Intervertebral Disc Prostheses

Aetna covers specified FDA‑approved cervical artificial discs (Bryan, M6‑C, MOBI‑C, Prestige/Prestige LP, PCM, ProDisc‑C variants, Secure‑C, Simplify) for single‑level C3–C7 disease and MOBI‑C/Prestige LP/Simplify for two contiguous cervical levels, while lumbar discs are covered only for a single FDA‑approved level (L3‑4, L4‑5, or L5‑S1) in patients aged 18–60; cervical >2 contiguous levels and lumbar discs for other indications are considered experimental/investigational. Key requirements: clinical signs of neural compression with corresponding imaging (nerve root/spinal cord compression or moderate-to-severe stenosis), no segmental instability, ADL limitation, and failure of conservative care (cervical ≥6 weeks; lumbar ≥6 months including ≥3 months of supervised in‑person PT in the past year); additional contiguous disc placement or adjacent fusion is allowed if criteria are met.

"Aetna considers the following Food and Drug Administration (FDA)-approved prosthetic intervertebral discs medically necessary for the treatment of skeletally mature persons with symptomatic cervica..."