Medicaid Member Incentives

We reward you for getting and staying healthy. The Healthy Incentives Program rewards you with up to $50 in gift cards for completing certain wellness exams and services.

How does it work?

  • If you qualify, we will send you a postcard in the mail.
  • The postcard has a form you will need to take with you when you go to your exam.
  • Ask your doctor to complete the form.
  • Mail, email ofc_referrals@sentara.com, or fax the completed form back to Optima Health.
  • After we verify the form is correct, we may elect to receive a virtual gift card within 3 to 5 business days or have it mailed to you within 6 to 8 weeks.
  • If there is an issue with the form, we will call you.

Contact the Member Outreach and Education Department to check eligibility.

Toll-free: 1-833-261-2367 (TTY: 711)
Monday - Friday, 8:00 a.m. - 5:30 p.m.
Email: ofc_referrals@sentara.com

About Rewards

The rewards maximum is $50 per member in a calendar year. Once you earn a total of $50, you will not be rewarded with additional gift cards. The visit, exam, or vaccination must be completed by December 31 to earn rewards for that same calendar year.

How to Send Your Form

There are three ways to send us your completed form.

1. Email to ofc_referrals@sentara.com
2. Fax to 1-833-552-3072
3. Mail to Optima Health Member Outreach and Education
    824 North Military Highway
    Suite 200
    Norfolk, VA 23502

Learn about the types of doctor’s visits that could earn you rewards:

Adolescent Immunizations

Vaccines help protect pre-teens from getting sick from viruses and other diseases.

Remember to bring your Healthy Incentives form with you to earn a $15 gift card.

How to Earn:

  • Members 9 to 13 years old: Must have all parts of the vaccines in the series by their 13th birthday; by December 31 of the calendar year.
    • hepatitis A (1)
    • rotavirus (2 or 3 dose)
    • influenza (2)
    • Tdap/td (1)
    • meningococcal (1)
    • HPV (2 or 3 dose)

A1C

An A1C test is a simple blood test to measure your blood sugar levels. It is also called the hemoglobin A1C or HbA1C test.

Remember to bring your Healthy Incentives form with you to earn a $15 gift card.

How to earn:

  • Members 18 to 75 years old with type 1 or type 2 diabetes: Complete by December 31 of the calendar year. HgbA1C screening, most recent:
    • 7 control
    • 8 control
    • 9 poor control

Adult Well Visit

A well visit is your yearly overall wellness check of your health with your doctor. It is also a good opportunity to ask your doctor important questions.

Remember to bring the Healthy Incentives form with you to earn a $25 gift card.

How to earn:

  • Members 22 years old and up: Complete by December 31 of the calendar year.

Child and Adolescent Well Visit

A well visit is a routine medical checkup. The exam will checks growth and development. This preventive visit can be helpful in avoiding health issues.

Remember to bring the Healthy Incentives form with you to earn a $15 gift card.

How to Earn:

Members 3 to 21 years old: Must have a well visit with a Primary Care Physician (PCP) or OB/GYN by December 31 of the calendar year. The well visit must include:

  • health history
  • physical developmental history
  • mental development history
  • physical exam
  • anticipatory guidance

Child and Adolescent Well Visit

A well visit is a routine medical checkup. The exam will checks growth and development. This preventive visit can be helpful in avoiding health issues.

Remember to bring the Healthy Incentives form with you to earn a $15 gift card.

How to Earn:

Members 3 to 21 years old: Must have a well visit with a Primary Care Physician (PCP) or OB/GYN by December 31 of the calendar year. The well visit must include:

  • health history
  • physical developmental history
  • mental development history
  • physical exam
  • anticipatory guidance

Childhood Immunizations

Vaccines protect children from certain diseases. Children should get them at certain ages.

Remember to bring the Healthy Incentives form with you to earn a $50 gift card.

