Optima Health is becoming Sentara Health Plans
Open Enrollment Period - Nov. 1, 2023 - Jan. 15, 2024
Sentara Individual & Family Health Plans
Our Quality Stars Rating
Our Individual & Family Health Plans received 4 stars out of 5 stars1 from The Centers for Medicare & Medicaid Services (CMS). This 2023 rating is based on factors that include member surveys, data from doctors and hospitals, and how long members have stayed with their health plan.
Your Health. Covered.
Having health insurance means you and your family will have the peace of mind and access to healthcare whenever you need it. We have several affordable plan options with a range of deductibles and copayment options so you can choose a healthcare plan that fits your needs, budget, and lifestyle.
We are committed to our mission: to improve health everyday, so we're always innovating to add value to the products we provide. Our health plans are part of an open-access network with no need to get a referral to see a specialist within our broad network of quality providers and facilities. Our plans include essential health benefits2 to help manage your health including value-added benefits and services such as wellness programs and gym membership discounts, useful tools like the Treatment Cost Calculator for comparing out-of-pocket expenses for common procedures, and savings to help you manage your healthcare costs.
With enhanced subsidies available now through 2025, we’ve made it easier than ever for you to find the healthcare plan that works for you!
Ask Us How. Talk to a Personal Plan Advisor today toll free at 1-855-460-5819.
Our Plans
Sentara Individual & Family Health Plans offer more choices, innovative solutions, and enhanced access to affordable, high-quality care.
Sentara Direct Plans
- Direct Plans offer our full network of providers and facilities in Virginia and North Carolina3. While members can choose to see providers in either Tier 1 or Tier 2, you'll maximize cost-savings using Tier 1 providers and facilities.
Sentara Standard Plans
- Standard Plans allow members an easier shopping experience by offering a uniform cost-sharing structure, maximum out-of-pocket (MOOP) amounts, and deductibles.
Value-Added Services & More
Our members have access to many great value-added services to help lower their healthcare costs.
Highlights
- On-Demand Virtual Consults4
- 24/7 Nurse Advice and Behavioral Health Crisis Lines
- Emergency Travel Assistance
- Gym membership discounts; health and wellness services
- Discounts on complementary therapies like acupuncture, chiropractic and massage
- Vision extras
Our Service Area
Our plans are in offered statewide in the Commonwealth of Virginia.
Our Broad Network
Discover the exceptional providers and hospitals in our network.Enrollment Periods
Learn the difference between Open Enrollment Period (OEP) and Special Enrollment Period (SEP).Subsidy Eligibility
Do you qualify? Discover which subsidy you and your family are eligible for based on your income bracket.Call Me
Request a call from a Personal Plan Advisor.
Other Health Insurance Coverage Options
Do you qualify for Medicaid? Even if you are not eligible for one of our Sentara Individual & Family Health Plans, you might be eligible for one of our other coverage options including Medicaid, or health insurance plans for self-employed sole-proprietors.
1 CMS scores qualified health plans (QHPs) offered through the Exchanges using the Quality Rating System (QRS) based on third-party validated clinical measure data and QHP Enrollee.
2 Essential Health Benefits are a set of 10 categories of services covered under the Affordable Care Act. These include inpatient and outpatient hospital care, prescription drug coverage, pregnancy and childbirth, mental health services and more.
3 Sentara Health Administration, Inc., Provider Database, 2023, available at sentarahealthplans.com.
4 Cost share my apply for Health Savings Account (HSA) plans.