General FAQ's
What sets OptimalMD apart?
At OptimalMD, we've assembled a team of experts in the healthcare field to assist those without adequate insurance in finding better healthcare options. We support individuals who may be insured but struggle to meet high deductibles, even when paying full retail prices. We also aid those who are stuck in the "Status Quo" healthcare system, forced to pay full price for care and medications, sometimes without any insurance at all.
Our mission extends to the millions of workers without insurance due to being part-time or holding 1099 contracting positions. Drawing from our extensive industry experience, relationships, partnerships, and purchasing power, we've pooled our resources to offer the most competitive prices and convenient access to everyday medical services and commonly prescribed medications at wholesale rates.
One distinctive feature of OptimalMD is that it's the sole program to extend membership to parents of the primary member, aged 55 and older. Additionally, we never charge a membership fee for children under 26 who are dependents of the primary member, with a maximum of seven dependents including spouses, children, and parents.
6 Million Users
95% Member Satisfaction
2000 Plus conditions managed
We’re powering the next generation of healthcare-a world where virtual care is more powerful than traditional care. We think the smartest healthcare solutions are those that break down the barriers between providing and receiving lifesaving care. At OptimalMD we power Intelligent Virtual Care.
What do I get when I sign up for OptimalMD?
When you sign up for OptimalMD, you gain access to a range of health services designed to cater to various medical and behavioral health needs. Our Access Plus plan includes urgent care, primary care, behavioral health counseling, dermatology, and specialty services. OptimalMD focuses on providing these services in a convenient, virtual format to ensure accessibility and efficiency in healthcare delivery.
How can we be so inexpensive? What is the catch?
The current healthcare system is 33% fraud, waste and abuse, 33% administration and profit costs, and only 33% of the cost is for clinical services.
To reduce the costs, contract directly with physicians, pharmacies, labs, and other services. By doing this, we eliminate the expense of fraud, waste and abuse along with the overinflated administration and profit costs.
Is our program perfect?
The answer is "No".
There is no perfect solution to America's healthcare crisis. However, our comprehensive membership undoubtedly provides the greatest value in healthcare.
Some services still cost extra, but significantly less than you would pay even if you have insurance. Insurance is no guarantee of payment.
We do not cover cancer treatments, surgeries, and high-cost services..Yet!
We are a great complement to a high-deductible insurance plan.
What services are covered?
Our membership covers a broad range of services including primary care, urgent care, mental health services, and prescription medications. For a detailed list of covered services, please refer to Access Services | Access Plus Services.
Who comprises our healthcare team?
Our network of highly qualified doctors and specialists is available to you and has a 95% satisfaction rate. In our program, you get a Primary Care doctor and you keep that same doctor so they can build a strong relationship with you.
Our physicians are rigorously trained, U.S. board-certified specialists with licenses and credentials. They hold Bachelor's (B.A. or B.S.) and either Doctor of Medicine (M.D.) or Doctor of Osteopathic Medicine (D.O.) degrees.
Our physician assistants are also extensively trained, NCCPA certified, licensed, and credentialed. They hold Bachelor's (B.A. or B.S.) and degrees in Physician Assistant Studies (MPAS), Health Science (MHS), or Medical Science (MMSc).
Our nurse practitioners are proficiently trained, ANCC or AANP certified in their respective specialties, licensed, and credentialed. They possess Bachelor of Science in Nursing (BSN) and Master of Science in Nursing (MSN) degrees.
Our behavioral health team consists of master's-level professionals, including Licensed Professional Counselors, Licensed Clinical Social Workers, Licensed Marriage and Family Therapists, and equivalent licensed professionals.
Psychologists usually acquire a four-year university degree, often with postgraduate work required.
To become a clinical psychologist, you will need an undergraduate degree (four to five years of college) plus a doctorate degree (four to seven years of graduate school). For this specialty area, most people will spend between eight to 12 years in higher education.
All our providers undergo a meticulous credentialing process aligned with the National Committee for Quality Assurance (NCQA) guidelines.
Additionally, they are licensed by the relevant state licensing boards where they practice.
Billing and Insurance
How much does OptimalMD cost?
