Transition of Care

We understand the importance of maintaining your health coverage without any interruption in your medical treatments or prescription medications. These steps will help you make a smooth transition switching over to the Optima Health Plan.

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What Are Your Needs?

  • I am in the middle of receiving care for a medical condition.

    Call your doctor's or specialist's office and tell them your coverage is changing to Optima Health effective January 1, 2020.

    In December, prior to the new plan effective date, ask your doctor to send any clinical notes and authorizations to the Optima Health Clinical Care Services team.

  • I am scheduled for treatment in early January 2020 that requires an authorization.

    Optima Health will likely need to authorize this treatment.

    In December, prior to the new plan effective date, ask your doctor to send any clinical notes and authorizations to the Optima Health Clinical Care Services team.

  • I need refills for my prescriptions.

    Tell your prescribing doctor your coverage will change to Optima Health effective January 1, 2020.

    If possible, get your prescriptions refilled in advance of your change in coverage.

  • My prescription requires prior-authorization.

    For all members newly enrolling with Optima Health currently taking prescriptions requiring prior authorization, Optima Health will temporarily waive prior authorization requirements if your prescription is filled within:

    • 60 days after plan effective date for retail
    • 120 days after plan effective date for mail order