confused - optimum choice

heather D.
on 7/27/07 6:23 am - Dover, DE
I have optimum choice and I work in Maryland. There's a MD state law basically saying insurance providers have to cover WLS. So I was all doing the happy dance and got ahead of myself and made an appointment for a surgery consult. Only to find out that my insurance is actually out of Washington D.C.! I called my insurance (again) to see if it was covered and they said no (again), it is an exclusion. So now I have this appointment and they got me in super early! I still would need to make an appointment with my PCP to get a referral, but I have the appt with the surgeon. I am bummed and wondering if I should still go ahead and try to get the ball rolling even though they told me it was an exclusion. I have this scenario in my head where anytime someone calls Optimum Choice, they are told to say NO if a customer asks if something is covered just so they can discourage the person from even trying. I may be wrong though.  Any advice? Should I try anyway? Anyone with Optimum Choice out of DC who actually got them to pay for WLS? Thanks a bunch! Heather
tbtroy78
on 8/2/07 11:12 pm - winchester, VA
I am having the same issue with my optinum choice being written out of Washington D.C.  I live in virginia work in Maryland even the state i live in has the regulation.
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