The cost of OptimalMD memberships vary, depending on whether you sign up individually or if the services are provided to you as a benefit through an association or your employer’s health plan design. In some cases, your employer or association may pay for your membership partially or in full.
a. Our Access Plan is $47 per month for your immediate family. It includes the essential services needed to take care of your family, including access to immediate care, basic prescriptions if a family member is sick, and talking with a therapist if needed.
b. Our Access Plus Plan is $97 a month for your entire family and includes a comprehensive care plan with your own primary care physician, urgent care, and various specialties if you need them.
i. It also includes full mental health with counselors, Psychologists* and Psychiatrists*.
ii. With this option, members get a robust prescription plan that covers 1100 of the most prescribed medications at no additional cost and 4000 other medications at the manufacturer's cost. (For example, Insulin in our program is only $19, compared to most plans, where the monthly cost is $80 or more.)
*Additional per visit fees apply
What are the options for dependents?
Adding your spouse and children incurs no additional cost, enhancing the value of our family-friendly memberships. You can also extend coverage to your parents for a nominal fee of $25 or $30 each (depending on your membership selection), which can result in significant savings on their healthcare expenses compared to traditional insurance. This flexibility makes our program one of the most inclusive available.
What are the deductibles?
There are no deductibles in our plans, meaning your care starts immediately without any out-of-pocket threshold to meet. This can drastically reduce your annual healthcare spending and simplify your financial planning.
What is the co-payment rate?
There is no copay for the vast majority of services, ensuring straightforward access to healthcare without additional fees per visit. A copay may apply to specialty treatments such as Psychology and Psychiatry visits. In cases like this where a copay might apply, we will be very transparent and will be more affordable than other similar options.
What are my payment options?
OptimalMD accepts all major credit cards and e-checks. If you have a visit fee, you will be shown the amount prior to confirming your visit request.
Does OptimalMD accept my health insurance?
Many health plans and employers provide OptimalMD as part of their benefits. To check whether you are covered, reach out to your benefits manager.
What is the process for filing claims?
There's no need to file claims with our program. All services are pre-paid, which not only simplifies your experience but also ensures you're not dealing with paperwork or waiting for reimbursements. This immediate access to care without the hassle of claims lets you focus on what’s important—your health.
What are the coverage limits?
There are no coverage limits on urgent or primary care, and you have access to unlimited Rx services.
Urgent Care
What is Virtual Urgent Care?
Virtual Urgent Care offers 24/7/365 access to healthcare services that are fast, convenient, and affordable. It provides a solution for when doctors are hard to reach, illnesses occur at inconvenient times, or when you simply have a health-related question.
When should I use the OptimalMD Urgent Care?
You should consider using OptimalMD Virtual Urgent Care in the following situations:
Difficulty Reaching Doctors: If you're having trouble reaching your regular healthcare provider, especially during non-office hours or in emergencies.
Urgent Medical Needs: When you or a family member has a medical concern that is not life-threatening but requires prompt attention. This could include symptoms like fever, minor injuries, colds, flu, infections, or other acute conditions.
Accessibility: Access to licensed and board-certified physicians 24/7/365 ensures you can receive care anytime, anywhere, with just a call, tap, or click.
Quick Access: If you need quick access to healthcare without incurring any costs, this program offers an exceptional service without financial burden.
Convenience: Virtual urgent care allows you to receive medical care from the comfort of your own home or wherever you may be, saving you time and hassle associated with traditional doctor's visits.
Medical Questions: Even if you don't necessarily have a pressing medical issue but have questions or concerns about your health, you can reach out to the medical team for guidance.
Remember, while virtual urgent care can be convenient and accessible, it's important to use common sense and seek emergency medical attention if you or someone else is experiencing a life-threatening situation or severe symptoms that require immediate attention.
When you need to save valuable time:
Accessing medical professionals through our service is easy, affordable, and saves time. Say goodbye to long waits for doctor appointments and missing work. Our platform provides convenient access to physicians anytime, anywhere, 24/7, all year round.
A typical doctor's appointment can eat up half of your workday. We understand your time is precious. With us, you can connect with a doctor swiftly, avoiding the hassle of scheduling appointments that can take up to 21 days.
Emergency room wait times can be excruciatingly long, averaging around 4 hours. Don't waste your time waiting when you could be getting the care you need promptly.
Don’t let the current healthcare system hold you back from receiving the care you deserve.
