OPTUM for your family member?

Optum, a health services company, partners with UnitedHealthcare to bring specialized healthcare benefits and clinical support and expertise to skilled nursing facilities.  

Why choose Optum?

  • Frequent attention & communication from Optum Clinician
  • Coordination and Management of resident care in the nursing facility
  • Personalized care led by a highly-trained nurse practitioner or physician assistant
  • Support to help enhance the quality of care in the nursing facility. 
  • Timely evaluation of acute change in condition
  • Offers supplemental benefits that include podiatry & medical transportation
  • No premium or copay for PCP and Specialist services rendered in a SNF

Key Benefits of the Program

  • Skilled Nursing/Part A benefit without 3 day hospital stay
  • No cap or limits for therapy if needed
  • Dental Benefit ($500/year)
  • Routine Podiatry (two visits per year)
  • Eye Exam and Eyewear ($150 credit per year)
  • Hearing Exam and Hearing Aid ($1600 credit every two years)
  • Non-Emergent Transportation (12 one-way trips)

Resident Enrollment/Eligibility

  • Long-term resident of participating skilled nursing facilities
  • Must be a resident for 90 days with no active discharges plan
  • Cannot have End-Stage Renal Disease (ESRD) at time of enrollment
  • Must be eligible for Medicare Part A and enrolled in Part B
  • Enrollment does not affect Medicaid benefits

HVA Senior Living Alliance Members and Associate Members currently participating in OPTUM:

  • St. Mary’s East
  • St. Pauls
  • Wesbury United Methodist

Effective July 1, 2017

  • Sarah Reed Senior Living
  • Pleasant Ridge Manor - West

For additional information:

Contact Tom Erickson, Senior Navigator -  HVA Senior Living Alliance @ 814-806-4556