Aetna patients receive a $3.4 million settlement for proton therapy.

April 12, 2023

There was a proposed class action lawsuit claiming improper denial of funding for proton beam therapy for cancer treatment by Aetna Life Insurance Co., which will be resolved for up to $3.4 million.


According to a March 3rd announcement in the US District Court for the Eastern District of Pennsylvania, the settlement allows 142 patients who were refused coverage between June 2017 and October 2020 to receive individual cash payments of up to $24,000. Each class member who submits a timely and valid claim form will receive a minimal payment of at least $10,000.


Proton beam therapy was incorrectly denied coverage by Aetna as a treatment for some cancers on the basis that it was experimental and investigational, according to the complaint. 


At the South Florida Proton Therapy Institute (SFPTI), we are one of the pioneers of proton therapy.  Clinically lead by Dr. Tim Williams, who has 30 years of radiation oncology expertise in South Florida, and Dr. James Snider, who recently joined SFPTI from the University of Alabama Birmingham Proton Center, our leadership boasts an exceptional amount of expertise in an emerging treatment modality.


Insurance coverage for proton therapy varies depending on your condition, medical history, insurance provider, type of benefit plan and other factors. Proton therapy is typically covered by Medicare and Medicaid. Some private insurance companies also cover proton therapy, but some may deny it as experimental.  


To learn more about your network coverage and particular proton therapy benefits, please use the contact link below.  SFPTI has dedicated insurance coordinators to help you understand the insurance authorization process.

For any other questions – feel free to reach out to us here.