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HEDIS® is a registered trademark of the National Committee for Quality Assurance (NCQA). CHRONIC SPECIAL NEEDS PLANS 2021 Page 1 of 29 Summary of Benefits January 1, 2021 – December 31, 2021 Optimum Diamond Rewards (HMO C-SNP) H5594_028 Optimum Diamond Rewards COPD (HMO C-SNP) H5594_029 Optimum Diamond Rewards (HMO C-SNP)H5594_030
2021 PROVIDER AND PHARMACY DIRECTORY Preface - 3 April 2021 Optimum HealthCare, Inc. HMO Plan Provider Directory This directory is current as of 04/12/2021. This directory provides a list of Optimum HealthCare, Inc.’s current networkproviders.
2021 SUMMARY OF BENEFITS Page 1 of 15 Summary of Benefits January 1, 2021 - December 31, 2021 Optimum Platinum Plan (HMO) H5594_002 Optimum Platinum Plan (HMO) H5594_019 The purpose of the Summary of Benefits is to provide you with summary of drug and health benefits covered by Optimum Platinum Plan (HMO) H5594_002 and Optimum Platinum Plan (HMO) H5594_019, which describes what we cover OPTIMUM DISENROLLMENT FORM Disenrollment Form and Attestation of Eligibility H5594_191EX10(NM)_C Page 1 of 2 Please return the completed form via Fax: 1-888-548-0098 OR mail to P.O. Box 151108, Tampa, FL 33684 If you request disenrollment, you must continue to get all medical care from Optimum HealthCare until the AT NO COST TO YOU! RECEIVE FROM TO 20 125 1 $20 $125 unty. 2021 OTC Benefits At NO COST To You! OPT21OTC Receive from to every month * in Over-the-Counter Drugs & Supplies based on plan selection and co en 0 ar!** 016 - OPTIMUM EMERALD PARTIAL (HMO D-SNP) 017 - OPTIMUM Page 2 of 26 Our service area includes the following counties in Florida: Optimum Emerald Partial (HMO D-SNP) H5594_016 and Optimum Emerald Full (HMO D-SNP) H5594_017: Brevard, Broward, Charlotte, Citrus, Collier, Hernando, Hillsborough, Indian River, Lake, Lee, Manatee, Marion, Martin, Orange,HIPAA AUTH FORM
HIPAA Privacy Authorization Form **Authorization for Use or Disclosure of Protected Health Information (Required by the Health InsurancePortability and
ENROLL MEDICARE ADVANTAGE PLANS OPTIMUM HEALTHCAREMEDICARE PLANSMEMBERSPROVIDERSOTCSERVICES NOT COVEREDSPECIAL NEEDS PLAN INFO Optimum HealthCare, Inc. is an HMO with a Medicare contract and a contract with the state of Florida Medicaid program. Enrollment in Optimum HealthCare, Inc. depends on contract renewal. This Information is not a complete description of benefits. Call 1 OTC - ORDER OVER-THE-COUNTER SUPPLIES ONLINE OPTIMUM Quick and Easy way to order OTC Drugs and Supplies at NO COST to you, based on plan selection and county. Members receive a monthly Over-the-Counter allowance of $20 to $125 every month based on plan and county. Choose from 16 different categories of products and supplies from OTC Online or our Catalog. English Catalog.LOG IN
HEDIS® is a registered trademark of the National Committee for Quality Assurance (NCQA). CHRONIC SPECIAL NEEDS PLANS 2021 Page 1 of 29 Summary of Benefits January 1, 2021 – December 31, 2021 Optimum Diamond Rewards (HMO C-SNP) H5594_028 Optimum Diamond Rewards COPD (HMO C-SNP) H5594_029 Optimum Diamond Rewards (HMO C-SNP)H5594_030
2021 PROVIDER AND PHARMACY DIRECTORY Preface - 3 April 2021 Optimum HealthCare, Inc. HMO Plan Provider Directory This directory is current as of 04/12/2021. This directory provides a list of Optimum HealthCare, Inc.’s current networkproviders.
2021 SUMMARY OF BENEFITS Page 1 of 15 Summary of Benefits January 1, 2021 - December 31, 2021 Optimum Platinum Plan (HMO) H5594_002 Optimum Platinum Plan (HMO) H5594_019 The purpose of the Summary of Benefits is to provide you with summary of drug and health benefits covered by Optimum Platinum Plan (HMO) H5594_002 and Optimum Platinum Plan (HMO) H5594_019, which describes what we cover OPTIMUM DISENROLLMENT FORM Disenrollment Form and Attestation of Eligibility H5594_191EX10(NM)_C Page 1 of 2 Please return the completed form via Fax: 1-888-548-0098 OR mail to P.O. Box 151108, Tampa, FL 33684 If you request disenrollment, you must continue to get all medical care from Optimum HealthCare until the AT NO COST TO YOU! RECEIVE FROM TO 20 125 1 $20 $125 unty. 2021 OTC Benefits At NO COST To You! OPT21OTC Receive from to every month * in Over-the-Counter Drugs & Supplies based on plan selection and co en 0 ar!** 016 - OPTIMUM EMERALD PARTIAL (HMO D-SNP) 017 - OPTIMUM Page 2 of 26 Our service area includes the following counties in Florida: Optimum Emerald Partial (HMO D-SNP) H5594_016 and Optimum Emerald Full (HMO D-SNP) H5594_017: Brevard, Broward, Charlotte, Citrus, Collier, Hernando, Hillsborough, Indian River, Lake, Lee, Manatee, Marion, Martin, Orange,HIPAA AUTH FORM
HIPAA Privacy Authorization Form **Authorization for Use or Disclosure of Protected Health Information (Required by the Health InsurancePortability and
DISCOVER THE OPTIMUM ADVANTAGE OPTIMUM HEALTHCARE Discover the Optimum Advantage. Knowledge you can rely on. Yes, we’re proud that Optimum HealthCare is one of Florida’s health plans; but we’re even more proud of the Medicare coverage we’ve been providing for over 15 years. It’s not only great value, but it helps you make positive changes to live long and stay strong! INFORMATION FROM OPTIMUM HEALTHCARE FOR CARE PROVIDERS Medicare Advantage Provider Bulletin June 2021 Information from Optimum Healthcare for Care Providers About COVID-19 (UPDATED May 25, 2021) Optimum Healthcare will update FAQs as more information becomesavailable.
SERVICE AREA OPTIMUM HEALTHCARE The Optimum Health Network has 50+ Primary Care Physician Providers, 200+ Specialist Offices and more than 10 Health Fitness Center locations in Collier County. Broward County. The Optimum Health Network has 250+ active members, 60+ Primary Care Offices, 500+ Specialist Offices and more than 80 Health Fitness Center locations inBroward County.
MEDICARE OPTIMUM HEALTHCARE But many of our Medicare Advantage Plans offer vision, dental and hearing coverage. Toll Free 1-888-286-2362. Speak to an Agent. Request an Appointment. Medicare Parts A and B pay for many healthcare services and supplies, but they don’t cover all of your healthcare costs. Also, drug coverage when not in the hospital is very limited. CLAIMS OPTIMUM HEALTHCARE For claim denials regarding untimely filing, incidental procedures, bundling, unbundling, unlisted procedure codes, non-covered codes, etc. Claims must be submitted to Optimum HealthCare within 90 days of date of denial from EOB. Mail claim appeals to: Optimum HealthCare, Inc. Claims Department. P. O. Box 151258. 2021 PROVIDER AND PHARMACY DIRECTORY Preface - 3 April 2021 Optimum HealthCare, Inc. HMO Plan Provider Directory This directory is current as of 04/12/2021. This directory provides a list of Optimum HealthCare, Inc.’s current networkproviders.
