What insurance companies cover stem cell therapy

A common question I hear from readers of The Niche is some version of, “Is stem cell therapy covered by insurance?” Sometimes they also ask about Medicare coverage.

To be clear, I’m talking about unproven stem cell “therapies” here. The type clinics sell. It’s not FDA approved so generally insurance companies and Medicare will not cover it.

By contrast, insurance does generally cover bone marrow and hematopoietic stem cell transplantation. These are proven methods that have saved tens or hundreds of thousands of lives.

Is stem cell therapy covered by insurance?

Unfortunately the fact that insurance does not provide any coverage often leads people to take extreme financial measures.

These steps can include fundraising from family, friends, their  church, or on sites like GoFundMe.

Do some employers cover stem cell therapies at clinics?

The Regenexx brand seems to have made a big deal out of how some employers contribute towards the costs of their clinic offerings. I’m not so clear on where that stands today in 2022, but it doesn’t seem super common to me.

Does Medicare cover stem cell therapy?

Medicare will also generally cover the cost of established bone marrow transplantation type therapies. However, it does not cover stem cells of the type sold by clinics.

Why doesn’t Medicare or insurance cover stem cell therapy from clinics?

The basic answer is that the injections sold by clinics are considered experimental and unproven.

In short, they often probably do not work. Some of them are not safe either.

Medicare does cover proven stem cell therapies that are FDA approved such as bone marrow transplantation.

Claims about stem cell therapy covered by insurance

Most stem cell clinics admit that insurance doesn’t cover their offerings. However, I found some examples where clinics seem to claim insurance does cover their offerings.

A Regenexx firm called Stem Cell Arts suggests possible insurance coverage on their website. They say, “StemCell ARTS participates in numerous insurances, health plans and provider networks.” Then they list more than 20 insurers.

Kaiser? United Healthcare? AIG and Aetna? The list goes on.

In general I couldn’t find evidence on the web of these insurers covering PRP or bone marrow cell treatments at clinics.

There is another clinic site claiming they accept some of these insurers.

I think what might be going on here is that certain insurers do cover the consultation or just a general office visit with Regenexx clinics. Not necessarily the stem cells or PRP that they sell. I’m going to dig more into this to try to clarify things.

When will insurance cover stem cell therapy?

Since insurance generally will not cover stem cell clinic offerings, when might that happen?

I don’t predict that’s not going to happen any time soon. The clinics just don’t generally have the data needed to get FDA approval and most aren’t even doing clinical trials to get to that point.

Alternatively, the FDA could really loosen its standards. For instance, it could define some specific offering such as unmodified autologous MSCs to not be drugs. Even though, I don’t see insurers suddenly covering such therapies. There still just won’t be the data to make them accepted standards of care.

Stem cell therapy cost since insurance generally won’t pay

To sum up, for the question, “Is stem cell therapy covered by insurance?” the answer is nearly 100% “no” when we are talking about stem cell clinic offerings. I mean the actual stem cell or PRP procedures that are common.

There may be rare exceptions. What this means is that if you go to a for-profit clinic and get stem cells or some other supposed regenerative therapy, you’ll have to pay big bucks. See my post on stem cell therapy cost.

December 14th, 2021

In the case of stem cell therapy, it’s a very simple reason why it isn’t covered by insurance yet: Stem cell therapy is not insured because of the lack of awareness there is about it. There are stem cell transplants from blood, bone marrow, umbilical cord, mesenchymal tissue, embryos, amongst others, there are allogeneic and autologous transplants, there are stem cell transplants that are done intrathecally, through IV or local applications. Every one of these types of stem cell transplants has its own process, properties, purpose and can be used for different conditions. Having so many variables and so little awareness about them can create misconceptions about the risks and effectiveness of stem cell therapy if generalized. For example, a common misconception is that stem cell transplants from embryos can create cancer or have harmful side effects and although this is true, it doesn’t mean bone marrow or mesenchymal stem cell transplants have these side effects.

In the US stem cell therapy is very limited by the FDA, the procedures cover a very narrow list of autoimmune, degenerative diseases and muscular injuries, and since it’s rigorously limited there are restrictions that prevent the manipulation of stem cells making it impossible to improve the therapy to achieve better results.

In Mexico, stem cell therapy is approved and providers that are regulated work under high medical standards and although it’s not covered by American insurance the difference is in the quality of the therapy since it’s perfectly legal to manipulate stem cells to attend directly to the patient’s condition.

Stem Cell Therapy and Insurance

In America, healthcare is a complicated subject compared to other countries where healthcare is a right and is accessible for the most part of the population. Americans often find themselves getting the treatments they can get with the help of their insurance, which is not really ideal because sometimes the treatment they need isn't covered by their insurance.

Procedures like chemotherapy end up being somewhat free but at what cost? Most traditional treatments for autoimmune and degenerative diseases are really aggressive and have severe consequences on the body in their way to stopping or slowing down the deterioration of the main disease. Secondary effects can lead to the degeneration of other organs in the process risking the overall health of the patient.

It’s really common for people to think that some procedures are insured because of their success rate, which is not an accurate assumption. Let’s take chemotherapy again for an example, chemotherapy’s success rate has been controversial for the last few years, some say there’s only 2% or 3% of the people who undergo chemotherapy that has been cured. This kind of statement can be alarming but it’s important to be aware that in any kind of treatment or therapy it’s almost impossible to generalize about the results and to have some kind of complete guarantee. The result of treatments and therapies depend on the condition of the patient, the deterioration, past treatments and their secondary effects, amongst others. So when people ask about the success rate of ANY kind of therapy, the percentage often will depend on the variables of the study such as delimitations, the sample of people that participate in the study, and more. So insurance companies can’t really base solely on success rate to cover treatment.

Giostar Mexico is continuously looking to provide our patients with resources and options to receive stem cell therapy at the best stem cell clinic in Mexico. We are happy to announce that, through United Medical Credit, our patients (exclusive for US patients) may now receive up to $25,000.00 USD in credit for their treatment (note: price for therapy varies depending on the condition to be treated and a number of stem cells (vials) included).

Why choose Giostar Mexico?

Here at Giostar Mexico, we provide personalized stem cell therapy. This means we understand although you may have the same disease as another person, variables such as your health, condition, lifestyle, nutrition, deterioration, side effects of previous treatments are considered when our medical team designs your protocol for therapy. The stem cells go under a specially designed process by Dr. Anand, the pioneer in the regenerative medicine field and Co-Founder of GIOSTAR, in which they are extracted, selected, cleared, programmed, cultivated, and inserted into the body, ensuring the best results possible. The stem cell therapy you get at GIOSTAR Mexico is backed up by the research protocols developed at the University of California San Diego Medical College (UCSD), University of California Irvine Medical College (UCI), Salk Research Institute, San Diego, Burnham Institute For Medical Research, San Diego, University of California Los Angeles Medical College (UCLA).

What is Stem Cell Therapy?

Stem cell therapy is a procedure in the regenerative medicine field. Regenerative medicine's ultimate goal is that our body regenerate itself. What stem cell therapy does in your body is slowing down or stopping the suffered deterioration and it can even regenerate tissue. That is why we ask patients to fill out a health form, so our medical staff may first identify if stem cell therapy is actually an option for them and the medical team knows the specifics of your health condition.

If you want to find out if you're a candidate for stem cell therapy, you can fill out this contact form and we will give you a call or email you as soon as possible! Or contact us directly on our US landline 619-866-6000.