When you want to save money:
Our Virtual Care Model helps you cut costs by reducing unnecessary office and ER visits. Online consultations are completely free. Unlike traditional office visits, where you might have to pay out of pocket even with insurance, our service ensures you get the care you need without breaking the bank.
When you need care for over 300 medical conditions:
Contacting our Care Team opens up a world of options. Whether you need to speak with a physician, pediatrician, or behavioral therapist, we've got you covered.
Our Convenient Care service treats over 300 conditions, including but not limited to flu symptoms, sinus problems, ear infections, allergies, urinary tract infections, nausea, pink eye, stomach viruses, rashes, sore throat, acne, men’s and women’s health issues, and more.
Our mission is to provide you with accessible, affordable healthcare whenever you need it most, 24/7/365.
We provide assistance in various situations:
a. In cases requiring immediate medical attention
b. When you seek professional advice for health-related inquiries
c. If you're contemplating a visit to the emergency room or urgent care center for a non-emergency matter
While you're traveling for leisure or business, or away from your usual residence
Even when you're attending school away from home.
What is the process for getting care through Virtual Urgent Care?
To access Virtual Urgent Care services, call 877-309-0297, or visit www.portal.optimal.md. to log into your member portal and schedule a consultation with a state-licensed physician. The process is simple:
a. Call, Tap, or Click - Contact the service through phone, app, or website.
b. Triage - Speak to a Care Coordinator who will triage and update the patient's Electronic Health Record (EHR).
c. Consult - Consult with a physician who will recommend a treatment plan. If medication is prescribed, it will be sent electronically.
What conditions can Virtual Urgent Care address?
Virtual Urgent Care can address a wide range of conditions, including but not limited to:
-> Cold and flu symptoms
-> Sinus problems
-> Ear infections
-> Allergies
-> Urinary tract infections
-> Nausea
-> Pink eye
-> Stomach viruses
-> Infections
-> Rashes
-> Sore throat
-> Acne
Can OptimalMD Virtual Urgent Care treat my sinus infection and rash in one visit?
Yes! Our qualified medical professionals can usually address multiple health concerns during a single consultation.
How effective is Virtual Urgent Care for treating low acuity illnesses?
Virtual Urgent Care is highly effective for treating low acuity illnesses, with 70% of such conditions being manageable virtually.
Primary Care
What is Virtual Primary Care?
Virtual Primary Care allows patients to have face-to-face visits with their physicians across various devices. This service enables patients to connect with a physician via phone or video technology, facilitating the establishment of a patient-physician relationship without the need for a physical visit to the doctor’s office.
How can I access Virtual Primary Care services?
To access Virtual Primary Care services, you can call (877) 309-0297, or visit www.portal.optimal.md to log into your member portal and schedule a consultation with a state-licensed physician.
How do I schedule an appointment?
The process is simple:
i. Login to your member portal and click “Connect with a Doctor”
ii. Click the “Schedule a Consultation” button and select the Primary Care option.
iii. Select your preferred provider and the date and time for your appointment. You will need to update your Electronic Health Record (EHR) and you will receive confirmation reminders prior to your appointment.
What types of services does Virtual Primary Care provide?
Virtual Primary Care provides a wide range of services including the establishment of a primary care physician, management of health conditions over time, medication management including ongoing refills, lab tests and routine screenings, health assessment screening and evaluation, and review and interpretation of lab test results. Additionally, it offers in-network recommendations and referrals for specialty care services.
When should I use Virtual Primary Care?
You should use Virtual Primary Care for the management of routine and ongoing health conditions, medication management, preventive care, lab tests and routine screening, health assessment screening and evaluation, and when you need a referral to see specialists.
What are the benefits of using OptimalMD Primary Care?
Benefits include no consultation fees, caregiver support that allows family or specialists to join video appointments, the ability to build a relationship with a chosen provider, scheduling routine checkups, ordering labs, refilling medications, monitoring key vitals virtually, and 24/7 direct access to a collaborative care team for unlimited ongoing health care needs.
What makes OptimalMD’s Integrated Primary Care different?
Integrated Primary Care is designed to uncover unknown conditions, integrates all services for continuity of care, provides immediate and long-term savings through redirected healthcare and continued care, and offers 24/7/365 collaborative care team support for treatment adherence and medication management.
Will my provider be able to prescribe a refill for my prescription?
