As of 1/1/24. Optima Health and Virginia Premier are now Sentara Health Plans.

Health Plan Transparency in Coverage

Table of Contents

https://mrfproddestinationdata.blob.core.windows.net/sentara-mrf-output/Sentara-Health-Plans-INN_index.html

https://mrfproddestinationdata.blob.core.windows.net/sentara-mrf-output/Sentara-Health-Plans-OON_index.html 

https://mrfproddestinationdata.blob.core.windows.net/sentara-mrf-output/Sentara-Health-Plans_HMO1X_in-network-rates_MRF.html 

https://mrfproddestinationdata.blob.core.windows.net/sentara-mrf-output/Sentara-Health-Plans_HMO_in-network-rates_MRF.html 

https://mrfproddestinationdata.blob.core.windows.net/sentara-mrf-output/Sentara-Health-Plans_O1XHMO_in-network-rates_MRF.html 

https://mrfproddestinationdata.blob.core.windows.net/sentara-mrf-output/Sentara-Health-Plans_OHIC0571_in-network-rates_MRF.html 

https://mrfproddestinationdata.blob.core.windows.net/sentara-mrf-output/Sentara-Health-Plans_OHIC571_in-network-rates_MRF.html 

https://mrfproddestinationdata.blob.core.windows.net/sentara-mrf-output/Sentara-Health-Plans_OHIC_in-network-rates_MRF.html 

https://mrfproddestinationdata.blob.core.windows.net/sentara-mrf-output/Sentara-Health-Plans_WC_in-network-rates_MRF.html

CMS Interoperability and Virginia State Based Exchange Machine-Readable

This link provides access to consumer education around protecting your personal and health data while using third-party applications.

Protecting Your Healthcare Data

 Machine-Readable Data Link (Type) Machine-Readable Data Description 
 Machine-Readable Data Link (Type) Provider Directory (JSON)Machine-Readable Data Description  Entry to Provider Directory Data
 Machine-Readable Data Link (Type) Organization (FHIR)Machine-Readable Data Description  Entry to Organization Data
 Machine-Readable Data Link (Type) Location (FHIR)Machine-Readable Data Description  Entry to Location Data
 Machine-Readable Data Link (Type) Organization Affiliation (FHIR)Machine-Readable Data Description  Entry to Organization Affiliation Data
 Machine-Readable Data Link (Type) Practitioner (FHIR)Machine-Readable Data Description  Entry to Practitioner Data
 Machine-Readable Data Link (Type) Practitioner Role (FHIR)Machine-Readable Data Description  Entry to Practitioner Role Data
 Machine-Readable Data Link (Type) Healthcare Service (FHIR)Machine-Readable Data Description  Entry to Healthcare Service Data
 Machine-Readable Data Link (Type) Insurance Plan (FHIR)Machine-Readable Data Description  Entry to Insurance Plan Data
 Machine-Readable Data Link (Type) Formulary (FHIR)Machine-Readable Data Description  Entry to Formulary Data
 Machine-Readable Data Link (Type) Medication Knowledge (FHIR)Machine-Readable Data Description  Entry to Medication Knowledge Data
 Machine-Readable Data Link (Type) Exchange Provider Directory (JSON)Machine-Readable Data Description Entry to Provider Directory Data
 Machine-Readable Data Link (Type) Exchange Formulary (JSON)Machine-Readable Data Description  Entry to Formulary Data

App Developer Guide

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© Sentara Health Plans 2025, PO Box 66189, Virginia Beach, Virginia 23466

Sentara Health Plans is the trade name for Sentara Health Plans, Sentara Health Insurance Company, Sentara Health Administration, Inc., and Sentara Behavioral Health Services, Inc. Vantage Health Maintenance Organization (HMO) and Point of Service (POS) plans are issued and underwritten by Sentara Health Plans. Medicare products are administered under an agreement with Sentara Health Plans and the Centers for Medicare and Medicaid Services (CMS). Medicaid and Family Access to Medical Insurance Security (FAMIS) products are administered under an agreement with Sentara Health Plans and the Virginia Department of Medical Assistance Services (DMAS). Plus Preferred Provider Organization (PPO) products are issued and underwritten by Sentara Health Insurance Company. The Sentara Employee Assistance Program (EAP) is administered by Sentara Behavioral Health Services, Inc. Large group self-funded health plans and BusinessEDGE® plans are administered but not underwritten by Sentara Health Administration, Inc. Wellness programs are administered by Sentara Health Administration, Inc. All plans have benefit exclusions and limitations, and terms under which the policy or plan may be continued in force or discontinued. For costs and complete details of coverage, please call your broker or review this website for more information. Sentara Health Plans complies with applicable federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, or sex.