OptimaFit® plans are Health Maintenance Organization (HMO) plans offered in the Commonwealth of Virginia2 with access to Inova Health System.
OptimaFit plans are part of an open–access network, meaning members are not required to get a referral to see a specialist within our vast provider network. We provide access to a quality network of providers and facilities3, so you and your family can find the healthcare you need. We offer affordable plans with a wide range of coverage, deductibles, and cost–sharing options, as well as Health Savings Account options to ensure we have a plan that's right for you. Our plans include both retail and mail-order prescription drug coverage, preventive care services, Emergency Travel Assistance, and access to our 24/7 Nurse Advice Line, so you can worry less, and we can help when you need it the most.
Understanding Your Silver Plan
If you qualify, you could receive extra savings when you select a plan in the silver category. Extra savings plans provide discounts that lower your out-of-pocket expenses on deductibles, copayments and coinsurance. These additional savings are only available by qualifying and enrolling in an exchange silver plan identified as having "Extra savings."
Instant Access to Plan Information
With our comprehensive suite of digital solutions, OptimaFit members have 24/7 access to their plan and benefits. Either online or with the Optima Health mobile app, members can:
- schedule virtual consults — new for 2023: virtual consults are available at no charge for most plans4
- search for doctors and facilities
- look up benefit deductibles and copayments
- contact member services
- find costs for treatments and services
- pay monthly premium
- get important preventive care reminders
- update or change PCP
- view claims history
- and much more!
Initial Payments for New Members
New members can make their initial premium payment in a variety of convenient ways. You may pay your first month's premium with a credit card or check upon completion of your application either online or by phone at 1–888–737–5479. You may also pay cash at participating MoneyGram® locations across Virginia.
Easy Ways to Pay for Recurring Payments
Auto–debit — premium is automatically deducted from your checking account each month.
Online/Mobile App — sign in at optimahealth.com/members or the mobile app to create a custom payment schedule, set up email reminders, and more.
Cash — pay in person using MoneyGram® at thousands of merchants, without any fees. Required for payment: cash, your member ID number, and Code: 15084.
Mail — in the form of a check, cashier's check, or money order mailed to: Optima Health, P.O. Box 715892 Philadelphia, PA 19171-5892.
Pay by phone — pay with our Automated Attendant by calling 1–888–645–4306. The monthly bill is needed to use this option. Follow the prompts to make a payment using a bank checking or savings account. Call with an Optima Health representative at 757–687–6434 or 1–888–737–5479.
For more information, visit optimahealth.com/payment
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 Survey responses. CMS calculates ratings yearly on a 5-star scale. Ratings may change from year to year.
2 Excludes Frederick County, Giles County, Montgomery County, Pulaski County, Radford City, and Winchester City
3 Sentara Health Plans, Inc. Provider Database, 2021
4 Cost share may apply for HSA plans; all CSR plans are not eligible for HSA