PEIA

Jody

New Member
Joined
Apr 7, 2016
Messages
4
Hello! I'm Jody, from West Virginia. I'm just trying to find out if PEIA ever approves any of the weight loss surgeries with a letter of medical necessity from the doctor? I have HBP, Diabetes II, sleep apnea, morbidly obese and pulmonary problems (unrelated to weight).
 
Hi Jody! Welcome. What is PEIA? I live in WV also, in the eastern panhandle.

The best way to find out what you want to know is to locate and get your hands (or eyes online) on a copy of your insurance benefit 'book' for the calendar year 2016. Without seeing that, it is hard to know that answers you're asking for. (Assuming PEIA is your insurance plan)...
 
It's the Evidence of Coverage, abbreviated to EOC. It's a huge 100 page+ thing, not the little 1-2 page summary flyer insurance companies often and out.
 
Hey guys! Sorry! It's Public Employees Insurance Company. I've seen all the requirements. It's ine that requires supervised dieting for a year. I just didn't know if anyone had any experience with it.
 
So is your question is will a doc's letter that the surgery is necessary get the insurance company to waive the stupid year long supervised diet?
 
Some people with a compassionate PCP will fudge the records (i.e. not browbeat you to actually lose weight). I don;t know of anyone who got the insurance company to concede (the whole purpose of the diet is so you get frustrated and drop out of the program so they don't have to pay for WLS) but perhaps there are some.

Sorry yours is a YEAR. Most are half that

You could do self pay as I did with Esquerra in MX and get it done next month for far less grief
 

Latest posts

Back
Top