Optima Health has exciting news regarding Health Maintenance Organization (HMO) and Point-of-Service (POS) plan members!

Effective January 1, 2008, many of our groups will be transitioning to referral-less plans in which referrals to see a participating specialist are no longer required!

Members will still need to select a primary care physician (PCP) to coordinate their care and guide their decisions, but are not required to obtain a referral prior to seeing a participating specialist.

Requirements for prior authorization are not affected by this change.

New Optima ID cards for affected members will display the words “No Referral Required” to make it clear that their plan is now referral-less.
 

Groups still requiring referrals to see a specialist are Virginia Beach City and Schools*, Bank of America, Raytheon, Bon Secours and Colonial Williamsburg.

If you have any questions, please contact your Network Educator.

*Members of the Virginia Beach City and Schools Retiree Plan continue to not require a referral.