Stem cell therapy, or regenerative medicine, is an exciting area of medicine that can offer significant benefits for appearance and overall health. Like many medical treatments, particularly newer innovations, the cost is one of the primary concerns that people have. Specifically, many patients want to know if stem cell therapy is covered by insurance, including Medicare.
This helpful guide will give you a clear picture of stem cell therapy, whether insurance carriers will pay for it, and the circumstances for coverage.
What is Stem Cell Therapy?
Stem cell therapy is treatment using stem cells to repair damaged or diseased tissues in the body. Stem cells are cell types that can become other kinds of cells. This includes cells with the ability to regenerate and repair damaged tissue.
There are several sources for stem cells:
- Umbilical cord and cord blood: These cells are harvested from a newborn baby. These cells are typically not related to the patient receiving the treatment.
- Adult stem cells: These cells can come from many tissues, including bone marrow, fat tissue, and the linings of the nose, mouth, or stomach. These are harvested from the person receiving the treatments.
Innovations Medical exclusively uses adult stem cells harvested from a patient’s own fat. The stem cells are then processed and purified before being injected back into the patient’s body. The cells then naturally move to the treatment area and differentiate into the cells needed to replace or repair affected tissue.
Is Stem Cell Therapy Cost Covered by Insurance?
Insurance companies’ coverage of stem cell therapy, or regenerative medicine, can vary depending on several factors, such as the type of stem cell therapy, the specific medical condition being treated, and your insurance coverage. Some types of insurance may cover specific stem cell therapies deemed medically necessary, such as bone marrow transplants. Elective stem cell therapy is generally seen as experimental and not covered by many plans. However, some plans may pay for some portions of the treatment such as IV placement and joint or ligament injections.
It is important to check with your insurance company to determine whether they cover stem cell therapy for your specific medical condition, including the type of therapy you are considering.
Why doesn’t insurance cover stem cell therapy?
Insurance companies may not cover certain types of stem cell therapy that are considered experimental or unproven, as they may not have sufficient evidence to support their effectiveness and safety. In the case of stem cells from fat, safety is well established and numerous studies show effectiveness. However, the best way to process and deliver the cells has not been established, making decisions for insurance coverage difficult.
Insurance companies are also working on ways to standardize stem cell offerings. This is because medical providers are phrasing the services differently and patenting unique processes in stem cell therapy.
When will stem cell therapy be covered by insurance?
Stem cell therapy is a rapidly advancing field, and as procedures become standardized and results are proven in clinical trials, more insurance carriers, including Medicare, will begin to cover procedures.
How to Talk to Your Insurance Provider About Stem Cell Therapy
Contact your insurance provider and inquire about coverage for the specific form of stem cell therapy you are interested in. Currently, most stem cell procedures approved by the FDA and likely to be covered by insurance are hematopoietic stem cell transplants. These are treatments that promote the development of healthy blood cells in people with conditions such as leukemia and sickle cell diseases. Many stem cell procedures from fat and other tissues are considered surgeries. The FDA does not have responsibility for approving surgical procedures. Consequently, stem cell procedures from fat may never be “FDA approved”. Just like other surgeries such as gall bladder removal or appendectomy, the FDA does not regulate these procedures.
As with other procedures, most insurance coverage is based on a deductible and will generally only cover part of the procedure costs after meeting the deductible. It is also important to discuss and understand which associated costs are covered by your plan, such as consultations, facilities, or equipment.
Paying for Stem Cell Therapy
Innovations Stem Cell Center has been performing stem cell treatments in North Texas since 2013 and has performed more than 12,000 treatments. Innovations Medical remains a leader in stem cells harvested from your own fat and was the first provider in Texas to begin performing these exciting procedures.
Our team is committed to making it possible for patients to undergo life-changing stem cell therapy procedures. Particularly for procedures that insurance does not cover, we offer flexible scheduling that enables patients to break up procedures and financing options that can spread treatment costs into affordable installments.
Contact Innovations Medical to Learn More About Stem Cell Therapy
If you want to improve your appearance, manage pain, or recover from illness using the healing power of your own body, Innovations Medical is here for you. Our skilled professionals help you decide which treatment is best for you – keeping you informed and confident in the next steps. We’ve been helping our patients look and feel their best since 2005, and even our most advanced procedures are often minimally invasive.