Medicare Plans

Care That Changes With Your Clients' Needs

We’re proud to offer Optima Medicare – plans that give your clients everything Medicare offers plus some extra benefits and preventive services including:

  • $0 copay for personal doctor visits
  • $0 copay for many generic drugs
  • Dental, vision and hearing benefits

Important Changes for 2019

New dental and plan options are available with the 2019 Optima Medicare HMO plans, and enrollment in Optima Community Complete (HMO SNP) is now available:

  • Dental Plan Comparison

    Enrollment in dental coverage is only available during the Annual Election Period, or when a new enrollee initially signs up with a plan.

    Plan

    Preventive

    Preventive Plus

    Comprehensive

    Premium $0.00 / month +$13.50 / month +$16.00 / month
    Oral Exams and Cleanings $0 copay
    2 oral exams and cleanings / year
    $0 copay
    2 oral exams and cleanings / year
    $0 copay
    2 oral exams and cleanings / year
    X-ray $0 copay
    1 x-ray / year
    $0 copay
    1 x-ray / year
    $0 copay
    1 x-ray / year
    Fluoride Treatment $0 copay
    2 treatments / year
    $0 copay
    2 treatments / year
    $0 copay
    2 treatments / year
    Maximum Benefit Coverage None $750 $1000
    Fillings None Yes Yes
    Extractions None Yes Yes
    Oral Surgery None Yes Yes
    Periodontal Treatment None Yes Yes
    Root Canal None Yes Yes
    Dentures and Denture and Prosthetic Maintenance None Yes Yes
    Crowns None Yes Yes
    Implants None None Yes
  • Optima Community Complete (HMO SNP)

    Optima Community Complete (HMO SNP) is a Dual Special Needs Plan (D-SNP) that offers members a more specialized level of care for highly sensitive needs. This type of plan may be available if a member receives Medicaid and is also eligible for Medicare. This coverage is a type of Medicare Advantage plan in that members still get the same great benefits from their Medicaid coverage, plus enhanced care coordination and management of their medical needs.

    Coverage and Eligibility

    Enrollees must:

    • be enrolled in Medicare Part A and Part B
    • receive help from state Medicaid assistance
    • live in our service area

    You can learn more about this plan on the Optima Community Complete website.


Broker Resources

2019 Plans

Optima Community Complete

Optima Medicare HMO

2018 Plans

Compare and Enroll


View Medicare Advantage plans and complete an online Optima Medicare HMO Enrollment Request.

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