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?

I am a PEIA insurance holder.  I have not been approved yet for the surgery, but I am taking the necessary steps.  I guess I do have the premorbid problems and I am considered morbidly obese.  However, there is still a lot of steps they require you to take before approval.  I work the medicaid program and it seems that medicaid people are getting approved easier than PEIA people.  I am in the 10th month of the year long saga.  I have not lost the necessary 10% of my body weight, so I guess I will struggle with that part of it.  Who is your doctor?  I have been gone to Dr. Shin.

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.

Dr. Shinns office is in the process of moving to a bigger and better facility, that is why it is so difficult to get in touch with them.
HOwever, one needs to go to the Dr. they feel comforatable with. Good luck to you on your weight loss.
p.s. The move should be complete by now.

I was just curious what your status was...if you had the surgery etc.  I'm in my 9th month follow through with my pcp.  Having a hard time losing the 10% also. 

No I haven't gotten my approval yet for surgery.  I have finished up my 12 months of contacts with my pcp, and she has submitted the paperwork.  But I have not heard from Dr. Shin's office yet.  I have called and left messages, but no one has gotten back with me.  It is extremely frustrating to not know what is going on.  I hope you are having better luck.

PEIA is very strict, you don't have to have all the co-problems to get approved.
I saw where someone else is going to Dr. Shinn, that is the DR. that did my surgery.
Get your primary care doctor to refer you to Dr. Shinn, CAMC Weight Loss Program (Pre surgery)
they will start you on a program, the most important part is your food log, be honest, spark people is a good site to get started on. This will last for a year, you will meet monthly with a dietician who will monitor your progress, give you support and tips on weight loss, this will last a year or until you lose the 10% of your body weight. These people know what to do and how to deal with PEIA and how to present your case to get you approved.
They also have a medical non surgical program you and your physician may wish to check into
before getting the more invasive procedure.
Dr. Shinn and his staff are top notch.

So do you have to follow the diet and maintain the weight for a year or can you get approved as soon as you've lost the ten percent of your body weight?

I am also wondering about the one year waiting period.  I will be starting a new job in August and would love to have it while I am off work.  Otherwise I don't know when I'll be able to have it.  Is there a way to get it approved faster?  I have diabetes, hypertension, and sleep apnea.  Thanks