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139

When drug after drug failed, a teen hoped brain surgery could fix her daily seizures. Insurance denied it. (www.nbcnews.com)

submitted 17 hours ago by MicroWave@lemmy.world to c/health@lemmy.world

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Several weeks after NBC News reached out to Anthem Blue Cross Blue Shield about the denial, the insurer changed its policy to include coverage of deep brain stimulation for certain children.

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[–] vrek@programming.dev 4 points 10 hours ago (1 children)

Yes the insurance system is horrible. Yes accountants should not be making medical decisions. That said dbs for epilepsy is not approved for anyone under 18. It can only be done "off label". I understand the insurance company not covering it. Location of stimulation needs to be precise and their brain is growing and changing as they age into adulthood. There have not been sufficient studies to prove safety and effective use of dbs in teenagers for epilepsy. Yes my child has epilepsy, I have previously manufactured dbs systems professionally. It may be great, it may be great for them but I can totally see why the insurance didn't cover in this case.

[–] SaveTheTuaHawk@lemmy.ca 2 points 5 hours ago (1 children)

We only see one side of these stories. There are hundreds of charlatans with fake remedies trying to bill insurance companies, and this includes pharma giants selling FDA approved drugs that do nothing.

[–] vrek@programming.dev 3 points 4 hours ago* (last edited 4 hours ago)

True. Most drugs and medical devices do work and have a lot of data behind them to prove that. It costs many millions to get that data and approvals.

That said if the data isn't there, regardless of the cost of the surgery, do you want to risk your health/your child's health on a hope? If so sign up for a medical trial to help get that data and prove it,most are not only free but pay you for doing so.