Optima Health

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So, what's new with the city's medical insurance for the 2017 Plan Year?  How about no increases in premiums and no increases in copays for office visits or prescriptions!  While there was an increase in the annual deductible and out-of-pocket maximums, this will not impact your copays that are excluded from the deductible, such as office visits, preventive services, prescriptions, and urgent care centers.

The city’s medical provider is Optima Health and we offer the choice of two medical plans for eligible employees and pre-65 retirees:

  • HMO  (Health Maintenance Organization)  
  • PPO   (Preferred Provider Organization)

The HMO plan allows members to choose their primary care physician (PCP) to guide and coordinate care without requiring a referral to visit a specialist. The PPO plan gives employees more freedom and flexibility when selecting providers, offering in network and out of network benefits options. 

For more information on benefits and services available through Optima, please read the Optima HMO Summary and the Optima PPO Summary.  To read more on coverage, cost and deductibles, please click
Optima HMO Summary of Coverage and Optima PPO Summary of Coverage.

   
Visit the Optima Website to learn more about the health care providers and services. Click here for answers to frequently asked questions regarding health insurance. If you are adding your spouse for the first time, please submit the 2017 Spouse Health Eligibility Employee or Retiree Form.  

If you are enrolled in an Optima plan, then you also have access to hearing aid discounts through EPIC. For more information, please click here for a flyer on the EPIC Hearing Service Plan (HSP).

To keep up to date with the innovative world we live in, Optima Health also offers a mobile app that can be downloaded from the App Store or Google Play for use on an iPhone or Android.  Just click here for a flyer to get more information on the Optima Health Mobile App.

MDLive offers 24/7/365 on-demand access to a national network of board-certified doctors and pediatricians that can diagnose, recommend treatment, and prescribe medication.  To get the care you need, when you need it, click here for more information on MDLive.

If you are looking for a convenient and cost-effective way to order up to a 90-day supply of maintenance or long-term medication for delivery to your home, office or location of your choosing, then click here for more information on OptumRx.  If you prefer to learn more about online pharmacy resources, then click here.

To help with the influenza ("flu") season, Optima Health has beneficial information on the flu vaccine and the locations to receive a flu shot...if you are interested, just click here.

If you are planning on having medical services and wish to get an estimate on the cost of the treatment or procedure, then click on these links for more information:  


Another helpful resource is Optima's EAP (Employee Assistance Program), which can be used to address life's challenges, solve personal problems, or tackle work related issues.  For more information on this program, simply click here.