Rewards and Incentives for Medicare Members

Annual Wellness Visit - $25 reward

• The Annual Wellness Visit is an appointment with someone from your primary care provider’s team. At this appointment you can discuss any health issues you are having as well as plan for all preventive screenings, tests, and vaccines you might need over the next few years.
• Available to all Optima Medicare and Optima Community Complete members. 

Annual Physical Exam - $25 reward

• The Annual Physical Exam is another great way for you to engage with your doctor. During an Annual Physical Exam, your provider reviews your current health history and completes a comprehensive physical exam and evaluation of chronic diseases, if applicable.
• Available to all Optima Medicare and Optima Community Complete members.

Annual Flu Vaccine - $10 reward

• Getting your Annual Flu Vaccine is an important step to keeping yourself healthy.
• Available to all Optima Medicare and Optima Community Complete members.

Health Risk Assessment - $25

The Health Risk Assessment (HRA) is a questionnaire that evaluates a member’s lifestyle and health status, as well as identifies possible health risks factors. You can easily complete your HRA by calling the Optima Medicare Outreach Team at 1-833-771-1427.

Your HRA must be completed within 90 days of enrollment, and then annually after the first year of enrollment.

Breast Cancer Screening (Mammogram) - $25 reward

• Regular mammograms can help detect breast cancer early, when it is easiest to treat. For most women, a mammogram is the best way to detect breast cancer. According to the Susan G. Komen Foundation, the five-year breast cancer survival rate for those diagnosed early (Stage 1) is 98-100%.
• Available to all Optima Medicare and Optima Community Complete members.

Colon Cancer Screening - $25 reward

• According to the Centers for Disease Control and Prevention, regular screening is key to preventing colorectal cancer. For questions about which colorectal cancer screening is best for you, contact your doctor to learn your options.
• Available to all Optima Medicare and Optima Community Complete members.

Diabetic HbA1c Test - $10 reward

• Managing your diabetes includes regular screenings to ensure you are staying as healthy as possible. The HbA1c test measures how much of your hemoglobin is coated with sugar. The higher your level, the greater your chance for diabetes related complications down the road.
• Available to Optima Medicare and Optima Community Complete members with diabetes.

Diabetic Eye Exam - $10 reward

• Diabetic retinopathy is a common diabetes complication, and it is the leading cause of blindness in adults in the United States. Annual diabetic eye exams are an important part of managing your diabetes and health.
• Available to Optima Medicare and Optima Community Complete members with diabetes.

Diabetic Kidney Function Test - $10 reward

• Diabetes can damage the kidneys. Kidney function testing, such as the urine protein (microalbumin) screening, is important to ensure your kidneys are functioning optimally.
• Available to Optima Medicare and Optima Community Complete members with diabetes.

Medication Therapy Management (Comprehensive Medication Review)* - $50 reward

• If you are eligible for the Medication Therapy Management Program, OptumRx will contact you on behalf of Optima Medicare and ask you to participate in a Comprehensive Medication Review. This review is a special opportunity for you to talk one-on-one with a clinical pharmacist about all of your medications, including over-the-counter drugs. Participating in the review can help you make sure you are taking all of your medications safely and identify any possible medication interactions your physician may need to know about.
• Available to Optima Medicare Value (HMO), Optima Medicare Prime (HMO), and Optima Community Complete (HMO D-SNP) members who are eligible to participate in the Medication Therapy Management program.

*Additional restrictions apply to this reward and it can only be used at limited grocery stores.

How does the rewards program work?

First, schedule an appointment with an in-network provider for the service. When you complete the screening, exam, or vaccine, a claim is submitted to us from the provider. Once Optima Medicare receives the claim, a gift card will be mailed to you within 8 - 10 weeks. The gift card is mailed to the address we have on record.

What are the eligibility criteria?

All Optima Medicare and Optima Community Complete members are eligible for at least four rewards, Annual Wellness Exam, Annual Physical Exam, Annual Flu Vaccine, and completion of the Health Risk Assessment. Some members may qualify for additional rewards, such as Breast Cancer Screening and Colorectal Cancer Screening. Members with diabetes can also earn a reward for completing a Diabetic Eye Exam, a Diabetic Kidney Function Test, or Diabetic HbA1c Testing.

All members eligible for Medication Therapy Management Program qualify for a reward.

Which plans are eligible?

• Members enrolled in Optima Medicare Value (HMO), Optima Medicare Prime (HMO), Optima Medicare Salute (HMO), Optima Community Complete (HMO D-SNP) in all regions are eligible for all rewards depending on qualifications.

Why should I participate in the 2022 Healthy Rewards Program?

The benefit you get from participating in the rewards program is more than just earning a gift card. Preventive care and staying on top of your health are important to healthy aging. The rewards activities selected can help you manage your overall wellness and help you develop a roadmap to achieve your health goals.

How can I follow up on my rewards eligibility or gift card status?

For questions about the rewards program or to follow up on gift card status, please call Optima Medicare member services at 1-800-927-6048 (TTY: 711) or email at members@optimahealth.com.