Welcome to the Optima Medicare “Be Healthy” digital event. Learn about new Extra Benefits for 2022, Healthy Rewards and the Annual Wellness Visit.
Be Healthy
Earn Up to $215 and Stay Healthy with the Optima Medicare Rewards Program
Taking an active role in managing your health is important. That’s why Optima Medicare wants to reward you for completing one or more preventive screenings, exams, or vaccinations.
One way to earn a reward is to complete your Annual Wellness Visit. The Annual Wellness Visit is a Medicare benefit that allows you to have a one-on-one discussion with your provider, once every 12 months, to identify any medical issues or health risks.
Managing Your Health is Easy with the Member Portal and Mobile App
Start making the most of your health plan by registering to use the member portal and mobile app.
Activate your account online. You will need your Optima Health member ID to register. If you don’t have it, you can contact Optima Medicare Member Services at 1-800-927-6048 (TTY: 711). The hours of operation are October 1–March 31, 7 days a week, 8 a.m.–8 p.m. | April 1–September 30, Monday–Friday, 8 a.m.–8 p.m.
The Flu Vaccine Saves Lives
The best way to prevent the flu is to get vaccinated every year. The flu is a highly contagious respiratory illness. It is spread from person to person through sneezing and coughing, and by touching surfaces that may not be clean.
You can still get a flu vaccine. Visit your primary care provider (PCP) or your local pharmacy. Some PCPs provide flu vaccines in their office. A copayment may apply if you receive the flu vaccine during a scheduled office visit. There is no copayment if you get one at your local pharmacy. You are eligible for a $10 reward when you get your flu vaccine!
COVID-19 Vaccine
You can get your COVID-19 vaccine at the same time you get your flu vaccine. The COVID-19 vaccine is safe and effective. It helps protect you from getting COVID-19. Once you are fully vaccinated, your level of protection is increased.
If you already received both doses of your vaccine, you may be eligible for a COVID-19 booster. Eligible individuals may choose which vaccine they receive as a booster. Visit the CDC COVID-19 website to see when you are eligible for your booster.
Some people may prefer the vaccine type that they originally received, and others may prefer to get a different booster. The CDC recommendation now allows for this type of mix and match dosing for booster shots. To find out if you are eligible, talk to your doctor or visit the CDC COVID-19 website
Use a “Preferred” Pharmacy for Lower Prescription Copays
Optima Medicare is offering lower copays on medications in 2022! Get your medications from our new “preferred” network of pharmacies and your copay is discounted. Tier 1 medications (also called Preferred Generic) have a $0 copay for all Optima Medicare plan members when purchased at a preferred in-network pharmacy. Our preferred pharmacy network includes pharmacies at Harris Teeter, Kroger, Walgreens, and Walmart. Members can still go to other in-network, also known as standard, pharmacies and pay the standard copay amounts.
For more information on your specific copay amounts, refer to your 2022 Evidence of Coverage. For a listing of Tier 1 medications, refer to your plan’s 2022 Formulary. Both documents can be found online.
New to Medicare?
Do you know the difference between the Welcome to Medicare preventive visit and Annual Wellness Visit?
Understanding the difference between the Welcome to Medicare preventive visit and Annual Wellness Visit is important.
Win a Door Prize
Optima Medicare Rewards Programs
Together, you will create an action plan to keep you healthy. Your provider will also talk to you about preventive services and health screenings, record your temperature, blood pressure, height and weight, and screen you for any cognitive impairment and depression.
Make an appointment with your in-network provider for an Annual Wellness Visit and when you complete your visit, you can earn a $25 gift card that you can use anywhere1. More information is available about the Annual Wellness Visit in the New to Medicare? article.
To receive rewards on your reloadable gift card, you must complete the following:
- Call your doctor and schedule an appointment.
- You must go to your appointment.
- After your appointment, your doctor must submit a claim.
- Processing your reward takes 8–10 weeks after we receive the claim from your doctor.
Make sure to keep your rewards card in a safe place! As you earn more rewards, the reward money will be added to your account and you can keep using the same card.
1 Rewards cannot be used to buy tobacco, alcohol, or firearms. Rewards cannot be converted to cash. You can only receive one reward per applicable service for which you are qualified.
