PEIA provides various care management programs including:
Did you know PEIA offers a Face-to-Face Diabetes Program for PEIA PPB Plan members who have diabetes? Under the program, eligible members and their dependents sign an agreement stating they will make regular visits to a participating provider of their choosing for counseling services regarding diabetes. These counseling sessions help participants get the best diabetes care available.
Maintaining a healthy weight is essential to a long and productive life. PEIA offers PEIA PPB members a weight management program which uses the services of registered dietitians and exercise professionals.
To qualify you must have PEIA Preferred Provider Benefit Insurance; be 18 years of age or older; have either a body mass index of 25 or greater, or a waist circumference of 35 inches or more for a woman or 40 inches or more for a man; and be ready to make permanent lifestyle changes.
PEIA is giving you an opportunity to lose weight – at no cost to you – with Wondr Health, formerly Naturally Slim. The program is delivered online to your smartphone or computer and doesn't include starving, counting calories or spending hours prepping 'approved' foods. Instead, it will teach you how to eat your favorite foods while losing weight, looking and feeling better and reducing your risk for major health conditions, like diabetes or heart disease.
PEIA is excited to announce that new online diabetes management pilot programs with Cecelia Health and Day Two, will be available to eligible PPB plan members this July. Members who enroll and actively participate in either pilot program will have no copay for generic and formulary brand diabetes medications and some diabetes supplies at a local Retail Maintenance Network pharmacy for up to one year. This is the same waived-copay benefit as our Face-to-Face Diabetes Program.
PEIA has partnered with “Let’s Get Checked” (LGC) , a provider who will be performing HbA1c lab tests for our Face-to-Face Diabetes Management participants as well as participants in the Cecelia Pilot Program. Members not enrolled in either of these programs are not eligible for this service at this time.
To provide quality care at a reasonable cost, PEIA has partnered with the Charleston Area Medical Center (CAMC) and West Virginia University Hospitals (WVUH) to provide a Hemophilia Care Program to PEIA PPB Plan members.
Co-payments for some diabetes-related prescription drugs and supplies are waived for Face to Face Diabetes Program participants as well as Diabetes Pilot Program (Cecelia and DayTwo) participants. However, participants are responsible for their deductibles and 75% co-insurance of any non-preferred brand medication. In addition, some medications have an ancillary fee for which participants are responsible. This waiver is for retail purchases only, mail order purchases are excluded. PEIA will pay 100% of PEIA’s allowance for in-network services. Out-of-network services are processed at the out-of-network benefit level.
Waived Diabetic Copays