OptimaFit® Direct and Select Network Plans for Individual & Family Health Plans

Our new network designs offer lower cost options that allow you to choose what works best for your clients' healthcare needs and their budget.

Direct network plans include the full network of over 35,0001 doctors and facilities, in a two-tier structure to maximize cost savings. Members can save money when they get services from a Tier 1 doctor or facility.

Select network plans utilize local doctors and facilities within key clinically integrated networks, to provide high-quality and efficient care. Members can save money if they get services from a regionalized group of doctors and facilities.

Select and Direct At–A–Glance Comparison Chart

OptimaFit Direct OptimaFit Select
Overview Direct network plans include the full network of over 35,0001 doctors and facilities, in a two-tier structure to maximize cost savings. Select network plans utilize local doctors and facilities within key clinically integrated networks, to provide high-quality and efficient care.
Available In... Charlottesville, Halifax, Hampton Roads, Harrisonburg, Mecklenburg, Richmond and Rockingham areas

Some surrounding areas may be included.

See a detailed listing of counties in the OptimaFit Direct service area

Search your zip code		 Charlottesville and Rockingham areas

Some surrounding areas may be included.

See a detailed listing of counties in the OptimaFit Select service area

Search your zip code
Spending Account Options
  • Health Savings Account (HSA)
  • Health Savings Account (HSA)
In–Network Coverage
  • Tier 1: All participating doctors and facilities except those in Tier 2
  • Tier 2: University of Virginia Health System (UVA) and Mary Washington Healthcare

Note: Effective January 1, 2021, UVA doctors and facilities are in Tier 2 and Virginia Commonwealth University (VCU) doctors and facilities are in Tier 1. Prior to January 1, 2021 UVA was in Tier 1 and VCU was in Tier 2
  • Sentara Quality Care Network (SQCN) and Sentara Healthcare statewide
  • Virginia Commonwealth University
  • Riverside Health System
  • All participating oral surgeons
  • Children’s Hospital of the King’s Daughters
  • Tidewater Physicians Multispecialty Group
  • Eastern Virginia Medical School
  • Other physician groups in Virginia

Most doctors and facilities in UVA Health System network are not in the Select network
Out–of–Network Coverage
  • Emergency care only
  • Emergency care only
Features and Benefits
  • Wide range of Gold, Silver, and Bronze level plans
  • Health Savings Accounts (HSAs)
  • Generous discounts on health and wellness services2
  • Comprehensive Health Management Programs
  • Emergency Travel Assistance2
  • Free preventive care services when received from an in-network doctor or facility3
  • Video Visits with MDLIVE®
  • Wide range of Gold, Silver, and Bronze level plans
  • Health Savings Accounts (HSAs)
  • Generous discounts on health and wellness services2
  • Comprehensive Health Management Programs
  • Emergency Travel Assistance2
  • Free preventive care services when received from an in-network doctor or facility3
  • Video Visits with MDLIVE®

More Information

For more information, please view the Frequently Asked Questions and flyers or contact your Optima Health representative.

1 Sentara Health Plans, Inc., Provider Status Report, 2020
2 Value-Added services; not a covered benefit
3 Office Visit copayment or coinsurance may apply

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