FORMS OPTIMUM HEALTHCARE Top rated Advantage Plans for Florida. Free to enroll, plans with $0 monthly premium, low out-of-pocket max. 1-866-245-5360. WELCOME TO OTC ON LIN E Welcome to OTC On lin e o o r r d d e e r r i i n n g g m m a a d d e e e e a a s s y y OTC Mail Program - The Easy Way To Get Your Medications It’sas easy as 1, 2HIPAA AUTH FORM
HIPAA Privacy Authorization Form **Authorization for Use or Disclosure of Protected Health Information (Required by the Health InsurancePortability and
PRE-CERTIFICATION REQUEST FORM ALL REQUIRE MEDICAL … ASC for Blepharoplasty, Podiatric Surgery, Implantable pump/device or stimulator Wound Care (outpatient hospital only) PRE-CERTIFICATIONREQUEST FORM
ENROLL MEDICARE ADVANTAGE PLANS OPTIMUM HEALTHCAREMEDICARE PLANSMEMBERSPROVIDERSOTCSERVICES NOT COVEREDSPECIAL NEEDS PLAN INFO Optimum HealthCare, Inc. is an HMO with a Medicare contract and a contract with the state of Florida Medicaid program. Enrollment in Optimum HealthCare, Inc. depends on contract renewal. This Information is not a complete description of benefits. Call 1 OTC - ORDER OVER-THE-COUNTER SUPPLIES ONLINE OPTIMUM Quick and Easy way to order OTC Drugs and Supplies at NO COST to you, based on plan selection and county. Members receive a monthly Over-the-Counter allowance of $20 to $125 every month based on plan and county. Choose from 16 different categories of products and supplies from OTC Online or our Catalog. English Catalog. DISCOVER THE OPTIMUM ADVANTAGE OPTIMUM HEALTHCARE Discover the Optimum Advantage. Knowledge you can rely on. Yes, we’re proud that Optimum HealthCare is one of Florida’s health plans; but we’re even more proud of the Medicare coverage we’ve been providing for over 15 years. It’s not only great value, but it helps you make positive changes to live long and stay strong! 2021 PROVIDER AND PHARMACY DIRECTORY Preface - 3 April 2021 Optimum HealthCare, Inc. HMO Plan Provider Directory This directory is current as of 04/12/2021. This directory provides a list of Optimum HealthCare, Inc.’s current networkproviders.
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HEDIS® is a registered trademark of the National Committee for Quality Assurance (NCQA). CHRONIC SPECIAL NEEDS PLANS 2021 Page 1 of 29 Summary of Benefits January 1, 2021 – December 31, 2021 Optimum Diamond Rewards (HMO C-SNP) H5594_028 Optimum Diamond Rewards COPD (HMO C-SNP) H5594_029 Optimum Diamond Rewards (HMO C-SNP)H5594_030
FORMS OPTIMUM HEALTHCARE Top rated Advantage Plans for Florida. Free to enroll, plans with $0 monthly premium, low out-of-pocket max. 1-866-245-5360. SPECIAL NEEDS PLAN INFORMATION Special Needs Plan: Case Management - Provider. The Special Needs Plan (SNP) provides Case Management assistance to all members, but primarily assists those that are determined to need the most help (Tier 3). Case Managers are nurses who work with you to improve your patient’s ability to manage their health. PHARMACY & PART D COVERAGE INFORMATION OPTIMUM HEALTHCARE From October 1 to March 31 from 8:00 a.m. to 8:00 p.m. 7 days a week and April 1 to September 30 from 8:00 a.m. to 8:00 p.m. Monday through Friday. We also have pharmacies that are in our network but are outside our service area. Please contact Optimum HealthCare, Inc. at 1-866-245-5360 for additional information. SPECIAL NEEDS PLAN: CASE MANAGEMENT The Special Needs Plan (SNP) provides Case Management assistance to all members, but primarily assists those that are determined to need the most help. Case Managers are nurses who work with you and your doctor to improve your ability to manage your health. This program also includes Social Workers who can help with community resourceassistance.
ENROLL MEDICARE ADVANTAGE PLANS OPTIMUM HEALTHCAREMEDICARE PLANSMEMBERSPROVIDERSOTCSERVICES NOT COVEREDSPECIAL NEEDS PLAN INFO Optimum HealthCare, Inc. is an HMO with a Medicare contract and a contract with the state of Florida Medicaid program. Enrollment in Optimum HealthCare, Inc. depends on contract renewal. This Information is not a complete description of benefits. Call 1 OTC - ORDER OVER-THE-COUNTER SUPPLIES ONLINE OPTIMUM Quick and Easy way to order OTC Drugs and Supplies at NO COST to you, based on plan selection and county. Members receive a monthly Over-the-Counter allowance of $20 to $125 every month based on plan and county. Choose from 16 different categories of products and supplies from OTC Online or our Catalog. English Catalog. DISCOVER THE OPTIMUM ADVANTAGE OPTIMUM HEALTHCARE Discover the Optimum Advantage. Knowledge you can rely on. Yes, we’re proud that Optimum HealthCare is one of Florida’s health plans; but we’re even more proud of the Medicare coverage we’ve been providing for over 15 years. It’s not only great value, but it helps you make positive changes to live long and stay strong! 2021 PROVIDER AND PHARMACY DIRECTORY Preface - 3 April 2021 Optimum HealthCare, Inc. HMO Plan Provider Directory This directory is current as of 04/12/2021. This directory provides a list of Optimum HealthCare, Inc.’s current networkproviders.
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HEDIS® is a registered trademark of the National Committee for Quality Assurance (NCQA). CHRONIC SPECIAL NEEDS PLANS 2021 Page 1 of 29 Summary of Benefits January 1, 2021 – December 31, 2021 Optimum Diamond Rewards (HMO C-SNP) H5594_028 Optimum Diamond Rewards COPD (HMO C-SNP) H5594_029 Optimum Diamond Rewards (HMO C-SNP)H5594_030
FORMS OPTIMUM HEALTHCARE Top rated Advantage Plans for Florida. Free to enroll, plans with $0 monthly premium, low out-of-pocket max. 1-866-245-5360. SPECIAL NEEDS PLAN INFORMATION Special Needs Plan: Case Management - Provider. The Special Needs Plan (SNP) provides Case Management assistance to all members, but primarily assists those that are determined to need the most help (Tier 3). Case Managers are nurses who work with you to improve your patient’s ability to manage their health. PHARMACY & PART D COVERAGE INFORMATION OPTIMUM HEALTHCARE From October 1 to March 31 from 8:00 a.m. to 8:00 p.m. 7 days a week and April 1 to September 30 from 8:00 a.m. to 8:00 p.m. Monday through Friday. We also have pharmacies that are in our network but are outside our service area. Please contact Optimum HealthCare, Inc. at 1-866-245-5360 for additional information. SPECIAL NEEDS PLAN: CASE MANAGEMENT The Special Needs Plan (SNP) provides Case Management assistance to all members, but primarily assists those that are determined to need the most help. Case Managers are nurses who work with you and your doctor to improve your ability to manage your health. This program also includes Social Workers who can help with community resourceassistance.
QUALITY AT OPTIMUM HEALTHCARE OPTIMUM HEALTHCARE The overall goal of this program is to achieve quality care and services for our members. We achieve this goal through the design, implementation and improvement of organizational systems. You can call Member Services (Toll Free) 1-866-245-5360 to request a paper copy of our QM Program. Providers can contact their Provider Relations SERVICE AREA OPTIMUM HEALTHCARE The Optimum Health Network has 50+ Primary Care Physician Providers, 200+ Specialist Offices and more than 10 Health Fitness Center locations in Collier County. Broward County. The Optimum Health Network has 250+ active members, 60+ Primary Care Offices, 500+ Specialist Offices and more than 80 Health Fitness Center locations inBroward County.
MEDICARE OPTIMUM HEALTHCARE But many of our Medicare Advantage Plans offer vision, dental and hearing coverage. Toll Free 1-888-286-2362. Speak to an Agent. Request an Appointment. Medicare Parts A and B pay for many healthcare services and supplies, but they don’t cover all of your healthcare costs. Also, drug coverage when not in the hospital is very limited. 2021 SUMMARY OF BENEFITS Page 1 of 15 Summary of Benefits January 1, 2021 - December 31, 2021 Optimum Platinum Plan (HMO) H5594_002 Optimum Platinum Plan (HMO) H5594_019 The purpose of the Summary of Benefits is to provide you with summary of drug and health benefits covered by Optimum Platinum Plan (HMO) H5594_002 and Optimum Platinum Plan (HMO) H5594_019, which describes what we cover SELF-MANAGEMENT TOOLS OPTIMUM HEALTHCARE Self-Management Tools. The following interactive self-management tools are meant to help you manage your health. These tools will allow you to assess your risk factors and provide you with personalized results and/or guidance on how you can improve your health. Please click on each tool’s title to open the tool in a new window. 2021 PROVIDER AND PHARMACY DIRECTORY Preface - 3 April 2021 Optimum HealthCare, Inc. HMO Plan Provider Directory This directory is current as of 04/12/2021. This directory provides a list of Optimum HealthCare, Inc.’s current networkproviders.