Here is a full list of ways to earn rewards!
|
$10 |
Annual Flu Vaccine |
All members |
|
$25 |
Annual Physical Exam |
All members |
|
$25 |
Annual Wellness Visit |
All members |
|
$25 |
Breast Cancer Screening (Mammogram) |
All members |
|
$25 |
Colorectal Cancer Screening |
All members |
|
$10 |
Diabetic Eye Exam |
Members with diabetes |
|
$10 |
Diabetic HbA1c Test |
Members with diabetes |
|
$10 |
Diabetic Kidney Function Test |
Members with diabetes |
|
$50 |
Medication Therapy Management Program2 |
All members eligible for Medication Therapy Management3 |
|
$25 |
NEW for 2022 Completion of your Health Risk Assessment |
All members |
You can also read more about the rewards program.
2: Additional restrictions apply to this reward and it can only be used at limited grocery stores.
3: Available to Optima Medicare Value (HMO), Optima Medicare Prime (HMO) and Optima Community Complete (HMO D-SNP) members.
What is a Health Risk Assessment?
The Health Risk Assessment (HRA) is a questionnaire that evaluates your lifestyle and health status, and identifies possible health risk factors. Your answers help us better serve your health and wellness needs. You can easily complete your HRA by calling the Optima Medicare Outreach Team at 1-833-771-1427 (TTY: 711). This will take about 10–15 minutes. They are available Monday–Friday, 8 a.m.–5 p.m. Your HRA must be completed within 90 days of enrollment, and then annually after the first year of enrollment.
Managing Your Health
You can also use your smartphone to download and register on the Optima Health mobile app. You only need to register once to be able to access your secure account from online and the app. Once you register, you can:
- find doctors and facilities
- view your benefit information
- update your Primary Care Provider (PDP)
- check your claims
- view, print, and order a new member ID card
- schedule virtual consults for medical and behavioral healthcare
The Flu Vaccine
People 65 and older are at higher risk for getting the flu. Call your doctor or schedule a Virtual Visit at the first signs of the flu. If you catch the flu, you can help keep it from spreading by:
- washing your hands frequently
- covering your nose and mouth when you sneeze or cough
- throwing away used tissues after one use
- avoiding touching your eyes, nose, and mouth
- staying away from others
Even if you get the COVID-19 vaccine, it is still important to get your flu vaccine! You can get both vaccines at the same time to save yourself a trip.
New to Medicare
Welcome to Medicare Preventive Visit
Once you enroll in Medicare Part B, you have 12 months to complete the Welcome to Medicare preventive visit. During the visit, your provider reviews your medical and social history and provides education and counseling about preventive services, including:
- screenings, flu and pneumococcal shots, and referrals for other care
- height, weight, and blood pressure measurements
- calculation of your body mass index
- simple vision test
- review of your potential risk for depression and your level of safety
If this is your first year with Medicare Part B, let your provider office know you want to schedule your Welcome to Medicare preventive visit.
Each year after this visit, you will see your provider for an Annual Wellness Visit. You cannot have your Welcome to Medicare preventive visit and Annual Wellness Visit in the same year.
Receive a $25 reward for completing your Welcome to Medicare Visit.
Annual Wellness Visit
The Annual Wellness Visit is a Medicare benefit. At the visit, you will talk one-on-one with your provider to identify any medical issues or health risks. You can schedule this visit every 12 months.
Together, you will create an action plan to keep you healthy. Your provider will also talk to you about preventive services and health screenings, record your temperature, blood pressure, height and weight, and screen you for any cognitive impairment and depression.
You can take advantage of the Annual Wellness Visit benefit 12 months after you have had Medicare Part B. If you are newly enrolled in Part B, you qualify for the Welcome to Medicare preventive visit benefit.
Receive a $25 reward for completing your Annual Wellness Visit.
What to Bring
Bring the following to each visit:
- medical records, including immunization records
- family health history
- list of any prescription drugs, over-the-counter drugs, vitamins, and supplements that you currently take, how often you take them, and why. You can even bring the actual prescription bottles with you.
- your Optima Medicare member ID card
Last Updated: 2/28/2022