Optimum HealthCare Medicare Advantage

Optimum HealthCare Medicare Advantage

Optimum Healthcare is one of the nations most popular providers of Medicare health plans. The health maintenance organization (HMO) is based in Tampa, and was established in 2004.  It’s operated by a group of physicians and offers policies to the residents of more than two dozen Florida counties. They offer four different Medicare health plans depending on where you live. There’s also a company office located in Spring Hill. Optimum Health Care Medicare Advantage plans offer more benefits than the original Medicare and include those with Part B premium reductions, prescription drug plans, and special needs plans (SNP), which are designed for those with chronic conditions. All of the plans come with zero deductibles and offer benefits such as dental, vision, and hearing coverage as well as fitness programs.

Plans with premium reductions for Part B include the Optimum Gold Rewards Plan (POS HMO)Diamond Rewards (POS HMO SNP), and Diamond Rewards COPD (POS HMO SNP). The part D prescription drug coverage plans provide both medical and drug insurance which can help you save on health care on cost.

These include the Optimum Platinum Plan (POS HMO), the Gold Rewards Plan (POS HMO), Diamond Rewards (POS HMO SNP), Diamond Rewards COPD (POS HMO SNP), and the Emerald Partial and Full plan.

To be eligible for the Diamond Rewards plan you need to be diagnosed with cardio vascular disease, diabetes mellitus, or chronic heart failure.

To be eligible for the Diamond Rewards COPD plan you need to be diagnosed with COPD (chronic obstructive pulmonary disease).

For the Emerald Plan you need to be eligible for both Medicare and Medicaid benefits (dual eligible).

The special needs plans are for those with specific chronic diseases. All of your hospital, medical services, and drug coverage come through these policies.

The plans available are the Optimum Diamond Rewards (POS HMO SNP), and Diamond Rewards COPD (POS HMO SNP).

To be eligible for the Diamond Rewards plan you need to be diagnosed with cardio vascular disease, diabetes mellitus or chronic heart failure.

For the Diamond Rewards COPD policy you need to have chronic obstructive pulmonary disease.


Special needs plans for those who are eligible for Medicare and Medicaid are classified either as partial or dual eligible. This will depending your income and other qualifying requirements and will be determined when you enroll with the Centers for Medicaid and Medicare. The plan for those who are dual eligible is the Emerald Partial and Full (HMO SNP).


If you use out-of-network services you’ll be asked to choose a primary care provider to coordinate your health care needs. You may need a referral to visit some doctors and in some instances non-network services are covered. You can always obtain emergency care from the closest health care provider. You’ll find that the rules for Optimum HealthCare POS options differ slightly. To get a quote please visit Medicare Supplement Insurance Quote.

1 Comment

  1. The people in Medicare advised me to contact you for dental plan and vision service. Please advise me.

    Reply

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