The Optima Health Vantage HMO plan offers a variety of features and services to help keep you and your family healthy.
Changing Health Plans?
Are you in the middle of treatment, but you want to move your health coverage to Optima Health? We understand the importance of maintaining your health coverage without interruption in your medical treatments. For those who may be receiving obstetrics care, have a future procedure scheduled or receive on-going treatment for a chronic condition, then you may wish to have added support in your transition to Optima Health. If this applies to you, please contact member services at 1-800-846-2682 and a representative will connect you with a case manager to help with your transition. You can also visit the transitioning health care page for additional resources.
Incentive Program for Members with Chronic Conditions
The Optima Health Vantage HMO plan for COVA and TLC members includes an incentive program for members with one or more of the following chronic conditions: Asthma/COPD, Diabetes, Hypertension.
Obesity and Weight Management
At-risk members who are ready to reduce their chances of developing obesity-related, chronic diseases are invited to participate in our digitally-delivered intensive behavioral counseling program. Within 16 weeks, previous participants in the program have lost an average of 4-5% of their body weight.
Members who are eligible for bariatric surgery may qualify for reduced inpatient or outpatient copayments upon completion of required program criteria. Download the Bariatric Surgery Flyer.
Partners in Pregnancy
Our Partners in Pregnancy, and Healthy Babies programs include maternity support and NICU case management. These no charge programs provide guidance, support and education to all interested expectant moms. Financial incentives are available upon completion of program criteria. View the Partners in Pregnancy Flyer.
Out-of-Area Dependent Program
Do you have dependents in your household? The Out of Area (OOA) Dependent Program offers enrolled dependent children access to care outside of the Optima Health service area. When enrolled dependent children access care outside of the Optima Health service area, they will be able to receive covered services from PHCS/Multiplan providers at the in-network benefit level. Pre-Authorization still applies when necessary. Download the Out of Area (OOA) Dependent Form.
Emergency Travel Assistance
Your Optima Health Plan includes emergency travel assistance1. You, and any dependents on your Optima Health Plan are covered whenever traveling 100 miles or more away from your permanent residence, or in another country.1Not a covered benefit.