Life-Changing Surgery For Teen Denied By AETNA Insurance
When will health insurance companies stop playing doctor, and yes, even God, and listen to specialists who know what they’re doing?
Fifteen-year-old Cara Pressman has suffered from severe seizures since she was 9-years-old. Finally, a neurosurgeon recommended she have a relatively new laser brain treatment that would stop the seizures.
“When my parents told me, I went kind of blank and started crying,” Cara said. “I cried for like an hour.”
The date was set, everything was well planned, and two days before the laser treatment was to be performed, AETNA insurance denied it on the grounds it was “experimental” and too new to approve. Yet they did accept a much more invasive actual brain surgery where the top half of the brain is removed, called a temporal lobectomy. Seriously?
According to doctors at Mayo Clinic, who have been successfully performing the laser surgery for several years, it is definitely NOT experimental. The procedure has been performed on thousands of patients, is much less complicated, and recovery time is 2 weeks. Brain surgery takes 6 to 12 weeks for recovery with a risk of death during the operation!
The laser treatment has been FDA approved for several years. Therefore, is not new or experimental.
“Considering they’re denying me getting surgery and stopping this thing that’s wrong with my brain, I would probably just say, ‘Screw you.’ ” Cara told HLN.
I have friends whose middle son, 5-years-old, suffers from seizures. He has since he was a baby. They have to take numerous precautions to keep him safe. Monitors watching at night. Medicines with whoever has him at all times. He’s on the most potent meds a 5-year-old can take, and it has helped, but who knows what long-term effects there might be? His great uncle has had seizures as well all of his life and has taken meds all of his life and has had some neurological problems because of it.
To think an insurance company even has the right to say no to a laser surgery, but recommend a brain surgery is almost too impossible to comprehend! It is beyond sad they would choose to possibly be responsible for this young girl’s death during the much more invasive brain surgery!
What parent would want the top of their child’s head to be opened and exposed during an unnecessary surgery?
Our country has become so dependent on insurance companies who do nothing but pay off government officials and lobby for more money and less help to the clients.
They have no right, but yet they can do it. I will be praying Cara’s parents file an appeal and that she will get the laser surgery somehow. I know how devastating this disease is for children and adults.
This new treatment should be the “go to” procedure. Not brain surgery!