[PapaBear3625]

Reading the article, Aetna did not deny her care, they just disapproved the particular treatment (laser surgery) as “experimental”. They would cover regular surgery.

[polymuser]

Ah, the rest of the story.

Imagine Paul Harvey with today’s stories...

[plain talk]

Thanks. I figured it was more complicated than the headline suggests.

[Slainte]

"While laser ablation has not yet undergone large randomized controlled trials, Van Gompel said existing data shows it’s effective more than 50% of the time. He hopes the current clinical trial will show a success rate of 60% to 70% or better in epilepsy patients. Temporal lobectomies, he said, have a slightly better rate, of more than 70%."

So, the non-Aetna medical expert they interviewed defines a 20% delta as a slightly better rate? I understand that a craniotomy is more invasive, but a 20% difference in outcome is nothing to sneeze at.

[LRoggy]

“Reading the article, Aetna did not deny her care, they just disapproved the particular treatment (laser surgery) as “experimental”. They would cover regular surgery.”

***

It seems that if she has had seizures since she was 9 then whatever Aetna covered so far HASN’T WORKED. Maybe a small ‘experimental’ approach would not be so experimental after all . . . I would not side with the insurer on this one. The insurance industry sometimes forgets that life isn’t always numbers, it’s also supposed to be about helping your PREMIUM PAYERS to get healthy.