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Kristen890’s Posts

Kristen890
on 7/2/11 7:57 pm
Topic: RE: Anyone have to deal with stupid PEIA?
I recently found out that PEIA changed their requirements back in Feb 2011. I found out from Dr. Nease's office. I was originally dealing with Dr. Shin's office staff, but getting through to them is like pulling teeth and they act like they don't keep up with insurance requirements b/c they obviously didn't know anything about PEIA's recent changes. Plus, everytime I would call them I would always get their answering service b/c they take extremely long lunches. Their answering service even said they were getting aggravated with them. Anyway, I filled out some info on the net and Jackie from Dr. Nease's office called me back and told me about the changes. I was so happy b/c she said you have to have a bmi of 40 now with no comorbidities, but you must loose the 10% of your weight and not gain an ounce before surgery or you won't qualify. I am waiting to talk to her July 5, 2011 bc she is on vacation. Dr. Nease's office staff seems alot more caring and seem to know what they are talking about better, so I am going to them if all works out. I was only trying to deal with Dr. Shin b/c he is closer. I have heard that Dr. Shin is very good doctor, but I have had it with his office staff never answering the phone. I have also heard from many people that Cabell-Huntington hospital is better than CAMC from other people's personal experiences, but I don't know. I am sticking with Dr. Nease if I can.
Kristen890
on 6/18/11 12:02 pm
Topic: RE: Anyone have to deal with stupid PEIA?
Does anyone know how to fight PEIA and get approved for weightloss surgery? I'm not even eligible to apply for weight loss surgery because I don't have any of PEIA's tiny list of comorbidities, eventhough I have other problems, it's just problems they don't recognize. It makes me so mad, because if I had any other insurance I would have already had the surgery and been done. I am 100t lbs overweight and I need this surgery desperately. I have been on diet after diet and can't loose weight. What do I have to do to get surgery?! I have already done the year PEIA requires and lost a few pounds and can't loose anymore weight and I have already had tests done to see if I have any of the qualifying comorbidities, which I don't. What else can I do? I can't just give up. I need to loose weight. I need to fight for this. PEIA wants you to be sick first and I don't want to get sick first before I get approved. Has anyone fought them and got their surgery without having their tiny list of comorbidities? Can anyone help me with some tips?