Even Better Together
Virginia Premier Medicaid is becoming a part of Optima Health on July 1, 2023. We are still committed to you and continuing to service all your healthcare needs.
Stay Covered
Medicaid members, don’t lose your healthcare coverage. The renewal process is back.
Member Benefits
Your health is more than just numbers and figures. It’s being able to live the life you want and deserve, which is why we provide you with a wide range of medical and related benefits to help you take charge of your health.
Take a look at our Summary of Benefits and Pharmacy Benefits to see some of the benefits we offer. Together, they list the medical services and prescription medications (drugs) we cover for you.
Your hearing coverage includes one annual routine hearing exam and an annual $2,000 hearing aid allowance, all administered through NationsHearing®. You also receive up to three no-cost hearing aid evaluations and fittings within the first year from the date of your initial hearing aid fitting and more! Learn more.
If you’re also eligible for Medicare, you have the option to enroll in Virginia Premier’s Medicare plans and get both your Medicare and Medicaid benefits in one place. Click here to learn more or contact us by calling 1-877-719-7358 (TTY: 711).
Member Resources
The Member Portal is a way for you to access your health care information online. Type in your username and password, and – wherever you are – Virginia Premier is with you. Don’t have a username and password yet? Go to the New User section, and we’ll show you how to register.
The Member Handbook will tell you all about Virginia Premier, including your benefits, your rights, important contact information and more. You can also read Member Newsletters to get news, health tips, and other information.
For a complete listing of our MLTSS providers, please see our Provider Directory.
Do you need care? Take a look at our “Where to Go Guide” for helpful tips to know where to go for your medical conditions.
Grievances and Appeals
If you would like us to take another look at a decision we have made about your coverage, you can request an appeal for us to review your case. Also, if you have dissatisfaction with any aspect of your health care plan, customer care, your provider or treatment facility, you can submit a grievance for us to review.
A request for an appeal or grievance must be signed by you and given to us in writing. You can download and complete the Appeals Form. You can also contact us to learn more about the grievance and appeal process:
Phone: 1-877-719-7358 (TTY: 711)
Fax: 1-804-649-9647
E-mail: grievancesandappeals@vapremier.com
Service Authorization
There are some treatments, services, and drugs that you need to get approval for before you receive them or in order to be able to continue receiving them. This is called a service authorization, sometimes called a prior authorization. You, your doctor, or someone you trust can ask for a service authorization. If you have questions about how to obtain a service authorization, please call the Authorizations & Organizational Determination Service Center at 1-888-251-3063 option 3 or Member Services 1-877-719-7358 option 1.
Pharmacy Service Authorization
If there is a restriction for your drug, it usually means that you or your provider will have to take extra steps in order for us to cover the drug. You or your provider can ask Virginia Premier to start a pharmacy service authorization, by either:
- Calling Envision Rx at 1-844-838-0711 (TTY: 711)
- Completing a prior authorization form and mailing it to:
Envision Pharmaceutical Services, LLC
2181 East Aurora Road, Suite 201
Twinsburg, Ohio 44087 - Completing a prior authorization and faxing it to 1-877-503-7231
- Requesting electronically on our website at vapremier.com
Frequently Asked Questions
If your question isn’t answered here, please contact Member Services at 1-877-719-7358, (TTY: 711). Our hours of operation are 8 am to 8 pm, Monday through Friday.
Contact your local Virginia Department of Social Services and tell them your new address. It’s also important that we have your most up-to-date contact information, so please update your information with us by submitting a change of address form.
Call us at 1-855-880-3480 (TTY: 711), Monday – Friday, 6 am – 6 pm to set up a ride. Trips need to be set up at least 5 business days beforehand. Weekends and holidays do not count toward these days.
If you have questions about your bill, please call Member Services at 1-877-719-7358 (TTY: 711).
Virginia Premier will pay for covered drugs as long as they’re medically necessary. To see if your drug is covered, use our searchable formulary (list of drugs).
If your drug is not covered, you can use the Envision online tool to request changes to your coverage.
Sometimes a drug requires prior authorization. In those cases, your doctor must provide medical information before the drug will be covered. This helps ensure that the drug is being used safely and appropriately.
If your drug requires prior authorization, use the Envision online tool or tell your doctor. Your doctor should contact us to get the drug covered for you.
Virginia Premier is open Monday through Friday, excluding certain holidays, from 8:00 am to 8:00 pm.
Virginia Premier will be closed during most State of Virginia holidays. During office closures, members will still have access to the following services by calling 1-877-719-7358 (TTY: 711):
- 24 Hour Nurse Line
- Pharmacy
- Non-Emergency Transportation
- Behavioral Health Crisis Calls
- Care Coordination
Questions? Contact Us
If you have any questions about Virginia Premier, feel free to reach out to us. Our phone lines are available Monday through Friday, from 8 am to 8 pm. Interpreter services are available for free.
Member helpline/services: 1-877-719-7358 (TTY: 711)
Fax:1-877-794-7952
Transportation: 1-855-880-3480 (TTY: 711)
IMPORTANT: Transportation must be scheduled at least five business days in advance.
Virginia Premier Health Plan will be closed during most State of Virginia holidays. During office closures, members will still have access to the following services by calling 1-877-719-7358 (TTY: 711):
- 24 Hour Nurse Line
- Pharmacy
- Non-Emergency Transportation
- Behavioral Health Crisis Calls
- Care Coordination
