12-year-old with scoliosis seeks a surgery that her insurance says is too new to cover

The FDA approved a new type of surgery for scoliosis in 2019. But Aetna declined to cover it for a 12-year-old girl in Colorado, saying the surgery is still experimental.

Anne Marie Hukriede has three times appealed her insurance company’s decision not to cover her daughter’s scoliosis surgery.

The answer each time was the same: Aetna considers the procedure that doctors recommend for her 12-year-old daughter, Vivian, to be experimental, citing a lack of evidence about long-term safety and efficacy.

Mother fights to get coverage for daughter’s scoliosis surgery03:34When the third denial came on Nov. 11, this time from an outside independent medical expert who reviewed the case on behalf of Aetna, Vivian’s surgery was just days away. Given that the procedure can cost up to $100,000 out of pocket, the family postponed it.

Hukriede, who lives in Centennial, Colorado, exhausted her final chance for appeal last month. Now, the ideal window for Vivian to access the treatment is closing, since the surgery must be done while a child still has a sufficient amount of growing to do. (Peak growth spurts for girls typically occur between ages 10 and 14.)

“It’s disheartening, frustrating,” Hukriede said. “You get angry. We pay a lot of money in insurance premiums to have things covered.”