PEIA coverage and rule about past surgeries & possible years wait for approval

I am still waiting for Dr. Shin's office to call to set up my initial appt. I was referred to have the surgery by my pain management doctor. The last meds he had me on caused me to gain 30 pounds. I read some of the posts and saw that PEIA won't approve if you have had more than 3 abdominal surgeries in the past. At 53 I have had more than 3 but I am desperate to lose weight. Right now I can hardly walk and if I don't lose weight I will not be able to walk or maybe even work due to my arthritis and spinal stenosis. I don't want to become totally disabled. I am also an insulin dependent diabetic with hypertension. I don't think I have a year to wait for approval. I cannot lose weight because I have such mobility problems. Do they take the serverity of your problems into consideration? Is the rule about past surgeries a hard and fast rule? Thanks for your help!

Hi Sue! Give Dr. Shin's office a call and ask them about your initial appointment. They'll be glad to help you. Also, it will probably depend on exactly what your past surgeries were as to whether or not PEIA will cover the surgery. The statement in the policy actually reads no MAJOR abdominal surgeries...not just abdominal surgeries. Here is the exact wording: Member must not have a past history or current conditions of the following: g: More than 3 prior major abdominal surgeries; To read PEIA's bariatric policy, go to http://www.westvirginia.com/peia/page.cfm?section=252&storyid=5366 Hope this helps! Good luck! Beth