一名得克萨斯学生在Aetna否认保险后为修复假脚支付了7 500美元,后来推翻了毕业后的决定。 A Texas student paid $7,500 for a prosthetic foot after Aetna denied coverage, later reversing its decision post-graduation.

得克萨斯州Burleson市21岁的大学生Gabrielle Guerrero, 在2025年12月毕业前, Aetna多次拒绝提供新假肢所需的保险。 College student Gabrielle Guerrero, 21, of Burleson, Texas, faced repeated insurance denials from Aetna for a new prosthetic foot needed before her December 2025 graduation. 尽管她最初的假肢被覆盖,但Aetna最初以编码不当为由拒绝替换,并声称替换是出于舒适,而不是医疗需要。 Despite her original prosthesis being covered, Aetna initially rejected the replacement, citing improper coding and claiming it was for comfort, not medical necessity. 随着毕业的临近,她母亲从口袋里掏出7 500美元。 With graduation approaching, her mother paid $7,500 out of pocket. 在仪式几天后,Aetna在同侪审查后推翻了它的决定,引用了新的信息。 Days after the ceremony, Aetna reversed its decision after a peer-to-peer review, citing new information. 律师说,这种否认是司空见惯的,许多患者尽管有医疗需要,却很难获得假肢,而且各州和计划的覆盖率差别很大。 Advocates say such denials are common, with many patients struggling to access prosthetics despite medical need, and coverage varies widely by state and plan.