Hospitalization for the Initiation of Ketogenic Diet for the Treatment of Intractable Seizures

Aetna covers hospitalization to initiate a ketogenic diet for intractable seizures (including Doose and Lennox‑Gastaut) only in patients <18 who have failed or are intolerant of anticonvulsant therapy after an adequate, monitored trial with correct drugs/doses and ≥1 year of compliance, and when parents/family are willing to support strict adherence. Hospitalization for ketogenic diet initiation for other indications is considered unproven/not covered (e.g., Alzheimer’s, autism, cancer, migraine, Parkinson’s, type‑2 diabetes, Prader‑Willi weight management, etc.), initiation of the Atkins diet and genetic testing for BAD/KCNJ11/SLC2A1 are experimental/investigational, most plans exclude dietary supplements, and induction hospital stay generally should not exceed 3 days.

"Determination of variants in BAD, KCNJ11, and SLC2A1 to predict response to ketogenic dietary therapies for epilepsy is considered experimental and investigational."