OPTIMUM QUICK REFERENCE GUIDE 2021 Optimum HealthCare Medicare Quick Reference Guide NOTE: This guide is not designed to be an all-inclusive list of covered services under Freedom Health, Inc.It provides current referral and prior authorization instructions. Authorization does not guarantee paymentof claims.
MAKE THE MOST YOUR BENEFITS H5594_2021_DVH Flyer_M . Optimum HealthCare, Inc. is an HMO plan with a Medicare contract and a contract with the state Medicaid program. Enrollment in Optimum HealthCare, APPEALS OPTIMUM HEALTHCARE Appointment of a Representative. The Appointment of Representative Form is located on the CMS Web site. Beneficiaries and providers may appoint another individual, including an attorney, as their representative in dealings with Medicare, including appeals you file. AT NO COST TO YOU! RECEIVE FROM TO 20 125 1 $20 $125 unty. 2021 OTC Benefits At NO COST To You! OPT21OTC Receive from to every month * in Over-the-Counter Drugs & Supplies based on plan selection and co en 0 ar!** ENROLL MEDICARE ADVANTAGE PLANS OPTIMUM HEALTHCAREMEDICARE PLANSMEMBERSPROVIDERSOTCSERVICES NOT COVEREDSPECIAL NEEDS PLAN INFO Optimum HealthCare, Inc. is an HMO with a Medicare contract and a contract with the state of Florida Medicaid program. Enrollment in Optimum HealthCare, Inc. depends on contract renewal. This Information is not a complete description of benefits. Call 1 OTC - ORDER OVER-THE-COUNTER SUPPLIES ONLINE OPTIMUM Quick and Easy way to order OTC Drugs and Supplies at NO COST to you, based on plan selection and county. Members receive a monthly Over-the-Counter allowance of $20 to $125 every month based on plan and county. Choose from 16 different categories of products and supplies from OTC Online or our Catalog. English Catalog. DISCOVER THE OPTIMUM ADVANTAGE OPTIMUM HEALTHCARE Discover the Optimum Advantage. Knowledge you can rely on. Yes, we’re proud that Optimum HealthCare is one of Florida’s health plans; but we’re even more proud of the Medicare coverage we’ve been providing for over 15 years. It’s not only great value, but it helps you make positive changes to live long and stay strong! 2021 PROVIDER AND PHARMACY DIRECTORY Preface - 3 April 2021 Optimum HealthCare, Inc. HMO Plan Provider Directory This directory is current as of 04/12/2021. This directory provides a list of Optimum HealthCare, Inc.’s current networkproviders.
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HEDIS® is a registered trademark of the National Committee for Quality Assurance (NCQA). CHRONIC SPECIAL NEEDS PLANS 2021OTC SHOW 2021 Page 1 of 29 Summary of Benefits January 1, 2021 – December 31, 2021 Optimum Diamond Rewards (HMO C-SNP) H5594_028 Optimum Diamond Rewards COPD (HMO C-SNP) H5594_029 Optimum Diamond Rewards (HMO C-SNP)H5594_030
FORMS OPTIMUM HEALTHCARE Top rated Advantage Plans for Florida. Free to enroll, plans with $0 monthly premium, low out-of-pocket max. 1-866-245-5360. SPECIAL NEEDS PLAN INFORMATION Special Needs Plan: Case Management - Provider. The Special Needs Plan (SNP) provides Case Management assistance to all members, but primarily assists those that are determined to need the most help (Tier 3). Case Managers are nurses who work with you to improve your patient’s ability to manage their health. PHARMACY & PART D COVERAGE INFORMATION OPTIMUM HEALTHCARE From October 1 to March 31 from 8:00 a.m. to 8:00 p.m. 7 days a week and April 1 to September 30 from 8:00 a.m. to 8:00 p.m. Monday through Friday. We also have pharmacies that are in our network but are outside our service area. Please contact Optimum HealthCare, Inc. at 1-866-245-5360 for additional information. SPECIAL NEEDS PLAN: CASE MANAGEMENT The Special Needs Plan (SNP) provides Case Management assistance to all members, but primarily assists those that are determined to need the most help. Case Managers are nurses who work with you and your doctor to improve your ability to manage your health. This program also includes Social Workers who can help with community resourceassistance.
ENROLL MEDICARE ADVANTAGE PLANS OPTIMUM HEALTHCAREMEDICARE PLANSMEMBERSPROVIDERSOTCSERVICES NOT COVEREDSPECIAL NEEDS PLAN INFO Optimum HealthCare, Inc. is an HMO with a Medicare contract and a contract with the state of Florida Medicaid program. Enrollment in Optimum HealthCare, Inc. depends on contract renewal. This Information is not a complete description of benefits. Call 1 OTC - ORDER OVER-THE-COUNTER SUPPLIES ONLINE OPTIMUM Quick and Easy way to order OTC Drugs and Supplies at NO COST to you, based on plan selection and county. Members receive a monthly Over-the-Counter allowance of $20 to $125 every month based on plan and county. Choose from 16 different categories of products and supplies from OTC Online or our Catalog. English Catalog. DISCOVER THE OPTIMUM ADVANTAGE OPTIMUM HEALTHCARE Discover the Optimum Advantage. Knowledge you can rely on. Yes, we’re proud that Optimum HealthCare is one of Florida’s health plans; but we’re even more proud of the Medicare coverage we’ve been providing for over 15 years. It’s not only great value, but it helps you make positive changes to live long and stay strong! 2021 PROVIDER AND PHARMACY DIRECTORY Preface - 3 April 2021 Optimum HealthCare, Inc. HMO Plan Provider Directory This directory is current as of 04/12/2021. This directory provides a list of Optimum HealthCare, Inc.’s current networkproviders.
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HEDIS® is a registered trademark of the National Committee for Quality Assurance (NCQA). CHRONIC SPECIAL NEEDS PLANS 2021OTC SHOW 2021 Page 1 of 29 Summary of Benefits January 1, 2021 – December 31, 2021 Optimum Diamond Rewards (HMO C-SNP) H5594_028 Optimum Diamond Rewards COPD (HMO C-SNP) H5594_029 Optimum Diamond Rewards (HMO C-SNP)H5594_030
FORMS OPTIMUM HEALTHCARE Top rated Advantage Plans for Florida. Free to enroll, plans with $0 monthly premium, low out-of-pocket max. 1-866-245-5360. SPECIAL NEEDS PLAN INFORMATION Special Needs Plan: Case Management - Provider. The Special Needs Plan (SNP) provides Case Management assistance to all members, but primarily assists those that are determined to need the most help (Tier 3). Case Managers are nurses who work with you to improve your patient’s ability to manage their health. PHARMACY & PART D COVERAGE INFORMATION OPTIMUM HEALTHCARE From October 1 to March 31 from 8:00 a.m. to 8:00 p.m. 7 days a week and April 1 to September 30 from 8:00 a.m. to 8:00 p.m. Monday through Friday. We also have pharmacies that are in our network but are outside our service area. Please contact Optimum HealthCare, Inc. at 1-866-245-5360 for additional information. SPECIAL NEEDS PLAN: CASE MANAGEMENT The Special Needs Plan (SNP) provides Case Management assistance to all members, but primarily assists those that are determined to need the most help. Case Managers are nurses who work with you and your doctor to improve your ability to manage your health. This program also includes Social Workers who can help with community resourceassistance.
