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the Optimum Advantage!

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Helpful Links	Hours	Telephone
CMS Model Electronic Complaint Form	8am to 8pm 7 days a week October 1st to February 14th	Toll Free: 1-866-245-5360
The Medicare Beneficiary Ombudsman	8am to 8pm Mon. - Fri. February 15th to September 30th	TTY/TDD: 711
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Click here for Multi-Language Interpreter Services

Website Disclaimer

Optimum HealthCare, Inc. is an HMO plan with a Medicare contract and a contract with the state Medicaid program. Enrollment in Optimum HealthCare, Inc. depends on contract renewal. This information is not a complete description of benefits. Contact the plan for more information. Limitations, co-payments, and restrictions may apply. Benefits, premiums and/or co-payments/co-insurance may change on January 1 of each year. The Formulary, pharmacy network, and/or provider network may change at any time. You will receive notice when necessary. Beneficiaries generally must use network pharmacies to access their prescription drug benefit. You must continue to pay your Medicare Part B premium. The Part B premium is covered for full dual members of Special Needs Plans. This plan is available to anyone who has both medical assistance from the state and Medicare. Medicare beneficiaries may also enroll in Optimum HealthCare through the CMS Medicare Online Enrollment Center located at http://www.medicare.gov. Medicare evaluates plans based on a 5-star rating system. Star Ratings are calculated each year and may change from one year to the next.

Depending on the services, a prior authorization or referral from your doctor may be required.

For Chronic Special Needs Plans (SNP): These plans are available to anyone who has been diagnosed with one or more of the following disorders: Cardiovascular Disease (CVD); Chronic Heart Failure (CHF); Diabetes Mellitus; Chronic Obstructive Pulmonary Disease (COPD)

For Dual Special Needs Plans (DSNP): This plan is available to anyone who has both medical assistance from the state and Medicare. Premiums, co-pays, co-insurance, and deductibles may vary based on the level of Extra Help you receive. Please contact the plan for further details.

This information is available for free in other languages. Please call our Member Services number at 1-866-245-5360 for additional information. TTY users should call 711. Hours are October 1 to February 14 from 8 a.m. to 8 p.m. 7 days a week and February 15 to September 30 from 8 a.m. to 8 p.m. Monday through Friday. Member Services also provides free language interpreter services for non-English speakers.

Esta informacion esta disponsible gratuitamente en otros idiomas. Por favor, llame a nuestro Departamento de Servicios al Miembro al 1-866-245-5360 para información adicional. Los usuarios de TTY deben llamar al 711. Nuestro horario es del 1ro de octubre hasta el 14 de febrero de 8 a.m. a 8 p.m., 7 días a la semana y del 15 de febrero hasta el 30 de septiembre de 8 a.m. a 8 p.m. de lunes a viernes.

These materials may be made available in alternate formats (e.g., large print) to individuals with disabilities, upon request.

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Discover...the Optimum Advantage!

About Medicare

Enrollment Center »

Tools

Health & Wellness

Helpful Tools

Helpful Resources

Providers

Provider Portals

Agent & Brokers

Tools

OTC Documents

Diabetic Documents

Discover...
the Optimum Advantage!