Having a Medicaid health plan means your visits to the doctor, hospital stays, and prescriptions are covered at little or no cost to you.
Here are some highlights of Medicaid covered benefits for Optima Health Medicaid members.
Medicaid and Medicare dual-eligible Optima Community Complete (HMO D-SNP) members: view plan details.
Quality Expert Care
- 35,000 providers including doctors, urgent cares and hospitals
- access to quality specialists for allergies, diabetes, heart problems, and more
- help scheduling doctor appointments and rides
- a dedicated advocate for coordinating your care and benefits
- preventive care
- routine medical care
- well-baby, well-child, and well-adolescent health exams
- dental benefits (covered by Virginia Medicaid under a separate program)
- eye exams
- hearing exams
Note: FAMIS Children members may have low copays.
- urgent care
- emergency care
- hospital stays
- no copays at in-network pharmacies for drugs on our drug list
- FAMIS Children: Low copay, typically $2 to $5
- Optima Community Complete (HMO D-SNP): view plan details for drug coverage if you are dual-eligible for both Medicare and Medicaid
Note: Does not cover Medicare Part D drugs, including the Medicare copayment.