In addition, it provides information such as copay amounts, applicable deductibles, your member ID number, and important phone numbers and addresses. Your member ID card identifies you as a covered member of Optima Health. Why do I need to carry my member ID card?.If your doctor requires you to present a card at the time of service, member services will fax a sample of your card to their office. This number allows a doctor to verify your eligibility and bill your services to the health plan. If your application has been processed they will be able to give you your unique member ID number. What should I do?Ĭontact member services. I have not received my member ID card but need to see my doctor.If you still have questions, contact member services. Refer to this section of the website for answers to commonly asked questions. When and where do I call if I have questions?.Whether you go to school, are self-employed or between jobs, are ready to retire, have a family, or don’t have a health plan through work, Optima Health has medical coverage that meets your unique needs. Individual Plans are offered for people who do not have coverage through their employer. It is best to check with your employer to see if a health plan by Optima Health is an option for you. Optima Health offers a HMO for Virginia Medicaid and FAMIS beneficiaries called Optima Family Care. These products include: Optima Vantage, Optima Plus, Optima Equity, and Optima Design. Call Delta Dental of South Dakota at 800.627.3961 if you have questions about pre-approval, payment or the $1,000 limit.Optima Health offers many products for large and small group employers, such as Health Maintenance Organization (HMO), Preferred Provider Organization (PPO), and Consumer Directed Health plans. Delta Dental of South Dakota can also tell you if the $1,000 yearly limit has been or will be reached.
Then you will know what will be covered and what portion of the bill you might be responsible to pay. You can ask your dentist to seek pre-approval from Delta Dental of South Dakota before you schedule your dental work. The limit does not apply to medically necessary emergency services or to dentures and partials. You must pay for services over the $1,000 yearly limit. There is a $1,000 limit every year (July 1 – June 30) for covered dental services. Crowns, root canals, dentures, partials and other services to fix problems have limits, and most must be pre-approved. A replacement retainer is covered one time.Īdult coverage includes two exams and two cleanings per year. The child’s teeth must be bad enough to limit the ability to eat, chew and talk. Talk to the dentist before treatment to know what is covered.īraces and other orthodontic services are covered only when medically necessary for the worst cases. Children coverage includes two exams and two cleanings per year, most dental sealants and other services to prevent tooth decay. What do I do if my name is spelled incorrectly or the date of birth is wrong on my Medicaid ID card?Ĭhildren and adults receive different dental coverage from Medicaid. If you believe this is the case please call 877.999.5612. If the payment ended, but you have since received another awards letter stating you are eligible for payment, it is possible DSS has not yet been notified. When this happens you will receive a notice from DSS instructing you to contact the local office nearest you to explore other possible eligibility options.
The Social Security Administration determines eligibility for SSI payments. If your child is no longer receiving a SSI payment, your child’s eligibility for Medicaid ends. In South Dakota individuals who receive a Supplemental Security Income (SSI) payment are automatically eligible for Medicaid. I just took my disabled child, who is on Supplement Security Income (SSI), to the doctor and was told he/she is not eligible for Medicaid. For more information, visit your Department of Social Services local office or check out your options for applying on our website. Eligibility for Medicaid depends on your income and circumstances.
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