Starting July 1, 2023, Virginia Premier will become a part of Optima Health.
As a combined health plan, we continue to provide you with excellent service and benefits.
We know that you may have questions about this change. This list of Frequently Asked Questions is designed to help answer those.
Who is impacted?
Virginia Premier Medicaid members.
What has changed?
Virginia Premier is now a part of Optima Health Plan as of July 1, 2023. This means that all Virginia Premier Medicaid members are Optima Health members.
Do I need to do anything to keep getting services on and after July 1, 2023?
- You do not need to take any action to continue receiving the benefits and services you have now.
- New member ID cards were mailed on June 1, 2023. If you have not already, you will soon receive an Optima Health member ID Card. You should begin using this on July 1, 2023.
Will I be able to keep my doctor(s)?
It is likely you will be able to keep your primary care provider and see many of the same healthcare providers. Virginia Premier and Optima Health have many of the same providers in their networks.
Virginia Premier and Optima Health have many of the same providers in their networks.
You may have recently recently received letters from us about providers that have left the network. Please be assured that this is not due to our health plans coming together. These providers are no longer servicing Virginia Medicaid Members.
If you have a question about providers, or need help locating a provider, please call:
- Optima Health member services: 1-800-881-2166
I am enrolled in care management. Will that change?
No, you will remain in care management. We will do our best to keep you with your assigned care manager. If you have concerns, please reach out to your current care manager to discuss this.
If we need to change your care manager, you will receive a letter from us.
Do I keep all of my benefits?
All of your core Medicaid benefits will stay the same.
You will have access to other additional benefits available for Optima Health members. See a list of these added benefits.
How can I find out whether my prescriptions are still covered?
There will be some changes to the formulary, or drug list. The list of those changes can be found on the pharmacy page.
Members that are being impacted by these changes will be notified by mail.
If there are additional questions about drug coverage, members should contact member services.
Am I able to change my healthcare plan?
We realize that as a Virginia Medicaid member, you have a choice in your healthcare. We hope you remain a member, but you are able to switch plans through September 30, 2023.
For information on available plans, and to learn more on how to change your plan, please visit the state’s enrollment website at https://www.virginiamanagedcare.com. You can also call the DMAS Managed Care helpline at 1-800-643-2273 (TTY: 1-800-817-6608), Monday – Friday from 8:30 a.m. to 6:00 p.m.