OptimaDirect® and OptimaSelect® Network Plans for Employer-Sponsored Health Plans

Our new network designs offer lower-cost options that allow you to choose what works best for your employees and your 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 more if they get services from a regionalized group of doctors and facilities.

Select and Direct At–A–Glance Comparison Chart

OptimaDirect OptimaSelect
Who can buy
  • Core product offering for Small Group
  • Option for Mid-Market and Large Groups
  • Option for all employer groups
Where plans are available
  • Entire Optima Health service area
  • Charlottesville area only
Product Lines available
  • HMO
  • POS
  • PPO (Small Group only)
  • HMO only
Spending Account Options2
  • Health Savings Account (HSA)
  • Health Reimbursement Account (HRA)
  • Health Savings Account (HSA)
  • Health Reimbursement Account (HRA)
In–Network Coverage
  • Tier 1: All participating doctors and facilities except those in Tier 2
  • Tier 2: Mary Washington Healthcare
Note: Effective April 15, 2021, University of Virginia (UVA) Health System is now in Tier 1.
  • 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
Note: Effective April 15, 2021, University of Virginia (UVA) Health System is now in the Select network.
Out–of–Network Coverage
  • POS and PPO plans
  • Emergency care only for HMO plans
  • Emergency care only
Features and Benefits
  • Wide range of Gold, Silver, and Bronze level plans
  • Generous discounts on health and wellness services3
  • Comprehensive Health Management Programs
  • Emergency Travel Assistance4
  • Free preventive care services when received from an in-network doctor or facility4
  • Video Visits with MDLIVE®
  • Wide range of Gold, Silver, and Bronze level plans
  • Generous discounts on health and wellness services3
  • Comprehensive Health Management Programs
  • Emergency Travel Assistance4
  • Free preventive care services when received from an in-network doctor or facility4
  • Video Visits with MDLIVE®

The Service Area

Select and Direct Network Map - Individual & Family Plans
Download a printable PDF version of this map

More Information

Frequently Asked Questions

Plan Brochure

For more information, please contact your broker or Optima Health representative.

1 Sentara Health Plans, Inc., Provider Status Report, 2020
2 May only be available in certain Product Lines, depending on group size
3 Value-Added services; not a covered benefit
4 Office Visit copayment or coinsurance may apply