Added Benefits for Optima Family Care
As a member of Optima Family Care, you have access to services that are not generally covered through Medicaid fee-for-service. These are known as “extra benefits.” We provide the following extra benefits:
- Partners in Pregnancy program
- Assistance with weight management
- Tobacco cessation program
- Care Management Programs for children and adults. Some programs include Sickle Cell, High-Risk Pregnancy, HIV/AIDS, and Transplants
Community Mental Health Rehabilitation Services (CMHRS), including:
- Mental health case management
- Therapeutic Day Treatment (TDT) for children under age 21
- Day treatment/Partial hospitalization for adults
- Crisis intervention and stabilization
- Intensive community treatment
- Mental Health Skill-building Services (MHSS)
- Intensive in-home
- Psychosocial rehabilitation
- Level A and B group home for children under age 21
- Treatment foster care case management
- Behavioral therapy
- Mental health peer supports
- Substance abuse residential treatment for pregnant women
- Substance abuse day treatment for pregnant women
- Substance abuse intensive outpatient
The name of the program is Smiles For Children. Smiles For Children provides coverage for the following populations and services:
- For children under age 21: diagnostic, preventive, restorative/surgical procedures, as well as orthodontia services.
- For pregnant women: x-rays and examinations, cleanings, fillings, root canals, gum related treatment, crowns, bridges, partials, and dentures, tooth extractions and other oral surgeries, and other appropriate general services. Orthodontic treatment is not included. The dental coverage ends 60 days after the baby is born.
- For adults age 21 and over, coverage is only available for limited medically necessary oral surgery services. Routine dental services are not covered for adults other than as described above for pregnant women.
Discover more information on the Smiles For Children program.
Early Intervention is designed to meet the developmental needs of an infant or toddler from birth up to age 3 with a developmental delay and the needs of the family related to enhancing the child’s development.
Infant Formula and Medical Foods includes specialized formula for children and enteral nutrition/medical foods for Members under 21.
Medicaid Expansion is coming to Virginia in January 2019. More information will be available soon.