QUALITY AT OPTIMUM HEALTHCARE OPTIMUM HEALTHCARE The overall goal of this program is to achieve quality care and services for our members. We achieve this goal through the design, implementation and improvement of organizational systems. You can call Member Services (Toll Free) 1-866-245-5360 to request a paper copy of our QM Program. Providers can contact their Provider Relations SERVICE AREA OPTIMUM HEALTHCARE The Optimum Health Network has 50+ Primary Care Physician Providers, 200+ Specialist Offices and more than 10 Health Fitness Center locations in Collier County. Broward County. The Optimum Health Network has 250+ active members, 60+ Primary Care Offices, 500+ Specialist Offices and more than 80 Health Fitness Center locations inBroward County.
MEDICARE OPTIMUM HEALTHCARE But many of our Medicare Advantage Plans offer vision, dental and hearing coverage. Toll Free 1-888-286-2362. Speak to an Agent. Request an Appointment. Medicare Parts A and B pay for many healthcare services and supplies, but they don’t cover all of your healthcare costs. Also, drug coverage when not in the hospital is very limited. 2021 SUMMARY OF BENEFITS Page 1 of 15 Summary of Benefits January 1, 2021 - December 31, 2021 Optimum Platinum Plan (HMO) H5594_002 Optimum Platinum Plan (HMO) H5594_019 The purpose of the Summary of Benefits is to provide you with summary of drug and health benefits covered by Optimum Platinum Plan (HMO) H5594_002 and Optimum Platinum Plan (HMO) H5594_019, which describes what we cover SELF-MANAGEMENT TOOLS OPTIMUM HEALTHCARE Self-Management Tools. The following interactive self-management tools are meant to help you manage your health. These tools will allow you to assess your risk factors and provide you with personalized results and/or guidance on how you can improve your health. Please click on each tool’s title to open the tool in a new window. 2021 PROVIDER AND PHARMACY DIRECTORY Preface - 3 April 2021 Optimum HealthCare, Inc. HMO Plan Provider Directory This directory is current as of 04/12/2021. This directory provides a list of Optimum HealthCare, Inc.’s current networkproviders.
OPTIMUM QUICK REFERENCE GUIDE 2021 Optimum HealthCare Medicare Quick Reference Guide NOTE: This guide is not designed to be an all-inclusive list of covered services under Freedom Health, Inc.It provides current referral and prior authorization instructions. Authorization does not guarantee paymentof claims.
MAKE THE MOST YOUR BENEFITS H5594_2021_DVH Flyer_M . Optimum HealthCare, Inc. is an HMO plan with a Medicare contract and a contract with the state Medicaid program. Enrollment in Optimum HealthCare, APPEALS OPTIMUM HEALTHCARE Appointment of a Representative. The Appointment of Representative Form is located on the CMS Web site. Beneficiaries and providers may appoint another individual, including an attorney, as their representative in dealings with Medicare, including appeals you file. AT NO COST TO YOU! RECEIVE FROM TO 20 125 1 $20 $125 unty. 2021 OTC Benefits At NO COST To You! OPT21OTC Receive from to every month * in Over-the-Counter Drugs & Supplies based on plan selection and co en 0 ar!** ENROLL MEDICARE ADVANTAGE PLANS OPTIMUM HEALTHCAREMEDICARE PLANSMEMBERSPROVIDERSOTCSERVICES NOT COVEREDSPECIAL NEEDS PLAN INFO Optimum HealthCare, Inc. is an HMO with a Medicare contract and a contract with the state of Florida Medicaid program. Enrollment in Optimum HealthCare, Inc. depends on contract renewal. This Information is not a complete description of benefits. Call 1 OTC - ORDER OVER-THE-COUNTER SUPPLIES ONLINE OPTIMUM Quick and Easy way to order OTC Drugs and Supplies at NO COST to you, based on plan selection and county. Members receive a monthly Over-the-Counter allowance of $20 to $125 every month based on plan and county. Choose from 16 different categories of products and supplies from OTC Online or our Catalog. English Catalog. DISCOVER THE OPTIMUM ADVANTAGE OPTIMUM HEALTHCARE Discover the Optimum Advantage. Knowledge you can rely on. Yes, we’re proud that Optimum HealthCare is one of Florida’s health plans; but we’re even more proud of the Medicare coverage we’ve been providing for over 15 years. It’s not only great value, but it helps you make positive changes to live long and stay strong! 2021 PROVIDER AND PHARMACY DIRECTORY Preface - 3 April 2021 Optimum HealthCare, Inc. HMO Plan Provider Directory This directory is current as of 04/12/2021. This directory provides a list of Optimum HealthCare, Inc.’s current networkproviders.
LOG IN
HEDIS® is a registered trademark of the National Committee for Quality Assurance (NCQA). CHRONIC SPECIAL NEEDS PLANS 2021OTC SHOW 2021 Page 1 of 29 Summary of Benefits January 1, 2021 – December 31, 2021 Optimum Diamond Rewards (HMO C-SNP) H5594_028 Optimum Diamond Rewards COPD (HMO C-SNP) H5594_029 Optimum Diamond Rewards (HMO C-SNP)H5594_030
FORMS OPTIMUM HEALTHCARE Top rated Advantage Plans for Florida. Free to enroll, plans with $0 monthly premium, low out-of-pocket max. 1-866-245-5360. SPECIAL NEEDS PLAN INFORMATION Special Needs Plan: Case Management - Provider. The Special Needs Plan (SNP) provides Case Management assistance to all members, but primarily assists those that are determined to need the most help (Tier 3). Case Managers are nurses who work with you to improve your patient’s ability to manage their health. PHARMACY & PART D COVERAGE INFORMATION OPTIMUM HEALTHCARE From October 1 to March 31 from 8:00 a.m. to 8:00 p.m. 7 days a week and April 1 to September 30 from 8:00 a.m. to 8:00 p.m. Monday through Friday. We also have pharmacies that are in our network but are outside our service area. Please contact Optimum HealthCare, Inc. at 1-866-245-5360 for additional information. SPECIAL NEEDS PLAN: CASE MANAGEMENT The Special Needs Plan (SNP) provides Case Management assistance to all members, but primarily assists those that are determined to need the most help. Case Managers are nurses who work with you and your doctor to improve your ability to manage your health. This program also includes Social Workers who can help with community resourceassistance.
ENROLL MEDICARE ADVANTAGE PLANS OPTIMUM HEALTHCAREMEDICARE PLANSMEMBERSPROVIDERSOTCSERVICES NOT COVEREDSPECIAL NEEDS PLAN INFO Optimum HealthCare, Inc. is an HMO with a Medicare contract and a contract with the state of Florida Medicaid program. Enrollment in Optimum HealthCare, Inc. depends on contract renewal. This Information is not a complete description of benefits. Call 1 OTC - ORDER OVER-THE-COUNTER SUPPLIES ONLINE OPTIMUM Quick and Easy way to order OTC Drugs and Supplies at NO COST to you, based on plan selection and county. Members receive a monthly Over-the-Counter allowance of $20 to $125 every month based on plan and county. Choose from 16 different categories of products and supplies from OTC Online or our Catalog. English Catalog. DISCOVER THE OPTIMUM ADVANTAGE OPTIMUM HEALTHCARE Discover the Optimum Advantage. Knowledge you can rely on. Yes, we’re proud that Optimum HealthCare is one of Florida’s health plans; but we’re even more proud of the Medicare coverage we’ve been providing for over 15 years. It’s not only great value, but it helps you make positive changes to live long and stay strong! 2021 PROVIDER AND PHARMACY DIRECTORY Preface - 3 April 2021 Optimum HealthCare, Inc. HMO Plan Provider Directory This directory is current as of 04/12/2021. This directory provides a list of Optimum HealthCare, Inc.’s current networkproviders.
