Member Information
Vision Services
Vision Services are provided by EyeMed Vision Care.
To find a participating provider, call EyeMed Vision Care at 1-888-610-2268 or visit EyeMed.com. EyeMed’s hours are 9 a.m. to 8:30 p.m. Monday through Friday, and Saturdays from 9 a.m. to 5 p.m.
Benefits:
Routine eye examinations for all enrollees shall be allowed at least once every 2 years.
Each Optima Family Care/FAMIS* member under age 21 is eligible to receive the following services:
- Writing of lens formulas and prescriptions
- Dispensing/fitting procedure
- Subsequent glasses adjustments as necessary
- If prescribed, each member is entitled to one of the following:*
- One pair of glasses with clear plastic single vision lenses, or
- One pair of glasses with multifocal plastic lenses, or
- One pair of glasses frames chosen from a selection on display in the provider’s office, or
- One pair of contact lenses, only if medically necessary
*Note: No more than one pair of glasses will be allowed within a 24 month period without a statement of medical need.
You are fully covered for these services and materials, as long as they are provided by an EyeMed provider. If you select frames or lenses costing more than the amount covered by an Optima Health insurance plan, you are responsible for the additional charge.
Prior authorization is needed for contact lenses and only as a result of any of the following conditions:
- To correct extreme visual acuity problems that cannot be corrected with lenses,
- Certain conditions of anisometropia, or
- Keratoconus
Members at or over the age of 21 will receive the following discounts:
- Standard Plastic Lenses priced at:
- $50 for Single Vision
- $70 for Bifocal
- $105 for Trifocal
- 40% off frames
- Contact lenses, 15% off conventional, no discount for disposal contact lenses (discounts and fees apply only if a complete pair is purchased in the same transaction.)
- Laser vision correction surgery (e.g. LASIK) 15% off retail price or 5% off discount on promotional price discount.
NOTE: FAMIS members please see Summary of Benefits in your member guide for Copayment information.
Dental Services
Starting July 1, 2021, Virginia Medicaid offers dental coverage for all members age 21 and up.
Children and pregnant women enrolled in Medicaid, FAMIS, or FAMIS MOMS will continue to receive comprehensive dental coverage under their own program. Call DentaQuest at 1-888-912-3456.
A representative can even help members make an appointment. The call center is available 8 a.m. – 6 p.m.,
Monday through Friday, or visit DentaQuest.com.
Partners in Pregnancy
Optima Family Care recognizes that pregnancy in itself can be a life-altering journey and even the most experienced mom may feel in need of extra support. That’s why we developed the Optima Health Partners in Pregnancy Program -- a program dedicated to providing guidance, support, and education to all expectant moms with Optima Health insurance.
Learn more about Partners in Pregnancy