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Documents and Forms

Optima Medicaid (Medicaid/FAMIS/CCC+)

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  • Member Handbooks

    • 2023 Optima Family Care (Medallion 4.0/FAMIS) Member Handbook
    • 2023 Optima Family Care (formerly Virginia Premier) Member Handbook
    • 2023 Optima Health Community Care (CCC+) Member Handbook
    • 2023 Optima Health Community Care (formerly Virginia Premier) Member Handbook
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    • 2022 Optima Family Care (Medallion 4.0) Formulary
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General Forms

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  • Advanced Directives

    • Advanced Directive Form
    • Advanced Directives - Your Right to Decide
  • Authorized Representative Form

    • P202A Designated Representative Authorization Form

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Medicaid members, don’t lose your healthcare coverage. The renewal process is back.
Learn what to do next.

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© Optima Health 2023, PO Box 66189, Virginia Beach, Virginia 23466

Optima Health is the trade name of Optima Health Plan, Optima Health Insurance Company, and Sentara Health Plans, Inc. Optima Health Maintenance Organization (HMO) products, and Point-of-Service (POS) products, are issued and underwritten by Optima Health Plan. Optima Preferred Provider Organization (PPO) products are issued and underwritten by Optima Health Insurance Company. Sentara Health Plans, Inc. provides administrative services to group and individual health plans but does not underwrite benefits. All Optima Health plans have benefit exclusions and limitations and terms under which the policy may be continued in force or discontinued. Optima Health Medicare, Medicaid, and FAMIS programs are administered under agreements with Optima Health and the Centers for Medicare and Medicaid Services (CMS) and the Virginia Department of Medical Assistance Services (DMAS).