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Documents and Forms

Optima Family Care (Medallion 4.0/FAMIS)

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  • Member Handbooks

    • 2022 Optima Family Care (Medallion 4.0/FAMIS) Member Handbook
  • Provider Directory

    • Optima Medicaid/FAMIS Directory
  • Health Screening

    • Member Health Screening Form
  • Drug Lists and Formularies

    • 2022 Optima Family Care (Medallion 4.0) Formulary
    • 2022 Optima Family Care (FAMIS) Formulary
    • Specialty Drug List

Optima Health Community Care (CCC Plus)

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  • Orientation Guide

    • Optima Health Community Care (CCC Plus) Orientation Guide
  • Manuals

    • 2022 Optima Health Community Care (CCC Plus) Members Handbook
    • Optima Health Community Care Caregiver Handbook
  • Provider Directories

    • Optima Health Community Care Provider Directory
    • Search the Online Provider Directory
  • Drugs Lists and Formularies

    • 2022 Optima Health Community Care Formulary
    • Specialty Drug List

General Forms

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  • Advanced Directives

    • Advanced Directive Form
    • Advanced Directives - Your Right to Decide
  • Authorized Representative Form

    • P202A Designated Representative Authorization Form

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© Optima Health 2022, 4417 Corporation Lane, Virginia Beach, VA 23462-3162

Optima Health is the trade name of Optima Health Plan, Optima Health Insurance Company, and Sentara Health Plans, Inc. Optima Health Maintenance Organization (HMO) products, and Point-of-Service (POS) products, are issued and underwritten by Optima Health Plan. Optima Preferred Provider Organization (PPO) products are issued and underwritten by Optima Health Insurance Company. Sentara Health Plans, Inc. provides administrative services to group and individual health plans but does not underwrite benefits. All Optima Health plans have benefit exclusions and limitations and terms under which the policy may be continued in force or discontinued. Optima Health Medicare, Medicaid, and FAMIS programs are administered under agreements with Optima Health and the Centers for Medicare and Medicaid Services (CMS) and the Virginia Department of Medical Assistance Services (DMAS).