Yes, our providers will discuss your health history and assess whether a refill is safe at the time of your visit or whether it's prudent to see a physician in person. The decision to provide a prescription for a refill and the quantity of the prescription is at the sole discretion of the provider.
Can OptimalMD providers prescribe birth control?
Generally, birth control prescriptions are dependent on your medical history and the provider's assessment of the risks and benefits to you. If medically appropriate, OptimalMD providers can start you on a new birth control regime.
If you are currently taking birth control medication, an OptimalMD provider can discuss your health history and assess whether a refill is safe at this time, or whether it would be prudent to see a physician in person.
Dermatology
What is Virtual Dermatology?
Virtual Dermatology offers on-demand access to board-certified dermatologists from the comfort of your home, providing reliable care for thousands of skin, hair, and nail conditions, including treatment for suspicious spots, rashes, cold sores, fungal infections, and more.
How can I access Virtual Dermatology services?
Access is available 24/7/365 through www.portal.optimal.md. After logging into your member portal, you can schedule a consultation with a dermatologist.
What is the process for a Virtual Dermatology consultation?
Log-in to Request a Consult - Use the OptimalMD member portal to schedule your consultation.
Upload Images - Describe your condition and upload at least three images of the affected area.
Dermatologist Review - A dermatologist reviews your consultation details, health records, and images within 72 hours, providing a treatment plan and prescriptions if necessary.
Prescription Delivery - Prescriptions will be sent electronically to your pharmacy.
When should I use Virtual Dermatology?
Use Virtual Dermatology:
-> When you need care immediately.
-> If you have health-related questions and need professional guidance.
-> If you're considering the ER or an urgent care center for a non-emergency issue.
-> While on vacation, a business trip, or away from home.
What conditions can Virtual Dermatology address?
Virtual Dermatology can address a wide range of conditions, including but not limited to:
-> Acne, alopecia (hair loss), boils, cold sores, cysts, eczema, folliculitis.
-> Hives, fungal skin infections, keratosis, dermatitis (including maskne), rosacea, moles, warts, suspicious spots, athlete's foot, ringworm, poison ivy, shingles, psoriasis, rash, skin infections, and much more.
What is the average turnaround time to receive a diagnosis?
The average turnaround time to receive a diagnosis is 12 hours, with a treatment plan and prescription provided within 72 hours after the interview intake.
How effective is Virtual Dermatology in treating conditions via virtual visit?
Virtual Dermatology is highly effective, with 87% of cases fully treated via a virtual visit and a 94% member satisfaction rate.
Behavioral Health Counseling
What is Virtual Counseling?
Virtual Counseling provides access to Master Degreed Counselors for short-term problem resolution, referral, and crisis intervention services. It's designed for those feeling overwhelmed, experiencing anxiety or depression, with no visit fee for counseling sessions, which are determined to be clinically appropriate based on the issue.
What services are offered under Behavioral Health Counseling?
Virtual Counseling: For short-term problem resolution with a Master's Degreed Counselor.
When should I use Virtual Counseling?
Virtual Counseling is suitable for:
-> Substance abuse
-> Depression
-> Stress and anxiety
-> Death of a loved one
-> Relationship issues
-> Parenting issues
How can I access these Virtual Behavioral Health Counseling services?
Once you become a member, access is available by visiting www.portal.optimal.md. After logging into your member portal, you can schedule your consultation with the appropriate mental health professional.
Psychology
What is a Psychologist?
Psychologist studies normal and abnormal mental states, perceptual, cognitive, emotional, and social processes, and behavior by experimenting with, and observing, interpreting, and recording how individuals relate to one another and to their environments. Psychologists usually acquire a four year university degree, often with postgraduate work required.
To become a clinical psychologist, you will need an undergraduate degree (four to five years of college) plus a doctorate degree (four to seven years of graduate school). For this specialty area, most people will spend between eight to 12 years in higher education.
How long will each counseling session last?
Each counseling session will last around 50 minutes.
May I speak to the same therapist every time?
Yes. You select and can keep your same provider throughout your treatment.
Can a Psychologist prescribe medication?
Unlike Psychiatrists, Psychologists CANNOT prescribe medication to patients.
When should I choose Psychology Health services?
If you are not feeling like yourself, confused about a personal situation, experiencing anxiety or depression, or overwhelmed with life.
