Member Information for COVID-19

We are working to remove barriers to care and to provide safe options for all of our members. Additionally, we are working to make care more accessible to our members, and to make sure members have continued access to the prescriptions drugs they need.

Use the links below to learn more about COVID-19 symptoms and prevention, view vaccine updates, and find out how Optima Health will provide coverage for COVID-19-related services.

Medical Benefits

Vaccine Coverage
Both COVID-19 vaccine does will be free for members. Learn more about COVID-19 vaccine coverage and information.

Testing Coverage
Waived out-of-pocket costs for coronavirus (COVID-19) testing as deemed appropriate by the ordering provider for commercial1, Medicaid or Medicare Advantage members. Out-of-pocket costs include coinsurance, copay and deductible amounts.

Treatment Coverage
Waived out-of-pocket costs for coronavirus (COVID-19) treatment at any in-network location and emergent out-of-network locations for commercial members1. All treatment costs are covered in full for Medicaid or Medicare Advantage members. Out-of-pocket costs include coinsurance, copay and deductible amounts.

Free Telehealth Visits for Members
No member copays or cost-share with our in-network virtual care partners including MDLIVE® and Sentara Medical Group (SMG) through April 30, 2021, including telephone-only visits. Learn more about accessing virtual care with MDLIVE.

Screening for Coronavirus (COVID-19)
Refer to our Coronavirus Assessment Tool and Sentara Healthcare Opens a new window or tab for additional guidance

Pharmacy Benefits

90-Day Refills
Optima Health allows members to fill 90-day supplies of most medications at most retail pharmacies and depending on your benefits, by mail order.

Home Delivery Option
Depending on your coverage, our mail order or specialty pharmacies can deliver a 90-day supply of medications to your house. Learn how to sign up for home delivery. Please refer to our member frequently asked questions about home delivery for more details.

1Select self-funded employers do not waive coronavirus (COVID-19) treatment cost-sharing. Please verify what your plan covers with your human resources department.