Does Medicare Cover Stem Cell Injections, Therapies and Treatments?
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.
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, 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 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 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 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 your medical procedure is approved, then your Medigap plan pays its share.
It’s that simple.
FAQ
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 “Compare Plans” button on this page to explore Medigap plan options in your area.
Michael Quinn is a seasoned Medicare insurance expert and licensed agent dedicated to simplifying the complexities of healthcare coverage. With over a decade of experience, he is a trusted advisor known for his compassionate guidance and commitment to empowering individuals. As the Cofounder of REMEDIGAP in 2013, Michael offers unbiased resources and personalized support to assist clients in making informed decisions.
His expertise has been recognized on reputable platforms such as USA Today and Nerdwallet, solidifying his reputation as a reliable and knowledgeable industry leader. With a Master's Degree in Communicative Disorders, Michael combines strong communication skills with a genuine passion for positively impacting lives through tailored insurance solutions.
Joann Quinn is the Chief Compliance Officer and Cofounder of REMEDIGAP. She is a licensed Medicare agent in 47 states. Her main role is to provide essential resources and tools to educate eligible individuals on Medicare. Joann provides helpful Medicare education to thousands of viewers with our popular REMEDIGAP YouTube channel. With expertise in Medicare Supplement, Medicare Advantage, and Medicare Part D, Joann is a highly knowledgeable and sought after Medicare insurance professional.
Written by Michael Quinn
Licensed Broker, REMEDIGAP Founder
Fact Checked by Joann Quinn
Chief Compliance Officer
As a licensed insurance broker, REMEDIGAP upholds the principles of integrity in our editorial standards and ensures transparency in how we receive compensation from our insurance partners.