Are online counseling sessions recorded?
No sessions are recorded nor stored.
Psychiatry
What is a Psychiatrist?
Psychiatry is the branch of medicine focused on the diagnosis, treatment, and prevention of emotional and behavioral disorders. Psychiatrists are qualified to assess both the mental and physical aspects of psychological problems and provide a picture of a patient’s physical and mindful state. Psychiatrists often prescribe medications in combination with psychotherapy.
What medications can the Psychiatrist prescribe?
-> Lexapro
-> Effexor
-> Paxil
-> Elavil
-> Zoloft
-> Cymbalta
-> Wellbutrin
-> Remeron
-> Celexa
-> Prozac
-> Prestiq
-> And more…
How long will each counseling session last?
Each counseling session will last around 50 minutes.
Are online counseling sessions recorded?
No sessions are recorded nor stored.
What prescriptions are NOT prescribed with Psychiatrist services:
-> DEA-controlled substances (ADHD stimulant medications, sleep medications, anti-anxiety benzodiazepines)
-> Stimulants (e.g., Adderall, Ritalin, etc.)
-> Medications intended for intra-muscular injections
-> Detox Medications (e.g., Suboxone, Methadone)
-> Other drugs with potential for abuse, such as muscle relaxants, pseudoephedrine
-> Medications that require regular lab work and monitoring (e.g., Lithium, Depakote, Tegretol) when lab work is not present for review
What conditions are NOT treated with OptimalMD Psychiatric services?
-> Emergency situations (suicidal, homicidal, self-harm)
-> ADHD prescription of stimulant (therapy and non-stimulant medication management are in scope)
-> Active hallucinations or delusions
-> Substance use in an active medical detox program
-> Moderate to severe autism spectrum disorders, and internationally located patients
-> Conditions that require laboratory or diagnostic imaging to determine final treatment recommendations without lab work present for review
-> Children under the age of 12
Visits, Appointments, Treatments, & Conditions
What if I need care late at night or over the weekend?
With OptimalMD you can request an urgent care visit 24/7/365.
I live in New York, but I'm on vacation in Florida – where should I request my medical visit?
You should request a consultation in the state where you are physically located at the time of the visit. If a provider determines that a prescription is medically necessary, the prescription can be submitted to a local pharmacy of your choice.
Can I cancel my appointment?
Yes, you can cancel your appointment by logging into the member portal at www.portal.optimal.md
Can OptimalMD treat conditions such as erectile dysfunction and hair loss?
Yes! Our primary care providers can treat most conditions, but we cannot prescribe any DEA controlled substances.
How do I schedule my visit?
Login to your member portal and click “Schedule a Consultation” then follow the prompts.
What if I have a question but don't need medical care?
Both of our membership options allow you to send a secure message to a doctor without having to schedule an appointment. Simply log in and go to “Message a Doctor” or “Message a Specialist” to start a conversation.
What are the age requirements for using OptimalMD virtual care?
Our virtual care providers cannot treat children under 2 years old. Our Psychiatrists cannot treat children under 12 years old.
How are emergencies handled?
OptimalMD providers do not treat emergencies. If you are having an emergency, please call 911.
Although our plan does not directly cover emergency services, we offer guidance on managing emergency care costs effectively, even providing potential avenues for cost reduction based on income. For more details on how to navigate emergency situations under our plan, please consult our emergency services guide.
Can OptimalMD's providers order lab tests?
Yes! If necessary, OptimalMD providers may order lab tests for Virtual Primary Care and Psychiatry patients. Please note that our Urgent Care providers will not order lab tests.
OptimalRx Acute Program
Will all prescribed medications be free of charge for me?
At OptimalMD, our aim is to offer affordable access to commonly prescribed medications at very low or no cost.
This program includes the top 125 most commonly prescribed generic medications and is available at no cost to you or your family members. If you need other medications, easily search our member portal for deeply discounted prices.
Can I start using this benefit immediately after signing up, or is there a waiting period?
Yes, you can begin using it immediately for home delivery, and at retail pharmacies 24 hours after you sign up.
Are my brand name medications free?
A significant aspect of our program is to educate members about generic equivalents of brand name drugs.
Many brand name drugs have a generic alternative that is equally effective but more affordable.