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HEDIS® is a registered trademark of the National Committee for Quality Assurance (NCQA). CHRONIC SPECIAL NEEDS PLANS 2021OTC SHOW 2021 Page 1 of 29 Summary of Benefits January 1, 2021 – December 31, 2021 Optimum Diamond Rewards (HMO C-SNP) H5594_028 Optimum Diamond Rewards COPD (HMO C-SNP) H5594_029 Optimum Diamond Rewards (HMO C-SNP)H5594_030
FORMS OPTIMUM HEALTHCARE Top rated Advantage Plans for Florida. Free to enroll, plans with $0 monthly premium, low out-of-pocket max. 1-866-245-5360. SPECIAL NEEDS PLAN INFORMATION Special Needs Plan: Case Management - Provider. The Special Needs Plan (SNP) provides Case Management assistance to all members, but primarily assists those that are determined to need the most help (Tier 3). Case Managers are nurses who work with you to improve your patient’s ability to manage their health. PHARMACY & PART D COVERAGE INFORMATION OPTIMUM HEALTHCARE From October 1 to March 31 from 8:00 a.m. to 8:00 p.m. 7 days a week and April 1 to September 30 from 8:00 a.m. to 8:00 p.m. Monday through Friday. We also have pharmacies that are in our network but are outside our service area. Please contact Optimum HealthCare, Inc. at 1-866-245-5360 for additional information. SPECIAL NEEDS PLAN: CASE MANAGEMENT The Special Needs Plan (SNP) provides Case Management assistance to all members, but primarily assists those that are determined to need the most help. Case Managers are nurses who work with you and your doctor to improve your ability to manage your health. This program also includes Social Workers who can help with community resourceassistance.
QUALITY AT OPTIMUM HEALTHCARE OPTIMUM HEALTHCARE The overall goal of this program is to achieve quality care and services for our members. We achieve this goal through the design, implementation and improvement of organizational systems. You can call Member Services (Toll Free) 1-866-245-5360 to request a paper copy of our QM Program. Providers can contact their Provider Relations SERVICE AREA OPTIMUM HEALTHCARE The Optimum Health Network has 50+ Primary Care Physician Providers, 200+ Specialist Offices and more than 10 Health Fitness Center locations in Collier County. Broward County. The Optimum Health Network has 250+ active members, 60+ Primary Care Offices, 500+ Specialist Offices and more than 80 Health Fitness Center locations inBroward County.
MEDICARE OPTIMUM HEALTHCARE But many of our Medicare Advantage Plans offer vision, dental and hearing coverage. Toll Free 1-888-286-2362. Speak to an Agent. Request an Appointment. Medicare Parts A and B pay for many healthcare services and supplies, but they don’t cover all of your healthcare costs. Also, drug coverage when not in the hospital is very limited. 2021 SUMMARY OF BENEFITS Page 1 of 15 Summary of Benefits January 1, 2021 - December 31, 2021 Optimum Platinum Plan (HMO) H5594_002 Optimum Platinum Plan (HMO) H5594_019 The purpose of the Summary of Benefits is to provide you with summary of drug and health benefits covered by Optimum Platinum Plan (HMO) H5594_002 and Optimum Platinum Plan (HMO) H5594_019, which describes what we cover SELF-MANAGEMENT TOOLS OPTIMUM HEALTHCARE Self-Management Tools. The following interactive self-management tools are meant to help you manage your health. These tools will allow you to assess your risk factors and provide you with personalized results and/or guidance on how you can improve your health. Please click on each tool’s title to open the tool in a new window. 2021 PROVIDER AND PHARMACY DIRECTORY Preface - 3 April 2021 Optimum HealthCare, Inc. HMO Plan Provider Directory This directory is current as of 04/12/2021. This directory provides a list of Optimum HealthCare, Inc.’s current networkproviders.
OPTIMUM QUICK REFERENCE GUIDE 2021 Optimum HealthCare Medicare Quick Reference Guide NOTE: This guide is not designed to be an all-inclusive list of covered services under Freedom Health, Inc.It provides current referral and prior authorization instructions. Authorization does not guarantee paymentof claims.
MAKE THE MOST YOUR BENEFITS H5594_2021_DVH Flyer_M . Optimum HealthCare, Inc. is an HMO plan with a Medicare contract and a contract with the state Medicaid program. Enrollment in Optimum HealthCare, APPEALS OPTIMUM HEALTHCARE Appointment of a Representative. The Appointment of Representative Form is located on the CMS Web site. Beneficiaries and providers may appoint another individual, including an attorney, as their representative in dealings with Medicare, including appeals you file. AT NO COST TO YOU! RECEIVE FROM TO 20 125 1 $20 $125 unty. 2021 OTC Benefits At NO COST To You! OPT21OTC Receive from to every month * in Over-the-Counter Drugs & Supplies based on plan selection and co en 0 ar!** ENROLL MEDICARE ADVANTAGE PLANS OPTIMUM HEALTHCAREMEDICARE PLANSMEMBERSPROVIDERSOTCSERVICES NOT COVEREDSPECIAL NEEDS PLAN INFO Optimum HealthCare, Inc. is an HMO with a Medicare contract and a contract with the state of Florida Medicaid program. Enrollment in Optimum HealthCare, Inc. depends on contract renewal. This Information is not a complete description of benefits. Call 1 OTC - ORDER OVER-THE-COUNTER SUPPLIES ONLINE OPTIMUM Quick and Easy way to order OTC Drugs and Supplies at NO COST to you, based on plan selection and county. Members receive a monthly Over-the-Counter allowance of $20 to $125 every month based on plan and county. Choose from 16 different categories of products and supplies from OTC Online or our Catalog. English Catalog. DISCOVER THE OPTIMUM ADVANTAGE OPTIMUM HEALTHCARE Discover the Optimum Advantage. Knowledge you can rely on. Yes, we’re proud that Optimum HealthCare is one of Florida’s health plans; but we’re even more proud of the Medicare coverage we’ve been providing for over 15 years. It’s not only great value, but it helps you make positive changes to live long and stay strong! 2021 PROVIDER AND PHARMACY DIRECTORY Preface - 3 April 2021 Optimum HealthCare, Inc. HMO Plan Provider Directory This directory is current as of 04/12/2021. This directory provides a list of Optimum HealthCare, Inc.’s current networkproviders.
LOG IN
HEDIS® is a registered trademark of the National Committee for Quality Assurance (NCQA). CHRONIC SPECIAL NEEDS PLANS 2021OTC SHOW 2021 Page 1 of 29 Summary of Benefits January 1, 2021 – December 31, 2021 Optimum Diamond Rewards (HMO C-SNP) H5594_028 Optimum Diamond Rewards COPD (HMO C-SNP) H5594_029 Optimum Diamond Rewards (HMO C-SNP)H5594_030
FORMS OPTIMUM HEALTHCARE Top rated Advantage Plans for Florida. Free to enroll, plans with $0 monthly premium, low out-of-pocket max. 1-866-245-5360. SPECIAL NEEDS PLAN INFORMATION Special Needs Plan: Case Management - Provider. The Special Needs Plan (SNP) provides Case Management assistance to all members, but primarily assists those that are determined to need the most help (Tier 3). Case Managers are nurses who work with you to improve your patient’s ability to manage their health. PHARMACY & PART D COVERAGE INFORMATION OPTIMUM HEALTHCARE From October 1 to March 31 from 8:00 a.m. to 8:00 p.m. 7 days a week and April 1 to September 30 from 8:00 a.m. to 8:00 p.m. Monday through Friday. We also have pharmacies that are in our network but are outside our service area. Please contact Optimum HealthCare, Inc. at 1-866-245-5360 for additional information. SPECIAL NEEDS PLAN: CASE MANAGEMENT The Special Needs Plan (SNP) provides Case Management assistance to all members, but primarily assists those that are determined to need the most help. Case Managers are nurses who work with you and your doctor to improve your ability to manage your health. This program also includes Social Workers who can help with community resourceassistance.
