Aetna Health insurance rejected a teen's request for minimally invasive brain surgery just days before she was scheduled to receive the procedure.
Cara Pressman, 15-years-old, was only 3-days away from receiving this surgery when she received the news from her parents that Aetna had backed out of the arrangement. Pressman has been affected by these seizures since she was 9-years-old and considers them a significant impediment to her quality of life.
According to CNN, "When the seizures strike, her body gets cold and shakes, and she zones out for anywhere from 20 seconds to two minutes, typically still aware of her surroundings. Her seizures can be triggered by stress, by being happy, by exerting herself -- almost anything. "It's like having a nightmare but while you're awake," Pressman said."
After learning the bad news from her parents, Pressman posted a video where she told Aetna, "screw you". Unfortunately, Aetna has done the same to others who require the same treatment.
The Pressman family and, separately, Jennifer Rittereiser, a 44-year-old mom who has struggled with seizures since she was 10, approached CNN in recent weeks after they were both denied, by Aetna, for laser ablation surgery, a minimally invasive procedure in which a thin laser is used to heat and destroy lesions in the brain where the seizures are originating.
Aetna claims that laser ablation surgery is 'experimental', thus should not be covered by insurance.
In denying Cara her surgery, Aetna said it considers laser ablation surgery "experimental and investigational for the treatment of epilepsy because the effectiveness of this approach has not been established."
Experts claim that the surgical procedure, far from experimental, is routine.
Dr. Jamie Van Gompel, a neurosurgeon at the Mayo Clinic, disputes Aetna's assessment. "I would not call it experimental at all," said Van Gompel, who is leading a clinical trial on the surgery at Mayo as part of a larger national study. "It's definitely not an experimental procedure. There've been thousands of patients treated with it. It's FDA-approved. There's a lot of data out there to suggest it's effective for epilepsy."