Our program provides access to free generic medications, If you require a brand name medication without a generic equivalent, we won't be able to provide it.
Is there a limit to how many prescriptions I can get filled?
There is no limit!
What type of membership card will I receive?
A digital member card will be available from the online portal to download or print after you enroll.
Can I use this plan at a retail pharmacy?
Yes, present your membership card to your local pharmacy when filling covered acute medications.
Where can I use OptimalRx?
You can use OptimalRx at over 60,000 retail pharmacies in the US, Puerto Rico and Guam.
My Pharmacist is not familiar with OptimalRx?
If your Pharmacist is not familiar with OptimalRx - Show the OptimalRx Card and ask them to process the claim just like they do with any other RX Benefit Card. If they are having trouble they can call our Pharmacist Hotline at 855-798-2538.
Will I owe any money at the Pharmacy?
If the medication(s) are on your free formulary, then you will owe nothing. Otherwise, you will owe the co-pay or the discounted price as shown on the website after you have logged in. This amount will be according to the contracted amount with OptimalRx . Present your card to the pharmacy with a valid prescription. Mail order is required on maintenance medications after the initial fulfillment at a retail pharmacy.
How can OptimalRx offer such deep discounts?
OptimalRx has worked with all major pharmacies to negotiate the best possible prices and we pass them along to our members.
Do I need a valid Prescription?
Yes - Your local pharmacy or our Home Delivery Program will require a valid Prescription. Please bring your prescription with you to your local pharmacy or have it electronically sent to the pharmacy of your choice. When picking up the prescription, show your OptimalRx card as form of payment.
I cannot find my medication in your app or on the web?
If you are having trouble, please use our live chat feature inside the pharmacy portal or call our Customer Support Team at (855) 798-2538.
OptimalRx Complete Program
What is the program about?
The uninsured and underinsured people who have insurance, but their deductibles are so high they never meet them, and they are paying full price for medicine. With decades of relationships, partnerships and buying power, we have pooled our resources and are providing the lowest prices on medications in the country.
Will all prescribed drugs be free; at no cost to me?
All generic medications on our formulary are free.
Can I begin using this benefit right after I sign up, or is there a minimum wait time?
Yes, you can begin using it immediately for home delivery, and at retail pharmacies 24 hours after you sign up.
How long will it take for me to sign up and become activated?
Signing up is easy, it will only take a few moments to answer the required information. We can help you sign up.
Are my brand name drugs free?
Only your generic medications on the formulary are free with your monthly subscription.
So, brand medication is not available?
Our pharmacists can help determine if there is an equivalent drug to help meet your medical needs. Or, you may obtain brand name medications through your retail pharmacy at a lower contracted cost.
Can I have multiple addresses for family members?
All family members must live at the same address. Shipping address can change depending upon circumstances.
How do I get my prescription transferred?
Our pharmacist will contact your local pharmacy or physician and have your prescription transferred to us.
What will the quantity be that I will receive as free?
The quantity will be per the doctor's order on the prescription. However, there is a maximum qty limit allowed by the program. Charges may occur for maximum quantity limits exceeded.
Do you support 30-day prescriptions? How about 90-days?
Yes, we support 30 day and 90- day prescriptions. The most economical will be a 90-day supply!
Is there a limit to how many prescriptions I can get filled?
There is no limit!
What type of membership card will I receive?
A digital member card will be available from the online portal to download or print after you enroll.
How long before I receive my membership card?
Your card will be available after you enroll.
Where can I determine what drugs are available?
Once in the pharmacy section of the member portal, click on “Medications” located on the menu bar at the top or call our customer service (855) 798-2538.
Do I have to contact my doctor to get a new prescription or request a refill?
Our pharmacists will reach out to your doctor to request a new prescription or refill.
How can my doctor contact you?
Escribe: 04229971 | Efax: (888) 870-3823 is on our e-fulfillment cards. Otherwise, they can call Customer Service at (855) 798-2538 for assistance or our pharmacists can reach out to them directly.
Can I use this plan at retail?
Yes, present your membership card to your local pharmacy anytime when filling covered acute medications, and the first time you fill a chronic medication. After your first fulfillment of chronic medication, our team will reach out to help you switch over to our mail-order services.
Do you have expedited shipping?
Yes, expedited shipping is $49.99 for overnight and $29.99 for the second day.