ENROLL MEDICARE ADVANTAGE PLANS OPTIMUM HEALTHCAREMEDICARE PLANSMEMBERSPROVIDERSOTCSERVICES NOT COVEREDSPECIAL NEEDS PLAN INFO Florida Medicare Advantage Plans with $0 monthly premium and up to $144.60 of your Part B premium refunded back to you each month. Enroll today (888) 286-2362. OTC - ORDER OVER-THE-COUNTER SUPPLIES ONLINE OPTIMUM Medicare Plans Toll Free 1-866-245-5360 TTY/TDD: 711 Monday through Friday, 8am to 8pm EST DISCOVER THE OPTIMUM ADVANTAGE OPTIMUM HEALTHCARE Medicare Plans Toll Free 1-866-245-5360 TTY/TDD: 711 Monday through Friday, 8am to 8pm ESTLOG IN
HEDIS® is a registered trademark of the National Committee for Quality Assurance (NCQA). 2021 PROVIDER AND PHARMACY DIRECTORY Preface - 3 April 2021 Optimum HealthCare, Inc. HMO Plan Provider Directory This directory is current as of 04/12/2021. This directory provides a list of Optimum HealthCare, Inc.’s current networkproviders.
CHRONIC SPECIAL NEEDS PLANS 2021OTC SHOW 2021 Page 1 of 29 Summary of Benefits January 1, 2021 – December 31, 2021 Optimum Diamond Rewards (HMO C-SNP) H5594_028 Optimum Diamond Rewards COPD (HMO C-SNP) H5594_029 Optimum Diamond Rewards (HMO C-SNP)H5594_030
FORMS OPTIMUM HEALTHCARE Top rated Advantage Plans for Florida. Free to enroll, plans with $0 monthly premium, low out-of-pocket max. 1-866-245-5360. SPECIAL NEEDS PLAN INFORMATION Medicare Plans Toll Free 1-866-245-5360 TTY/TDD: 711 Monday through Friday, 8am to 8pm EST PHARMACY & PART D COVERAGE INFORMATION OPTIMUM HEALTHCARE Medicare Plans Toll Free 1-866-245-5360 TTY/TDD: 711 Monday through Friday, 8am to 8pm EST AT NO COST TO YOU! RECEIVE FROM TO 20 125 1 $20 $125 unty. 2021 OTC Benefits At NO COST To You! OPT21OTC Receive from to every month * in Over-the-Counter Drugs & Supplies based on plan selection and co en 0 ar!** SERVICE AREA OPTIMUM HEALTHCARE Medicare Plans Toll Free 1-866-245-5360 TTY/TDD: 711 Monday through Friday, 8am to 8pm EST QUALITY AT OPTIMUM HEALTHCARE OPTIMUM HEALTHCARE Medicare Plans Toll Free 1-866-245-5360 TTY/TDD: 711 Monday through Friday, 8am to 8pm EST MEDICARE OPTIMUM HEALTHCARE Medicare Plans Toll Free 1-866-245-5360 TTY/TDD: 711 Monday through Friday, 8am to 8pm EST SELF-MANAGEMENT TOOLS OPTIMUM HEALTHCARE Top rated Advantage Plans for Florida. Free to enroll, plans with $0 monthly premium, low out-of-pocket max. 1-866-245-5360. 2021 PROVIDER AND PHARMACY DIRECTORY Preface - 3 April 2021 Optimum HealthCare, Inc. HMO Plan Provider Directory This directory is current as of 04/12/2021. This directory provides a list of Optimum HealthCare, Inc.’s current networkproviders.
2021 SUMMARY OF BENEFITS Page 1 of 15 Summary of Benefits January 1, 2021 - December 31, 2021 Optimum Platinum Plan (HMO) H5594_002 Optimum Platinum Plan (HMO) H5594_019 The purpose of the Summary of Benefits is to provide you with summary of drug and health benefits covered by Optimum Platinum Plan (HMO) H5594_002 and Optimum Platinum Plan (HMO) H5594_019, which describes what we cover MAKE THE MOST YOUR BENEFITS H5594_2021_DVH Flyer_M . Optimum HealthCare, Inc. is an HMO plan with a Medicare contract and a contract with the state Medicaid program. Enrollment in Optimum HealthCare, OPTIMUM QUICK REFERENCE GUIDE 2021 Optimum HealthCare Medicare Quick Reference Guide NOTE: This guide is not designed to be an all-inclusive list of covered services under Freedom Health, Inc.It provides current referral and prior authorization instructions. Authorization does not guarantee paymentof claims.
APPEALS OPTIMUM HEALTHCARE Appointment of a Representative. The Appointment of Representative Form is located on the CMS Web site. Beneficiaries and providers may appoint another individual, including an attorney, as their representative in dealings with Medicare, including appeals you file. AT NO COST TO YOU! RECEIVE FROM TO 20 125 1 $20 $125 unty. 2021 OTC Benefits At NO COST To You! OPT21OTC Receive from to every month * in Over-the-Counter Drugs & Supplies based on plan selection and co en 0 ar!** Skip to main content* Medicare Plans__
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MEDICARE ADVANTAGE PLANS 2020 EXPLORE OUR COVERAGE OPTIONS Optimum Health Care Medicare Advantage Plans help cover most of your health needs, often with $0 additional premium costs per month. We offer plans to help with the additional costs of Vision, Dental and more that original Medicare does not cover. $0 COST OTC BENEFITS ✓ Receive a monthly over-the-counter allowance from $20 to $100 each month, based on plan selection. That’s a savings between $240 to $1200 over the course of a year! Easy online ordering or phone yourorder in!
$0 COST HEALTH CLUB
✓ Get a SilverSneakers® Fitness Membership at no cost to you! Search facilities and available amenities by zip code at www.silversneakers.com You can also order a SilverSneakers® Steps home fitness kit if that is moreconvenient!
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✓ Save between $50 and $135.50 each month with a Part B premium refund on select 2020 plans ✓ Comprehensive Dental, Vision and Hearing benefits $0 COST PREVENTATIVE CARE ✓ Stay healthier with an array of Preventive Services at NO COST to YOU! Receive an Annual Wellness Visit, screenings, vaccines and many other services to keep you on track. Becoming an Optimum HealthCare Member ensures that your out-of-pocket costs are never more than you expect. Explore Advantage PlansSPEAK TO AN AGENT
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_One of the least concerns in my daily life is my health. It’s really under extraordinary care with a great group of people. I’m dealing with a company that genuinely seems concerned with my health and also is in a position to keep it good.Ralph Crance
Optimum Diamond Rewards (HMO C-SNP) 028_ _I've told so many friends about it _(Optimum Health Care Medicare Advantage)_ and the reason I can do that is because I've had to use my services. Now you can have an insurance but you only find out how good it is when you have to use it. So because they know that I've had issues, they really do listen when I tell them what outcome was. And when you don't have to pay for anything and get no bill that is a hugebenefit.
Jerilyn Gay Fraser
Optimum Gold Rewards Plan (HMO) 001_Previous Next
MARION COUNTY
Over 500 active Optimum Health network members, 60+ Primary Care Offices, 200+ Specialist Offices and 10 Health Fitness Centerlocations.
VOLUSIA COUNTY
Over 600 active Optimum Health members in Volusia County, 30 Primary Care Offices, 200+ Specialist Offices and 40 Health Fitness Centerlocations.
BREVARD COUNTY
Over 30 Primary Care Offices, 100+ Specialist Offices and 30 Health Fitness Center locations in the Optimum Health Care network in BrevardCounty.
CITRUS COUNTY
The Optimum Health Network has over 700 active members, 30+ Primary Care Offices, 100+ Specialist Offices and 10 Health Fitness Center locations in Citrus County.SUMTER COUNTY
The Optimum Health Network has over 200 members, 30+ Primary Care Offices, 80+ Specialist Offices and 4 Health Fitness Center locationsin Sumter County.
