4/$30/$60/30% $4/$30/$60/30%

You must continue to pay your Medicare Part B premium if not otherwise paid for under Medicaid or by another third party.

 

H4908_SEN_COMPARE09_CMS Approved 072808

 

For more information about any of our Medicare Plans, please call 1-866-806-0333 (TTY/TTD 1-800-225-7784).

 

 

 

 

2009 Optima Medicare Plan Documents

 

Adobe Reader is required to view plan documents – get Adobe Reader.

 

Optima Medicare Value Plus and Optima Medicare Value

 

2009 Summary of Benefits -- Optima Value Plus and Optima Value

 

2009 Evidence of Coverage -- Optima Value Plus

 

2009 Evidence of Coverage -- Optima Value

 

 

Optima Medicare Preferred Plus and Optima Medicare Preferred

 

2009 Summary of Benefits -- Optima Preferred Plus and Optima Preferred

 

2009 Evidence of Coverage -- Optima Preferred Plus

 

2009 Evidence of Coverage -- Optima Preferred

 

 

 

 

 

Enroll in a 2009 Optima Medicare Plan

 

To enroll in a 2009 Optima Medicare Plan, please visit our enrollment page.

 

 

 

What Would You Like to Do Now?

 

 What would you like to do now? If you want to enroll now, a Medicare Advisor can help, 
call toll-free 1-866-806-0333 (TTY/TTD 1-800-225-7784)

 

Enroll Now -- a Medicare Advisor can help,
call toll-free 1-866-806-0333 (TTY/TTD 1-800-225-7784)

 

Register for a free Optima Medicare (PPO) Meeting

 

Request a free Enrollment Kit and Decision Guide



 * This form is only intended as a snapshot comparison of Optima Medicare plans. For a complete summary, please refer to the Summary of Benefits documents provided by Optima, or view them at www.optimahealth.com/medicare or on the CMS website for health plan comparison information at www.medicare.gov.

 

Except for emergencies and urgent care, the use of non-plan providers or non-participating network pharmacies may cost more. Please go to www.optimahealth.com/medicare for a list of providers and network pharmacies, or call 1-800-927-6048 (TTY users: 1-800-225-7784) seven days a week, 8 a.m.– 8 p.m.

 

If you have questions about Medicare benefits, including general information regarding health or Part D benefits, you can call 1-800-MEDICARE (1-800-633-4227); TTY/TDD users should call 1-877-486-2048, 24 hours a day, seven days a week. You can also visit www.medicare.gov.

 

Optima Health Insurance Company has a contract with the federal government to provide Medicare Part D benefits to people with Medicare in many cities and counties in Virginia. Benefits, formulary, pharmacy network, premium and/or co-payments or coinsurance may change January 1, 2010. Please contact Optima Health for details.

 

Optima Medicare Preferred, Optima Medicare Preferred Plus, Optima Medicare Value and Optima Medicare Value Plus are Medicare Advantage Preferred Provider Organizations (PPO) plans with a Medicare contract.

 

By law, Optima Health can refuse to renew its contract with CMS, and CMS also may refuse to renew the contract. Termination or nonrenewal may result in termination of the beneficiary’s enrollment in the plans. In addition, the plan may reduce its service area and no longer offer services in the area where the beneficiary resides.

 

Optima Medicare Preferred, Optima Medicare Preferred Plus, Optima Medicare Value and Optima Medicare Value Plus are underwritten by Optima Health Insurance Company.

 

 

Last Updated October 01, 2009 8:52:21 AM