Complete This Form To Access Your Personal Information
Please have your Member ID Card available. The information you enter must match the information we have on file for you. Your member ID card is the best place to find this information.
Member ID Number:
Enter your Member ID Number (labeled Member #) exactly as it appears on your ID card.
Member Name :
Enter your full name (labeled Member Name) exactly as it appears on your ID card.
Date of Birth :
Example 06/19/1963
Last Four Digits of SSN :
Enter the last four digits of your SSN OR your Medicaid ID # if you are an Optima Family Care Member.
Or Medicaid ID# :
Create Username :
Usernames must:
Create Password:
Passwords must:
Confirm Password:
Enter Secret Question:
What is your mother's maiden name? What is your pet's name? When is your wedding anniversary? What elementary school did you attend?
Enter Secret Answer:
If you forget your password, we'll verify your identity by asking you this question.
Email Address:
Optima Health occasionally e-mails Members with general notices, excluding personal health information, and about changes at optimahealth.com. Would you like to receive these e-mails?
YesNo
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I Accept the Terms and Conditions of Use and Privacy Statement