LAKE COUNTY
The Optimum Health Network has over 700 members, 70+ Primary Care Offices, 200+ Specialist Offices and 10 Health Fitness Center locations in Lake County.SEMINOLE COUNTY
The Optimum Health Network has 100+ members in Seminole County, 30+ Primary Care Offices, 200+ Specialist Offices and more than 20 Health Fitness Center locations in Seminole County.ORANGE COUNTY
The Optimum Health Network has 600+ members, 90+ Primary Care Offices, 600+ Specialist Offices and more than 40 Health Fitness Center locations in Orange County.OSCEOLA COUNTY
The Optimum Health Network has 200+ members, 80+ Primary Care Offices, 200+ Specialist Offices and more than 10 Health Fitness Center locations in Osceola County.POLK COUNTY
The Optimum Health Network has 700+ active members, 90+ Primary Care Offices, 200+ Specialist Offices and more than 30 Health Fitness Center locations in Polk County.HERNANDO COUNTY
The Optimum Health Network has over 11,600 active members, 60+ Primary Care Offices, 100+ Specialist Offices and more than 10 Health Fitness Center locations in Hernando County.PASCO COUNTY
The Optimum Health Network has over 12,100 members, 80+ Primary Care Offices, 400+ Specialist Offices and more than 30 Health Fitness Center locations in Pasco County.PINELLAS COUNTY
The Optimum Health Network has over 13,100 members, 100+ Primary Care Offices, 600+ Specialist Offices and more than 80 Health Fitness Center locations in Pinellas County.HILLSBOROUGH COUNTY
The Optimum Health Network has over 12,700 active members, 100+ Primary Care Offices, 800+ Specialist Offices and more than 70 Health Fitness Center locations in Hillsborough County.MANATEE COUNTY
The Optimum Health Network has 30+ Primary Care Offices, 100+ Specialist Offices and more than 20 Health Fitness Center locations inManatee County.
SARASOTA COUNTY
The Optimum Health Network has over 500 active members, 50+ Primary Care Offices, 200+ Specialist Offices and more than 20 Health Fitness Center locations in Sarasota County.CHARLOTTE COUNTY
The Optimum Health Network has 20+ Primary Care Offices, 100+ Specialist Offices and more than 10 Health Fitness Center locations within Charlotte County.LEE COUNTY
The Optimum Health Network has 70+ Primary Care Offices, 500+ Specialist Offices and more than 30 Health Fitness Center locations inLee County.
COLLIER COUNTY
The Optimum Health Network has 50+ Primary Care Physician Providers, 200+ Specialist Offices and more than 10 Health Fitness Center locations in Collier County.BROWARD COUNTY
The Optimum Health Network has 300+ active members, 60+ Primary Care Offices, 500+ Specialist Offices and more than 80 Health Fitness Center locations in Broward County.PALM BEACH COUNTY
The Optimum Health Network has 80+ in-network Primary Care Offices, 600+ in-network Specialist Providers and more than 50 Health Fitness Center locations in Palm Beach County.MARTIN COUNTY
The Optimum Health Network has 3+ Primary Care Offices, 90+ Specialist Offices and more than 10 Health Fitness Center locations in MartinCounty.
ST LUCIE COUNTY
The Optimum Health Network has 10+ Primary Care Offices, 100+ Specialist Offices and more than 9 Health Fitness Center locations inSt Lucie County.
INDIAN RIVER COUNTY
The Optimum Health Network has 7+ Primary Care Offices, 100+ Specialist Offices and more than 6 Health Fitness Center locations in Indian River County. _Last Updated: 04/13/2020_HELPFUL LINKS
CMS Model Electronic Complaint Form The Medicare Beneficiary Ombudsman Unable to view PDFs? Click here Benefits During Disasters and Catastrophic Events Click here for Multi-Language Interpreter Service Servicios de interpretación en varios idiomas (Multi-Language Insert) | (Inserción de varios idiomas) Section 1557 Notice of Non-Discrimination: English| Spanish
HOURS
From October 1 to March 31, we are open 7 days a week from 8 a.m. to 8p.m. EST.
From April 1 to September 30, we are open Monday through Friday, 8a.m. to 8 p.m. EST.
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Toll Free 1-866-245-5360TTY/TDD: 711
PHYSICAL ADDRESS
5403 N Church Ave
Tampa, FL 33614
SERVICE CITIES __ __ SERVING THE FOLLOWING AREAS IN FLORIDA:* BREVARD COUNTY:
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Includes Cape Canaveral, Cocoa Beach, Cocoa, Indian Harbour Beach, Melbourne, Palm Bay, Rockledge, Satellite Beach, Sebastian, Titusville and West Melbourne, Florida* BROWARD COUNTY:
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Includes Coconut Creek, Cooper City, Coral Springs, Dania Beach, Deerfield Beach, Fort Lauderdale, Hallandale Beach, Hollywood, Lauderdale Lakes, Lauderhill, Lighthouse Point, Margate, Miramar, North Lauderdale, Oakland Park, Parkland, Pembroke Pines, Plantation, Pompano Beach, Sunrise, Tamarac, West Park, Weston and Wilton Manors,Florida
* CITRUS COUNTY:
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Includes Crystal River, Inverness, Beverly Hills, Black Diamond, Citrus Hills, Citrus Springs, Floral City, Hernando, Homosassa, Homosassa Springs, Inverness Highlands North, Inverness Highlands South, Lecanto, Pine Ridge, Sugarmill Woods, Chassahowitzka andHolder, Florida
* CHARLOTTE COUNTY:
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Includes Punta Gorda, Charlotte Harbor, Charlotte Park, Cleveland, Englewood, Grove City, Harbour Heights, Manasota Key, Port Charlotte, Rotonda, Solana, Adrian Town, Boca Grande and Cape Haze, Florida* COLLIER COUNTY:
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Includes Everglades City, Marco Island and Naples, Florida* HERNANDO COUNTY:
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Includes Aripeka, Bayport, Brookridge, Brooksville, Garden Grove Estates, Hernando Beach, High Point, Hill n Dale, Istachatte, Lake Lindsey, Masaryktown, Nobleton, North Brooksville, North Weeki Wachee, Pine Island, Ridge Manor, Ridge Manor West, South Brooksville, Spring Hill, Spring Lake, Weeki Wachee and Weeki Wachee Gardens, Florida * HILLSBOROUGH COUNTY:*
Includes Plant City, Tampa, Temple Terrace, Apollo Beach, Balm, Bloomingdale, Boyette, Brandon, Carrollwood, Cheval, Citrus Park, Dover, East Lake-Orient Park, Egypt Lake-Leto, Fish Hawk, Gibsonton, Keystone, Lake Magdalene, Lutz, Mango, Northdale, Palm River-Clair Mel, Pebble Creek, Progress Village, Riverview, Ruskin, Seffner, Sun City Center, Thonotosassa, Town 'n' Country, University, Valrico, Westchase and Wimauma, Florida * INDIAN RIVER COUNTY: * Includes Fellsmere, Sebastian, Vero Beach, Indian River Shores, Orchid, Florida Ridge, Gifford, Roseland, South Beach, Vero Beach South, Wabasso, Wabasso Beach, West Vero Corridor, Windsor (formerly North Beach) and Winter Beach, Florida* LAKE COUNTY:
* Includes Clermont, Eustis, Fruitland Park, Groveland, Leesburg, Mascotte, Minneola, Mount Dora, Tavares, Umatilla, Astatula, Howey-in-the-Hills, Lady Lake, Montverde, Altoona, Astor, Ferndale, Four Corners, Lake Kathryn, Lake, Mack-Forest Hills, Lisbon, Mount Plymouth, Okahumpka, Paisley, Pine Lakes, Pittman, Silver Lake, Sorrento and Yalaha, Florida* LEE COUNTY:
