Using Your Benefits

Virginia Premier Medicaid became a part of Optima Health on July 1, 2023.
This page is for members enrolled in Optima Family Care or Optima Health Community Care that were formerly with Virginia Premier.

Table of Contents

Added Benefits

We provide our members with access to extra benefits and services not generally covered through Medicaid. These are known as “added benefits.”

Case/Care Management

Sometimes there are health conditions beyond your control. You may need a little help, but you do not know where to turn. Our medical assistance program can support you with our Case/Care Management Services.

Who can participate in Case/Care Management?

You are encouraged to participate if:

  • You have been hospitalized or have used the emergency room several times
  • You have a chronic or life threatening illness
  • You have a high risk pregnancy
  • You have children with special health care needs

What does the program include?

  • A Registered Nurse case manager who determines your needs
  • Referrals to community resources, specialists, counseling and a social worker
  • Educational materials
  • Follow-up calls and home visits will be scheduled, as needed

How do I get more information?

You can call 800-727-7536 and press option 3 for Medical Management, then option 4 for Case/Care Management, or fill out the CMDM Form and fax it to 800-827-7192.

Chronic Care Management

We are committed to helping you take control of your health. Our Chronic Condition Management programs help you better understand the following conditions and health concerns.

Join our Chronic Condition Management Program

Join today by calling us at 1-866-243-0937. Once you've joined, a Registered Nurse will talk to you about:

  • Your overall health
  • The effects of your condition(s), your feelings about them, and how well you are managing
  • Important health exams you might need or benefit from
  • How going to your doctor appointments will improve your health

Health and Wellness

Our revolutionary programs can help you exceed your health improvement goals.

Transportation

Virginia Premier partners with Southeastrans to provide members with safe and reliable rides to and from medical appointments when there are no other options available.

How to Schedule

Call member services at 1-855-880-3480 (TTY: 711) 6 am to 6 pm, Monday through Friday. You may also schedule online at any time. Language assistance is available for free. Call 1-800-367-9599 (TTY: 711). Si habla español, tiene a su disposición servicios gratuitos de asistencia lingüística. Llame al 1-800-367-9599 (TTY: 711). Provide:

  • Your name, phone number, address, county, and date of birth
  • Your ID from your Medicaid card
  • Your appointment date and time
  • Your pick-up address and the destination address
  • The name and phone number of the facility or doctor

Scheduling Tips

Schedule at least five working days in advance. Weekends and holidays do not count toward these days. We schedule 30 days out at a time. You may schedule multiple rides at one time, as long as they are within the 30 day window. Mention if you have needs such as oxygen, a wheelchair, or an escort. An escort may go with you if you have a medical reason for assistance.

COVID-19 Safety

All members and drivers are required to follow the Centers for Disease Control and Prevention’s (CDC) coronavirus safety recommendations. You are required to wear a mask when using the service unless you have a medical condition preventing you from doing so. When you schedule your ride, you will be asked the following screening questions:

  • Do you have a fever?
  • Do you have a worsening cough or flu-like symptoms?
  • Have you traveled outside of the United States within the past 14 days?
  • Have you been in close contact with someone confirmed to have the novel coronavirus?

View more policy details

Your Experience

Your safety is our top priority. Drivers will be wearing an ID badge. Vehicles will be marked. Drivers must follow all traffic laws.  This is a shared service. You may be riding with other passengers.  Need to cancel? Call the transportation phone number at 1-855-880-3480 (TTY: 711) at least 24 hours before your pick-up time. If your appointment is on a Monday, you would need to cancel on a Friday. Running a bit behind? If you are not ready when your ride arrives, the driver will only wait 10 minutes. What if the driver is more than 15 minutes late? Call 1-855-880-3480 (TTY: 711). Assistance is available 24 hours a day, every day, including holidays. What is considered on-time transport? Arriving at your appointment 15 minutes before or after your scheduled appointment is considered on-time transport. Call us after your appointment to request pick-up. The driver has one hour to return to your location. The driver will pick you up within one hour of your call. Need an urgent care ride? If your doctor calls and requests you come to the office immediately for a matter that cannot wait, you are eligible for urgent care transport. A hospital admission or discharge could be considered as urgent transport. Assistance for hospital discharges is available 24 hours a day, 7 days per week, including holidays. Issues? Let us know. Call 1-855-880-3480 (TTY: 711).

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