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We're here to help. Our Member Services Representatives are available 24 hours a day, seven days a week. Just call the telephone number on your health plan identification card or check the Members section of our Web site for additional contact information.

On Your Health you’ll find a link to Aim for a Healthy Weight, a National Heart, Lung, and Blood Institute Web site with key recommendations on weight management, plus practical tips for controlling weight.

Find out what tier a prescription medication is on or if it requires prior authorization. Check the Prescription Drug List. You can also check Quantity Level Limits and view our list of Maintenance Prescription Medications.

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Home > Members > Your Health > Choosing a Hospital

Your Health

Centers for Cardiac Surgery, Total Joint Replacement and Transplants (effective July 1, 2007)

In certain geographic areas, we have designated centers for cardiac surgery, total joint replacement and transplants. These centers do a large volume of these procedures each year and have a comprehensive program of care. You must refer MD-Individual Practice Association, Inc. (M.D. IPA) and Optimum Choice, Inc. (OCI) members to one of these centers for any planned cardiac surgery, total joint replacement or transplant if the procedure is to be performed in one of the jurisdictions listed below, or if the member's Primary Care Physician (PCP) is located in one of these jurisdictions. Other members may also use these centers.

Centers for Cardiac Surgery

State

Jurisdiction

Facilities

District of Columbia

District of Columbia

George Washington University Hospital, Washington, DC
Washington Hospital Center, Washington, DC

Maryland

Counties: Anne Arundel, Baltimore, Carroll, Calvert, Charles, Frederick, Harford, Howard, Montgomery, St. Mary's or Prince Georges

Sinai Hospital, Baltimore, MD
Union Memorial Hospital, Baltimore, MD
Washington Adventist Hospital, Tacoma Park, MD
The Johns Hopkins Hospital, Baltimore, MD
St. Joseph’s Medical Center, Towson, MD
University of Maryland Medical Center, Baltimore, MD
Suburban Hospital, Bethesda, MD

Virginia Cities

Cities: Alexandria, Manassas, Fairfax or Falls Church
Counties: Arlington, Manassas, Fairfax or Prince William

Inova Fairfax Hospital, Falls Church, VA
Virginia Hospital Center, Arlington, VA
Inova Alexandria Hospital, Alexandria, VA


Centers for Total Joint Replacement

State

Jurisdiction

Facility

District of Columbia

District of Columbia

George Washington University Hospital, Washington, DC
Washington Hospital Center, Washington, DC

Maryland

City: Baltimore
Counties: Anne Arundel, Baltimore, Carroll, Harford, Howard

Anne Arundel Medical Center, Annapolis, MD
Good Samaritan Hospital, Baltimore, MD
Johns Hopkins Bayview Medical Center, Baltimore, MD
The Johns Hopkins Hospital, Baltimore, MD
Howard County General Hospital, Columbia, MD
Union Memorial Hospital, Baltimore, MD

Virginia

Cities: Alexandria, Manassas, Fairfax or Falls Church
Counties: Arlington, Manassas, Fairfax or Prince William

Inova Fairfax Hospital, Falls Church, VA
Virginia Hospital Center, Arlington, VA
Inova Alexandria Hospital, Alexandria, VA
Inova FairOaks, Fairfax, VA
Inova Mount Vernon, Alexandria, VA

Centers for Transplants

Please call our Outpatient Clinical Care Coordination Department at 301-545-5803 to be referred to the appropriate facility.

1 Members with a Point-of-Service (POS) plan may use their out-pf-plan benefits to access services from facilities other than those listed for cardiac procedures. Members may have higher out-of-pocket costs when using their out-of-plan benefits.

 

 

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