How to Earn:

  • Members 0 to 2 years old: Must have the following by their second birthday by December 31 of the calendar year:
    • combo 3 immunizations: four diphtheria, tetanus, and acellular pertussis (DTaP)
    • three polio (IPV)
    • one measles, mumps, and rubella (MMR)
    • three haemophilus influenza type B (HiB)
    • three hepatitis B (HepB)
    • one chicken pox (VZV)
    • four pneumococcal conjugate (PCV)
    • one hepatitis A (HepA)
    • two or three rotavirus (RV)
    • two influenza (flu) vaccines

Colorectal Screening

A colorectal screening checks for polyps or cancer inside the colon and rectum.

Remember to bring your Healthy Incentives form with you to earn a $10 gift card.

How to Earn:

  • Members 40 to 75 years old: Must have a screening by December 31 of the calendar year. Screening options include
    • fecal occult blood test (FOBT)
    • flexible sigmoidoscopy
    • colonoscopy
    • CT colonoscopy
    • FIT-DNA test

COVID-19 Vaccination

The vaccine helps protect against the COVID-19 disease. Members must be fully vaccinated to be eligible. Booster shots are excluded.

Remember to bring your Healthy Incentives form with you to earn a $50 gift card.

How to Earn:

  • Members 6 months old and up: Must be fully vaccinated by December 31 of the calendar year. Vaccine options include:
    • Johnson & Johnson (one vaccine dose)
    • Moderna (two vaccine doses)
    • Pfizer (two vaccine doses)

Diabetic Eye Exam

Diabetes may put the health of your eyes at risk. It can lead to blurry vision or blindness.

If you are living with diabetes, it is important to have your eyes checked every year.

Remember to bring the Healthy Incentives form to the visit to earn a $15 gift card.

How to Earn:

  • Members 18 to 75 years old: Have your eye exam by December 31 of each calendar year.

Flu Vaccine

The vaccine helps protect against the seasonal flu.

Remember to bring your Healthy Incentives form with you to earn a $10 gift card.

How to Earn:

  • Members 18 to 64 years old: Complete by December 31 of the calendar year.

Foster Care Health and Dental Visits

We are here to help children in foster care with their health needs. Routine checkups with the doctor and dentist may help prevent issues.

Remember to bring the Healthy Incentives form to the visit to earn a $50 gift card.

How to Earn:

  • Members in Foster Care: Have both a doctor visit and dental visit within 30 days of becoming an Optima Health member.

Mammogram

A mammogram is a breast cancer screening.

Remember to bring the Healthy Incentives form to the visit to earn a $15 gift card.

How to Earn:

  • Members 40 to 74 years old: Complete by December 31 of the calendar year.

Pap Test

A Pap test or Pap smear is a screening to check for cervical cancer.

Remember to bring the Healthy Incentives form to the visit to earn a $15 gift card.

How to Earn:

  • Members 21 to 64 years old: Complete by December 31 of the calendar year.

Pneumonia Vaccination

The vaccine helps protect against pneumonia, a lung infection that makes it harder to breathe.

Remember to bring the Healthy Incentives form to the visit to earn a $10 gift card.

How to Earn:

  • Members 18 to 64 years old: Complete by December 31 of the calendar year.

Prenatal Care

We want to help you have a healthy pregnancy. A prenatal visit means going to your doctor to check your baby’s development.

Your first appointment is important. Remember to bring your Healthy Incentives form with you to earn a $15 gift card.

How to Earn:

  • New member: Have a prenatal visit within 42 days of plan enrollment.
  • Existing member: Have a prenatal visit within the first trimester (12 weeks) of becoming pregnant.

Postpartum Care

We want to help you recover after giving birth. A postpartum visit with your doctor checks on your health.

Remember to bring your Healthy Incentives form with you to earn a $15 gift card.

How to Earn:

  • Have a postpartum visit between 7 to 84 days after your baby is born.

What if I never received my gift card?

If you never received your gift card, please call the Member Outreach and Education Department.

Toll-free: 1-833-261-2367 (TTY: 711)
Monday - Friday, 8:00 a.m. - 5:30 p.m.

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