This page is intended to provide assistance to Virginia Premier Individual & Family Plan members losing health plan coverage effective January 1, 2021. If you are a current Virginia Premier Medicare Advantage member, please visit optimahealth.com/medicare. If you are not a current Virginia Premier Individual & Family Plan or Medicare Advantage member, please visit optimahealth.com.
OptimaFit® Individual & Family Health Plans
Welcome to Optima Health! If you’re a current Virginia Premier member, you may be wondering why you have been directed to Optima Health for Individual & Family Plan coverage beginning January 1, 2021.
Recently, Virginia Premier became part of Sentara Healthcare, who also owns Optima Health. Because Virginia Premier and Optima Health are both part of Sentara Healthcare, Optima Health is able to simplify your coverage search and automatically renew Virginia Premier members into an Optima Health plan for coverage beginning January 1, 2021.
Shop for Optima Health Plans both on and off The Health Insurance Marketplace, or visit HealthCare.gov directly. You have until Open Enrollment ends on December 15, 2020 to make a final plan selection for coverage effective January 1, 2021. If you received a renewal letter and are happy with the plan selection, then you do not need to do anything. You will be automatically enrolled, effective January 1, 2021.
The following information will help answer your questions about our benefits and services to ensure a smooth transition to an Optima Health Individual & Family Plan. You may also contact one of our Personal Plan Advisors at email@example.com or call 1-800-251-6840 from 8:00 a.m. to 8:00 p.m., seven days a week. You can also download the 2021 Buyer's Guide to help you determine which insurance plan best fits your needs.
Why Choose Optima Health?
Optima Health offers OptimaFit® Individual & Family Plans in the greater Richmond area1. OptimaFit Direct tiered cost-share plans come in a variety of deductible and cost-share options to meet your healthcare and budget needs. OptimaFit Catastrophic plans are high-deductible plans for persons age 30 and under.
Our Provider Network
Our robust provider network includes over 35,0002 doctors and facilities. To find out if your current doctor is in our network, use our provider search. When prompted, enter OptimaFit for the plan name, and then choose any of the Direct or Catastrophic options, depending on your preference. Then you can search for doctors and facilities by name or specialty.
If you currently have a primary care physician (PCP), please provide your PCP’s name when you enroll for our records. If you do not enter a PCP, one will automatically be assigned to you. However, you can change your PCP any time by registering at optimahealth.com/member or calling Member Services at 1-866-514-5916.
Our Prescription Medication Coverage
Are you currently taking any prescription medications? You can check to see how Optima Health covers your prescription drugs using our Plan Formularies and Drug Lists for OptimaFit Plans.
Transition of Care
If you are currently under a doctor’s care or medication regimen, please take a minute to complete a Transition of Care Assessment. This will enable our clinical care services team to ensure there’s no interruption in care while you transition to an Optima Health Plan.
4-Star Plan Quality Rating
OptimaFit Individual & Family Health Plans offered through the Health Insurance Marketplace have achieved a 4-Star quality rating from CMS. The star ratings reflect our members’ responses to questions about plan quality and satisfaction.
Value-Added Services and Benefits
Optima Health offers members a comprehensive suite of online tools and resources for 24/7 access to plan and benefit information. You only need to register once on either the Optima Health mobile app or optimahealth.com/members for access to:
- deductible and max out-of-pocket balances
- plan benefit information
- virtual care through MDLIVE®
- treatment cost calculator
- claims and authorizations
- virtual member ID card
- bill payment
- personal health assessment and wellness tools
- update contact information and primary care provider
- forms and documents
- Health Savings Account3
- request electronic preference
- and much more!
Bill Payment Options
Optima Health offers a variety of options to pay your monthly premium. Plus, with online bill payment, you can customize how and when you pay your bill based on your individual needs.Learn More
For help with choosing the right OptimaFit plan for you and your family, our Personal Plan Advisors can assist you from 8:00 a.m. to 8:00 p.m., seven days a week. Email firstname.lastname@example.org or call 1-800-251-6840.
Once you are a member and have questions about your benefits, services, and claims, please email email@example.com or call Member Services at
1OptimaFit Select plans are only available in Charlottesville and Rockingham.
2 Sentara Health Plans, Inc., Provider Status Report, 2020.
3You must be enrolled in a Health Savings Account for access.