A 4-Star Plan

OptimaFit® Individual & Family Health Plans earn top score in Virginia

Optima Health received Virginia's highest score, a Global 4-Star quality rating, for the OptimaFit® Individual & Family health plans, by the Centers for Medicare & Medicaid Services (CMS) 5-Star Quality Rating System1. The star ratings reflect our members' experience with member services, care from our doctors, and care coordination.

This rating demonstrates our commitment to members and providers to help our members achieve their best health.

Additional highlights from our 4-Star rating include:

  •       5 out of 5 Stars - Enrollee Experience with Health Plan (the highest rating for the service we provide, answering questions and providing the information members need)
  •       5 out of 5 Stars - Patient Safety (the highest rating for the care members receive and access to medications needed to manage members' conditions)
  •       5 out of 5 Stars - Doctors and Care (the highest rating for members' experience with medical services, including those provided by personal doctors and specialists)

1CMS rates qualified health plans (QHPs) offered through the Marketplaces using the Quality Rating System (QRS), which is based on third-party validated clinical measure data and QHP Enrollee Survey response data. CMS calculates QRS ratings annually using a 5-star scale. QHP issuers contract with HHS-approved survey vendors that independently conduct the QHP Enrollee Survey each year. QRS ratings and QHP Enrollee Survey results may change from one year to the next. For more information, please see CMS’ Health Insurance MarketplaceSM Quality Initiatives website at: http://www.cms.gov/Medicare/Quality-Initiatives-Patient-Assessment-Instruments/QualityInitiativesGenInfo/Health-Insurance-Marketplace-Quality-Initiatives.html.