Medical Care
If you are new to Sentara Health Plans, we recommend that you call your doctor’s or specialist’s office and tell them your coverage is changing to Sentara Health Plans. Your doctor can work with the Sentara Health Plans Clinical Care Services team to provide clinical notes and update any authorizations necessary.
If you have specific questions about your condition or on-going course of care, you can call or email Sentara Health Plans directly to discuss your situation.
Sentara Health Plans Clinical Care Services Team
8 a.m. to 5 p.m. Monday through Friday
Phone: 1-866-503-2730
Email: CBCM_COMM@sentara.com
Pharmacy Care
Some drugs require prior authorization by Sentara Health Plans in order to be covered. Your prescribing provider is responsible for initiating prior authorization.
For those members new to the plan, Sentara Health Plans will temporarily waive prior authorization requirements for members taking drugs that would usually require prior authorization. Your prescription must be filled within 60 days after your plan becomes effective (if filling at a retail location) or 120 days after the effective date (if filling through mail order). There are some exceptions to this and Sentara Health Plans representatives can help you with your transition.
After this period, if you begin taking a new medication for which prior authorization applies then you will need to work with your doctor and pharmacist for approvals.