Incentive Programs for Chronic Conditions

The Optima Health plan for COVA and TLC members includes an Incentive Program for members with one or more of the following chronic conditions: Asthma/COPD, Diabetes or Hypertension. Incentive program benefits include a waived deductible and/or waived copayments on certain medications for your condition.

Members are allowed to enroll prior to the plan year (July 1 for COVA members and July 1 or October 1 for TLC members). If you are currently enrolled in the Incentive Program, you must take action to re-enroll for each new plan year. Mid-year enrollments in the incentive plan are allowed for new hires or those with a new diagnosis of one of these conditions. *Enrollments are allowed during a designated timeline prior to the beginning of your plan year. Refer to the table below:

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Timeline for Enrollment

Plan Year Enroll in Program
July 1 - June 30 May 1 - June 10
October 1 - September 30 August 1 - September 10

*Mid-year enrollments may be accepted for those newly diagnosed or new hires. Partial program benefits may be available for those eligible for the program. Mid-year requests may Contact Us to learn more.

COVA Members: Your plan begins on July 1.  Look for more information in the spring of 2021 to enroll in the incentive program. If you are newly diagnosed or you are a new hire and wish to enroll, you may be eligible for some of the program benefits.  Contact Us to learn more.

TLC Members: Your initial plan offering begins on July 1 or October 1 of 2021. Look for more information in the spring of 2020 or with your employer’s enrollment materials to find out more about the incentive program.