Stem cell treatments are rising in the public conscious, and with that rise in fame comes the wealth of people that could potentially benefit from stem cell therapy. The issue, of course, is that stem cell treatments aren’t fully approved by the FDA, which complicates matters like availability, and also affordability.
If you need to have your healthcare covered by your medical insurance, for example, you may be wondering does Medicare cover stem cell therapy.
Is Stem Cell Therapy Covered by Medicare?
So, does Medicare pay for stem cell therapy? Yes, but only in very limited circumstances. This means if you were hoping to get Medicare approved treatment for things like your chronic pain or arthritis, then you are out of luck. Now, you may be asking yourself what are stem cells if they can tackle issues from chronic pain to cancer. In short, they are the building blocks of cells and can work to help the body rejuvenate in ways it cannot on its own.
Despite its wide variety of uses, there are only two main areas where you can get coverage for stem cell therapy, even on Medicare Advantage plans:
- Bone marrow disorders like aplastic anemia or Sickle cell disease
- Blood cancers like lymphoma or leukemia
When Can I Get Coverage for Stem Cell Therapy from Medicare?
Before you get too excited that the answer to does Medicare pay for stem cell therapy is yes, remember that’s a tentative yes. To get Medicare coverage for stem cell therapy, you need to meet very specific criteria. This means that most won’t be able to get their Medicare to pay for stem cell therapy.
Original Medicare
Original Medicare (Parts A and B) does offer some coverage for stem cell therapy. To start with, coverage usually only covers hematopoietic stem cell transplants. It is incredibly unlikely that true embryonic stem cell treatments will ever be offered, but induced (meaning adult stem cells are genetically reprogrammed) may be.
The good news is that if you are getting Medicare approved stem cell therapy for a pre-approved use, then you should be able to get both the hospital inpatient (Part A) and outpatient (Part B) covered.
Medicare Advantage Plans
If you have this type of insurance, then you will be covered for everything included in the original type of Medicare, as well as potential additional benefits, depending on your condition.
What Medicare Does Not Cover
The reason why the answer to is stem cell therapy covered by Medicare is usually no is because it will not cover any experimental or even investigational treatments. This includes if you are part of a study trial. If you want to get treated for anything that isn’t a bone marrow disease or blood cancer, then you will need to pay out of pocket.
Is Stem Cell Therapy Covered by Any Other Insurance?
While you may be a bit disappointed in the answer of does Medicare pay for stem cell therapy, the simple fact is that it’s not widely covered by any insurance plan. This is because FDA approved uses for stem cell therapy are currently very limited, and until more clinical trials are held to corroborate findings, insurance companies won’t cover the cost. This doesn’t mean it’s impossible to have your treatment covered, or that you have no other avenue to consider.
What You Can Do If You Still Want to Try Stem Cell Therapy
While the answer to “is stem cell therapy covered by Medicare” is usually no unless it’s blood cancer or bone marrow related, that doesn’t mean that you are out of options until more clinical trials are conducted.
It simply means that you’ll need to split up the stem cell therapy cost with a payment plan. Since you will be paying out of pocket, however, it is important to check in advance that you and your condition are a good fit for this treatment. To do that, you’ll need to follow these steps:
Understand the Different Types of Stem Cell Treatments
When it comes to choosing stem cell treatments, it’s important to understand that there are different types of stem cells.
After Birth Stem Cells
This is the most common type of stem cell treatment, and it used by the best clinics today. In essence, these stem cells are taken either from the umbilical cord blood, or alternatively from the Wharton’s Jelly which surrounds the umbilical cord.
At Bioxcellerator, not only are the patients who donated their umbilical cords tested, but the cells themselves are also tested. This is to provide patients with the safest treatment, with the highest possibility of success.
Adult Stem Cells
Adult stem cells can also be used, though to less effect. The good news, however, is that it isn’t just stem cells taken from bone marrow (this is officially referred to as allogeneic hematopoietic stem cell transplantation (HSCT)) that are used nowadays. This is because we can now genetically reprogram adult cells, from blood, skin or bone marrow, to their pluripotent state. This means we can essentially reprogram cells so they become embryonic cells, without harming any embryos.
The difference between embryonic stem cells and adult stem cells can be a bit confusing, so we’ve put together a full ‘what are stem cell injections’ guide to help you come to grasp with just what stem cells are, and how they can be used to help you with your healthcare condition.
Explore Stem Cell Clinics
You need to be very careful when choosing stem cell clinics. This is because there are many centers that say they use stem cells but don’t have the necessary facilities to actually offer this treatment. That’s why it’s critical you opt for a specialized center like ours. Not only do we offer the highest quality of stem cells for our treatments, but we also have the facilities to properly process and check these stem cells for quality as well. See the locations we cover, and get in touch with your nearest clinic to learn more.
Consider Payment Plans
It is important to note, if your insurance won’t cover your treatment, then you can pay for stem cell therapy in installments. This makes the treatment option far more accessible, allowing those the option to invest in this treatment option for issues as ranging as chronic pain to spinal cord injuries.
We hope we’ve helped you answer the question does Medicare cover stem cell therapy. Do reach out if you have any questions.
