Choosing Optima Family Care
You have the right to choose your preferred Medicaid plan from one of the six participating plan providers, within 90 days of being assigned.
If you need to find out if you qualify for a Virginia Medicaid program, visit coverva.org or call 1-866-873-2647.
New Program Changes for 2018
DMAS will send you a letter that will include your assignment to a health plan under the new Medicaid program.
- You may be assigned to the same health plan you have now, or you may be assigned to a new health plan.
- If you choose to stay with the health plan to which you are assigned, there is nothing you need to do. You will receive further information from that health plan.
- If you would like to switch to Optima Family Care, you can do so by calling the Virginia Managed Care Helpline toll-free at 1-800-643-2273, or by enrolling through the Virginia Managed Care website.
- If you would like to learn more about Optima Family Care and the Medicaid changes in Virginia, call Optima Health Customer Service toll free at 1-800-881-2166.
If your enrollment ends with us and you regain eligibility for the program within 60 days or less, you will automatically be re-enrolled with Optima Family Care. You will be sent a re-enrollment letter from the Department of Medical Assistance Services (DMAS).
Enrollment for Newborns
If you have a baby, you will need to report the birth of your child as quickly as possible to enroll your baby for Medicaid. You can do this by:
- Calling the Cover Virginia Call Center at 1-855-242-8282 to report the birth of your child over the phone, or
- Contacting your local Department of Social Services to report the birth of your child.
You will be asked to provide your information and your newborn's:
- Date of Birth
- The newborn’s mother’s name and Medicaid ID number
Optima Family Care will provide coverage for your newborn for the entire birth month plus two additional consecutive months regardless of whether the newborn receives a Medicaid ID number. If you change the newborn’s enrollment during the “birth month plus two” period, then the new Managed Care Organization (MCO) will provide coverage for your newborn. In such cases, the former MCO is not responsible once the newborn is enrolled into another MCO.
Coverage for your newborn for the “birth month plus two” period is not contingent on the mother’s continued enrollment with Optima Family Care. Optima Family Care will cover the newborn even if the mother does not remain enrolled after the MCO newborn’s date of birth.
Medicaid Expansion is coming to Virginia in January 2019. More information will be available soon.