Aetna Medical Insurance Policy Regarding ETS Surgery

We find it curious that Aetna has such a seemingly strict policy on ETS, yet many other insurance carriers are so much more lenient. The publishers of TruthAboutETS are in personal contact with many hundreds of ETS patients worldwide, we have reseached the subject relentlessly for months, and we have yet to discover even a single patient who's pre-operative work-up met Aetna's criteria. We don't deny the possibility that such patients may exist, we just haven't heard from them yet.

The Aetna policy and associated medical references are here.

Policy

I. Aetna considers thoracoscopic sympathectomy medically necessary for hyperhidrosis ONLY if the sweating is "INTRACTABLE" and "DISABLING" and only if ALL of the following are also met:

Topical aluminum chloride or other extra-strength antiperspirants are ineffective or result in a severe rash

AND

Unresponsive or unable to tolerate pharmacotherapy prescribed for excessive sweating (e.g., anti-cholinergics, beta-blockers, or benzodiazapines);

AND

Iontophoresis or electrophoresis, (e.g., Drionic® device) is ineffective (see CPB 229 - Iontophoresis);

AND

Unresponsive or unable to tolerate Botulinum toxin type A (Botox®) (see CPB 113 - Botulinum Toxin)

AND

Significant disruption of professional and/or social life has occurred because of excessive sweating.



II. Aetna considers thoracoscopic sympathectomy NOT medically necessary as treatment for excessive spontaneous facial blushing, since this is considered a cosmetic condition.

[Emphasis added]