Do you ship to P.O. Boxes?
Yes, we can ship to P.O. Box.
Is tracking information available?
Yes, your delivery courier provides tracking information.
What if my medication is not on the formulary online?
If the medication is not on the formulary, call customer service at (855) 798-2538 to see if we can special order the medication. Additionally, our pharmacists can help determine an equivalent drug to help meet your medication needs.
What if my shipment is damaged?
If your medication is damaged, give customer service a call at (855) 798-2538 and we assist you with the next steps to obtain your medication.
Can I sign up for automatic refills?
Yes, automatic refills are preferred!
Where can I use OptimalRx?
You can use OptimalRx at over 60,000 retail pharmacies in the US, Puerto Rico and Guam.
My Pharmacist is not familiar with OptimalRx?
If your Pharmacist is not familiar with OptimalRx - Show the OptimalRx Card and ask them to process the claim just like they do with any other RX Benefit Card. If they are having trouble they can call our Pharmacist Hotline at 855-798-2538.
Will I owe any money at the Pharmacy?
If the medication(s) are on your free formulary, then you will owe nothing. Otherwise, you will owe the co-pay or the discounted price as shown on the website after you have logged in. This amount will be according to the contracted amount with OptimalRx . Present your card to the pharmacy with a valid prescription. Mail order is required on maintenance medications after the initial fulfillment at a retail pharmacy.
How can OptimalRx offer such deep discounts?
OptimalRx has worked with all major pharmacies to negotiate the best possible prices and we pass them along to our members.
Do I need a valid Prescription?
Yes - Your local pharmacy or our Home Delivery Program will require a valid Prescription. Please bring your prescription with you to your local pharmacy or have it electronically sent to the pharmacy of your choice. When picking up the prescription, show your OptimalRx card as form of payment.
Why are Brand Medications so expensive?
Drug companies control the prices and try to recoup the investment in research and development. Thus, causing high prices. OptimalRx strives to offer the lowest cost on Brand drugs as possible. We will also work with you to look for alternatives that could save you money. Our customer support team is available to discuss options.
Does Optimal Rx Cover Brand Medications?
Yes, we do. Our first option is to try to fulfill your prescription with the low-cost generic alternatives. The formulary is generic based. Brand name medication would not be covered as part of the $0 copay, but greatly discounted and may be available for Prescription Assistance Program or International Sourcing. These programs save between 30-85% off retail costs on brand medications.
Do the prices vary by Pharmacy?
No, you will pay the same at any Pharmacy. Show your OptimalRx card and pay the Pharmacy nothing! You have the ability to save more through Home Delivery.
I cannot find my medication in your app or on the web?
If you are having trouble, please use our live chat feature inside the pharmacy portal or call our Customer Support Team at (855) 798-2538.
How does OptimalRx Home Delivery work?
OptimalRx is affiliated with Advanced Pharmacy, LLC. Advanced is a URAC accredited pharmacy, located in Greenville, South Carolina. Advanced is our exclusive Mail Order distributor and is Licensed in all 50 states. Advanced will dispense and deliver your medication via USPS or FedEx.
Will the Home Delivery Program obtain refill prescriptions?
Yes, fourteen days (14) before your medication is due for renewal, our pharmacy will attempt to obtain a new prescription from your Physician. We will call, text and or email on all of our activity.
Will it cost me extra to have my medications sent via Home Delivery?
Your medications will be sent at NO Additional Cost! We even will ship your medications that require cooler packs and special handling at NO Charge.
Will I be reminded when needing a refill on Home Deliver orders?
Yes, we will contact you via phone, email and or text to confirm your next shipment 14 days in advance.
Do I have to prepay for my meds?
OptimalRx will bill your credit card at the time of purchase but if you do not fill your prescription your credit card will not be used.
How do you handle refunds?
If you choose to obtain a refund, we will process your refund from the pharmacy portal. If you need help, or your pharmacy needs assistance, please call our Pharmacist Hotline at 855-798-2538. Our Home delivery program will bill your card at the time of dispensing your medication prior to shipment. You will receive notification that your medication has been shipped and your card was billed. Once a medication is shipped no returns are accepted.
What forms of payment does OptimalRx accept?
We accept debit and credit cards to include Visa, MasterCard, American Express.
Can I claim my Medications on my HSA or FSA account?
