Request Printed Plan Documents
Plan Year
2022
2023
2024
2025
Plan Name
Sentara Medicare Advantage Plans
Sentara Individual and Family Plans
Cardinal Care (Medicaid)
Medicare Advantage Plans*
-- Select Plan --
Sentara Medicare Engage – Diabetes and Heart (HMO C-SNP) Central Halifax
Sentara Medicare Engage – Diabetes and Heart (HMO C-SNP) Hampton Roads
Sentara Medicare Engage – Diabetes and Heart (HMO C-SNP) Northern Virginia
Sentara Medicare Engage – Diabetes and Heart (HMO C-SNP) Roanoke Alleghany
Sentara Medicare Engage – Lung (HMO C-SNP)
Sentara Community Complete (HMO D-SNP)
Sentara Community Complete Select (HMO D-SNP)
Sentara Medicare Prime (HMO) Peninsula
Sentara Medicare Prime (HMO) Southside
Sentara Medicare Value (HMO) North Carolina
Sentara Medicare Value (HMO) Peninsula
Sentara Medicare Value (HMO) Roanoke Alleghany Southwest
Sentara Medicare Value (HMO) Southside
Sentara Medicare Salute (HMO)
Material Option
Evidence of Coverage (EOC)
Annual Notice of Changes
Pharmacy Formulary
Please contact member services at 1-800-927-6048 (TTY:711) to request a printed provider directory.
Member Services hours vary by time of year:
October 1–March 31 | 7 days a week | 8 AM–8 PM
April 1–September 30 | Monday–Friday | 8 AM–8 PM
Individual and Family Plans*
-- Select Plan --
Sentara Individual Family And Health Plans
HIOS Code/OptimaFIT Plan Name
Material Option
Evidence of Coverage or Certificate of Insurance - Legal Benefit Documents
Summary of Benefits and Coverage (SBC)
Material Option*
Handbook
Formulary
Directory
HIOS Code/Commercial Plan Name
Material Option
Evidence of Coverage or Certificate of Insurance - Legal Benefit Documents
Summary of Benefits and Coverage (SBC)
To request printed OptimaFit benefit information for plans prior to 2021 please call the number on the back of your member ID card. Electronic copies are available when you sign in to optimahealth.com or the Optima Health mobile app.
Effective Date
Effective Date
Member ID
Member ID#*
Member ID / Group Number
Member ID#
Group Number
Barcode
Barcode
Barcode
EOC Barcode
SBC Barcode
Full Name
First Name*
Last Name*
Email Address
Email Address*
We will send you an email confirmation of your request that you have submitted today. Once your documents are dropped in the mail, you will receive another email notification to let you know they have been mailed.
Address
Street Address*
Street Address Line 2
City*
State / Province*
Zip / Postal Code*
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