Stem cell injections and therapies have been extremely successful at helping people with a variety of chronic illnesses. We’ve recently begun to receive questions regarding: Does Medicare Cover Stem Cell Injections? Medicare will cover stem cell injections and therapies only if they’re medically necessary and are approved by the FDA.
Below, you’ll learn which stem cell treatments, injections and therapies can be covered and which ones won’t.
In this article we’ll discuss:
does medicare pay for stem cell therapy?
Currently, the only stem cell therapy that is FDA approved in the U.S. are treatments that involve blood-forming stem cells. Hematopoietic stem cell transplantation and Autologous Stem Cell Transplantation are the only stem cell therapies that are currently approved.
When stem cell injections are covered under Medicare, it will be paid for by Part A or Part B. If your treatment is provided in a hospital inpatient setting, then your treatment will be paid for by your Part A. Treatments will be paid for under Part B if they are provided in an outpatient setting.
- Part A has a deductible that you’re required to meet as well as some cost sharing.
- Part B provides 80% coverage and you’re responsible for the remaining 20%.
average stem cell therapy cost
The average cost of stem cell treatments ranges from less than $5,000 for uncomplicated procedures to over $25,000 or more for complex ones. For Medicare beneficiaries that have a Medigap plan, your cost sharing may be zero depending on the Medicare Supplement plan that you have purchased.
does medicare cover stem cell therapy?
As mentioned above, Hematopoietic Stem Cell treatments as well as Autologous Stem Cell Transplantation are covered when they are deemed medically necessary.
Hematopoietic Stem Cell Treatment
Hematopoietic Stem Cells treatments (also known as HSCT) are covered by Medicare when it is deemed medically necessary. Here are examples of health conditions that may qualify as medically necessary:
- Leukemia
- Myelodysplastic Syndromes
- Wiskott-Aldrich Syndrome
- Severe Combined Immunodeficiency Disease
Autologous Stem Cell Transplantation
Autologous Stem Cell Transplantation can be covered by Medicare for the following medical conditions:
- Recurrent Neuroblastoma
- Acute Leukemia in remission
- Advanced Hodgkin’s Disease
- Resistant Non-Hodgkin’s Lymphomas
does medicare cover stem cell injections?
Stem Cell injections are currently not covered by Medicare to help treat the following medical conditions:
- Stroke
- Multiple Sclerosis
- Rotator Cuff tears
- Parkinson's Disease
- Arthritis of the knee
- Arthritis of the hip
- Arthritis of the spine
- Degeneration of the spine
- Meniscus & Ligament tears
Will My Medigap Plan Cover Stem Cell Injections?
Medigap coverage is pretty straightforward. If Medicare approves your medical procedure, then your Medigap plan pays its share.
It’s that simple.
FAQ
does medicare cover stem cell therapy for knees?
Unfortunately, Medicare currently doesn't cover stem cell therapy for knees. Stem cell injections for knee pain and osteoarthritis is not FDA approved at this time. Out of pocket costs for this treatment ranges from approximately $3,000 – $6,000 per knee.
does medicare cover stem cell therapy for COPD?
Currently, Medicare will not pay for stem cell therapy in order to treat COPD.
Does Medicare Cover Stem Cell Therapy for Back Pain?
Stem cell injections for back pain are not covered by Medicare as they are not approved by the FDA.
is PRP covered by medicare?
Platelet-rich plasma (PRP) injections are not covered by Medicare at this time. PRP is designed to help stimulate the healing of soft tissue and bone in the knee joint.
Do you have questions about your coverage options? You can contact REMEDIGAP and speak with an independent licensed insurance agent. Use the “BOOK YOUR APPOINTMENT” button on this page below to schedule a time. Or use the “SEE PLANS” button on this page to explore Medigap plan options in your area.