Yes, we will send you a receipt that you may be able to apply to your account. All plans are designed differently. Please check with your plan administrator.
Technology & Account Management
How do I set up my OptimalMD account?
If your account is affiliated with an organization (e.g. an employer, an association, or a nonprofit), check with your organization administrator or email us at [email protected] to confirm your onboarding path.
To set up a new individual/family account, visit https://www.optimalmd.com/patient-onboarding and submit the form to get started. You’ll receive an email with a link to our member portal, and a username and password to access and finish setting up your account.
How do I provide or update my billing information?
You will be prompted to enter your billing information in the member portal if a membership fee is due upon registration. You can always update your billing information at any time by going to the “My Profile” page on portal.optimalmd.com.
Why do I need a webcam or video-enabled mobile app?
Some states require a video connection for telehealth visits. Even where it is not required, we recommend a video connection to help our providers deliver the best possible care. When a provider can see you, she/he can better assess and monitor visual cues.
What are the technical requirements for using OptimalMD?
A valid email address is required to create your account
Users must have a high-speed Internet connection.
OptimalMD Virtual Care works best with the following browsers: Chrome for computers, androids, and MacBooks; and Safari for iPhone/iPads.
For video consultation, users must have a webcam or video-enabled mobile device.
JavaScript and Cookies should remain enabled.
Why won't my Clinic and Pharmacy Portal tiles open when I click on them?
If you are experiencing issues with opening the Clinic and Pharmacy Portal tiles, it is likely due to your browser's pop-up blocker settings. Our system requires pop-ups to open certain portals in new tabs. Here's how you can enable pop-ups on both PC and mobile devices:
For PC (Google Chrome, Mozilla Firefox, Microsoft Edge):
Google Chrome:
a. Click the three dots in the upper right corner of your browser.
b. Select 'Settings', then 'Privacy and security'.
c. Click 'Site Settings' and scroll down to 'Pop-ups and redirects'.
d. Choose the option to 'Allow' pop-ups and redirects or add our site to the list of allowed sites.
Mozilla Firefox:
a. Click the three lines in the upper right corner.
b. Select 'Preferences', then 'Privacy & Security'.
c. Scroll to the 'Permissions' section and uncheck 'Block pop-up windows' or add our site to the exceptions list.
Microsoft Edge:
a. Click the three dots in the upper right corner.
b. Select 'Settings', then 'Cookies and site permissions'.
c. Click on 'Pop-ups and redirects' and toggle the setting to 'Allowed' or add our site to the allow list.
For Mobile Devices (Google Chrome, Safari):
Google Chrome on Android:
a. Tap the three dots in the upper right corner.
b. Select 'Settings', then 'Site settings'.
c. Tap on 'Pop-ups and redirects' and switch it to 'Allowed'.
Safari on iOS:
a. Go to 'Settings' on your device and scroll down to 'Safari'.
b. Under the 'General' section, toggle off 'Block Pop-ups'.
After adjusting these settings, try accessing the Clinic and Pharmacy Portal tiles again. If you continue to experience issues, please contact our support team for further assistance.
Data Storage, Documents, & Records Requests
Is my information secure?
Our platform is designed to be private, secure, and HIPAA-compliant, allowing you to safely consult with one of our therapists online. Our Code of Ethics ensures your sessions are completely confidential.
Can I get a copy of my medical records?
Yes! Simply log into OptimalMD's patient portal to print or download your medical records. We store medical records as PDF documents, so they are easy to keep or share with your physician.
Can you send my medical record to a designated person, entity, or company?
Yes, if you would like us to send or disclose your medical records on your behalf to another person or entity, we require written authorization and signed consent.
Will my information and data remain confidential?
Yes, OptimalMD and its parent company, Optimal MD, strictly adhere to guidelines aimed at safeguarding all data and are dedicated to upholding the privacy of all members. Our practices align with applicable state, national, and international laws and regulations, notably the U.S. Health Insurance Portability and Accountability Act of 1996, commonly known as HIPAA. Except where permitted or mandated by law, your medical information will not be disclosed without your explicit consent.
We enforce the same rigorous privacy standards on all our partners as we do on ourselves.
We require all partners we engage with to adhere to proper protocols and maintain adequate insurance coverage, including liability and cybersecurity protection.
