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Grandfather’s fight for coverage of spinal surgery
NBC News· 2025-10-17 00:30
Healthcare Coverage & Insurance Disputes - Aetna initially denied coverage for a 68-year-old man's spinal reconstruction surgery, despite his doctor's recommendation [3][4] - The denial was partly based on the patient not completing physical therapy, which the doctor deemed ineffective for his condition [4] - The insurance company reversed its decision and approved the surgery after NBC News contacted them [6] - Aetna claimed the patient's doctor had opportunities to engage with their medical team but declined, and that necessary documentation was not previously provided [6] - The patient disputes Aetna's claim about the information and the doctor declined to comment [7] - The denial of coverage resulted in the patient losing approximately one year of normal life [7] Patient Experience & Impact - The patient experienced severe back pain that significantly impacted his daily life and activities [2] - The patient sought various methods of pain relief, including a human dog bed [2] - The patient's family expressed frustration and helplessness due to the denial of necessary medical treatment [5]
One brother approved, one denied for same gene therapy
NBC News· 2025-08-28 01:30
Ready, go. Chicago area dad William Smalls strives to care for his three sons equally, but says he and his wife Allison can't. Your insurance company is denying one son, correct.The same treatment your other son has received and seems to be thriving after receiving. Yes. It's baffling. It's the exact same diagnosis.That diagnosis, duchen musculardrophe or DMD, a genetic disorder that progressively attacks a person's muscles. Experts say most are in a wheelchair around 12 and don't live to see 30. Parents al ...