* Includes Bonita Springs, Cape Coral, Fort Myers, Sanibel, Fort Myers Beach, Estero, Alva, Bokeelia, Buckingham, Burnt Store Marina, Captiva, Charleston Park, Cypress Lake, East Dunbar, Fort Myers Shores, Gateway, Harlem Heights, Iona, Lehigh Acres, Lochmoor Waterway Estates, Matlacha (on Matlacha Island), Matlacha Isles-Matlacha Shores, McGregor, North Fort Myers, Olga, Page Park, Palmona Park, Pine Island Center, Pine Manor, Pineland (on Pine Island), Punta Rassa, San Carlos Park, St. James City, Suncoast Estates andTanglewood, Florida
* MARION COUNTY:
* Includes Belleview, Dunnellon, Ocala, McIntosh, Reddick, Silver Springs Shores and The Villages (with Sumter County), Florida* MANATEE COUNTY:
* Includes Anna Maria, Bradenton, Bradenton Beach, Holmes Beach, Palmetto, Longboat Key, Bayshore Gardens, Cortez, Ellenton, Memphis, Samoset, South Bradenton, West Bradenton, West Samoset, Whitfield, Duette, Village of the Arts, Myakka City, Oneco, Parrish, Terra Ceia, Rubonia, Gillette, Palm View, Memphis Heights, Palma Sola, Manavista, Fort Hamer, Manhattan, Oak Knoll, Waterbury, Verna, Marsh Island, Snead Island, Rattlesnake Key, Rye, Elwood Park, Ward Lake and CedarHammock, Florida
* MARTIN COUNTY:
* Includes Stuart, Jupiter Island, Ocean Breeze, Sewall's Point, Indiantown, Hobe Sound, Jensen Beach, North River Shores, Palm City, Port Salerno, Rio, Hutchinson Island and Port Mayaca, Florida* ORANGE COUNTY:
* Includes Apopka, Bay Lake, Belle Isle, Edgewood, Lake Buena Vista, Maitland, Ocoee, Orlando, Winter Garden, Winter Park, Eatonville, Oakland and Windermere, Florida* OSCEOLA COUNTY:
* Includes Kissimmee, St. Cloud, Buenaventura Lakes, Campbell, Celebration, Four Corners, Poinciana, Yeehaw Junction, Bull Creek, Deer Park and Harmony, Florida * PALM BEACH COUNTY: * Includes Atlantis, Belle Glade, Boca Raton, Boynton Beach, Briny Breezes, Cloud Lake, Delray Beach, Glen Ridge, Golf, Greenacres, Gulf Stream, Haverhill, Highland Beach, Hypoluxo, Juno Beach, Jupiter, Jupiter Inlet Colony, Lake Clarke Shores, Lake Park, Lake Worth, Lantana, Loxahatchee Groves, Manalapan, Mangonia Park, North Palm Beach, Ocean Ridge, Pahokee, Palm Beach, Palm Beach Gardens, Palm Beach Shores, Palm Springs, Riviera Beach, Royal Palm Beach, South Bay, South Palm Beach, Tequesta, Wellington, Westlake and West PalmBeach, Florida
* PASCO COUNTY:
* Includes Dade City, Port Richey, New Port Richey, San Antonio, Zephyrhills, St. Leo, Aripeka, Bayonet Point, Beacon Square, Connerton, Crystal Springs, Dade City North, Elfers, Heritage Pines, Holiday, Hudson, Jasmine Estates, Key Vista, Lacoochee, Land O' Lakes, Meadow Oaks, Odessa, Pasadena Hills, Quail Ridge, River Ridge, Shady Hills, Trinity and Trilby, Florida* PINELLAS COUNTY:
* Includes Belleair, Belleair Beach, Belleair Bluffs, Clearwater, Dunedin, Gulfport, Indian Rocks Beach, Largo, Madeira Beach, Oldsmar, Pinellas Park, Safety Harbor, Seminole, South Pasadena, St. Pete Beach, St. Petersburg, Tarpon Springs, Treasure Island, Indian Shores, Kenneth City, Redington Beach, Redington Shores, Bardmoor, Bay Pines, Bear Creek, East Lake, Feather Sound, Greenbriar, Harbor Bluffs, Lealman, Palm Harbor, Ridgecrest, South Highpoint and Tierra Verde,Florida
* POLK COUNTY:
* Includes Auburndale, Bartow, Davenport, Eagle Lake, Fort Meade, Frostproof, Haines City, Lake Alfred, Lakeland, Lake Wales, Mulberry, Polk City, Winter Haven, Dundee, Hillcrest Heights, Lake Hamilton, Highland Park, Alturas, Babson Park, Bradley Junction, Combee Settlement, Crooked Lake Park, Crystal Lake, Cypress Gardens, Four Corners, Fuller Heights, Fussels Corner, Grenelefe, Highland City, Homeland, Inwood, Jan Phyl Village, Kathleen, Lakeland, Highlands, Loughman, Medulla and Poinciana, Florida * SAINT LUCIE COUNTY: * Includes Fort Pierce, Port St. Lucie, St. Lucie Village. Fort Pierce North, Fort Pierce South, South Hutchinson Island, Indian River Estates, Lakewood Park, River Park, White City and Viking, Florida* SARASOTA COUNTY:
* Includes Sarasota, Venice, North Port, Longboat Key, Desoto Lakes, Englewood, Fruitville, Gulf Gate Estates and Laurel, Florida* SEMINOLE COUNTY:
* Includes Altamonte Springs, Casselberry, Lake Mary, Longwood, Oviedo, Sanford, Winter Springs, Black Hammock, Chuluota, Fern Park, Forest City, Geneva, Goldenrod (with Orange County), Heathrow, Midway, Wekiwa Springs, Bertha, Indian Mound Village, Lake Monroe, Slavia, Sanlando Springs and Taintsville, Florida* SUMTER COUNTY:
* Includes Bushnell, Center Hill, Coleman, Webster, Wildwood, Lake Panasoffkee, The Villages, Croom-A-Coochee, Linden, Mabel, Oak Grove, Orange Home, Oxford, Royal, Rutland, St. Catherine, Sumterville,Tarrytown, Wahoo
* VOLUSIA COUNTY:
* Includes Daytona Beach, Daytona Beach Shores, DeBary, DeLand, Deltona, Edgewater, Holly Hill, Lake Helen, New Smyrna Beach, Oak Hill, Orange City, Ormond Beach, Port Orange, South Daytona, Pierson, Ponce Inlet, DeLand Southwest, De Leon Springs, Glencoe, North DeLand, Ormond-by-the-Sea, Samsula-Spruce Creek, Seville, West DeLand, Alamana, Allandale, Ariel, Bakerstown, Barberville, Benson Junction, Beresford, Bethune Beach, Blake, Blue Springs Landing, Bluffton, Boden, Cassadaga, Cabbage Bluff, Connersville, Conrad, Cow Creek, Creighton, Cypress Lake Estates, Daisy Lake, Daytona Highridge Estates, Daytona Park Estates, Deadman Landing, DeLand Highlands, DeLeon Springs Heights, Edgewater Junction, Eldora, Eldridge, Ellinor Village, Emporia, Enterprise, Farmton, Fatio, Fort Florida, Glenwood, Halifax Estates, Harbor Oaks, Hucomer, Isleboro, Kalamazoo, Lake Ashby Shores, Lemon Bluff, Maytown, Mission City, Mound Grove, National Gardens, Florida, Orange City Hills, Ortona, Osteen, Packwood Place, Pennichaw, Riverside, Seabreeze and Senyah, Florida WEBSITE DISCLAIMER __ __ Optimum HealthCare, Inc. is an HMO with a Medicare contract and a contract with the state of Florida Medicaid program. Enrollment in Optimum HealthCare, Inc. depends on contract renewal. This Information is not a complete description of benefits. Call 1-866-245-5360 (TTY: 711) for more information. Medicare beneficiaries may also enroll in Optimum HealthCare through the CMS Medicare Online Enrollment Center located at http://www.medicare.gov. Every year, Medicare evaluates plans based on a 5-star rating system Optimum HealthCare has been approved by the National Committee for Quality Assurance (NCQA) to operate Chronic Special Needs Plan (SNP) Plans until December 2020 and Dual Special Needs Plan (SNP) Plans until December 2021 based on a review of Optimum HealthCare’s Modelof Care.
Optimum HealthCare, Inc. complies with applicable Federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, or sex. Optimum HealthCare, Inc. cumple con las leyes federales de derechos civiles aplicables y no discrimina por motivos de raza, color, nacionalidad, edad, discapacidad o sexo. Optimum HealthCare, Inc. konfòm ak lwa sou dwa sivil Federal ki aplikab yo e li pa fè diskriminasyon sou baz ras, koulè, peyi orijin, laj, enfimite oswa sèks. Español (Spanish): ATENCIÓN: Si habla español, tiene a su disposición servicios gratuitos de asistencia lingüística. Llame al 1-866-245-5360 (TTY: 711). Kreyòl Ayisyen (French Creole): ATANSYON: Si w pale Kreyòl Ayisyen, gen sèvis èd pou lang ki disponib gratis pou ou. Rele 1-866-245-5360(TTY: 711).
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