ORIGINAL MEDICARE
Medicare coverage for stem cell therapy will only apply to services that the FDA approves. Further, treatment must be medically necessary for Medicare to cover.
In your research below, you’ll learn which services have coverage and which don’t. Also, we’ll go over supplemental options that can help cover the cost of stem cell treatments.
Does Medicare Cover Stem Cell Therapy
Medicare covers a portion of several types of stem cell therapies. But therapy must be medically necessary and the procedure must have FDA approval.
Part A will help cover inpatient costs while Part B will cover a portion of outpatient costs. The only treatments approved are those consisting of blood-forming stem cells.
Some of the most common therapies that Medicare covers are:
- Hematopoietic Stem Cell Transportation
- Autologous Stem Cell Transplantation
Hematopoietic Stem Cell Transplantation
Medicare partially covers Hematopoietic Stem Cell Transplantation. But, coverage only applies to those with specific conditions.
Some of these conditions are Leukemia and Severe Combined Immunodeficiency Disease.
Autologous Stem Cell Transplantation
Another stem cell therapy that Medicare will cover is Autologous Stem Cell Transplantation.
Autologous therapy can help treat Acute Leukemia that’s in remission and Advanced Hodgkin’s Disease.
Medicare Advantage Policies and Stem Cell Therapy
Advantage plans must provide the same coverage as Part A and B. Yet, Advantage plans require you use in-network doctors.
If you go out of network, you’ll have high costs. Advantage plans vary by county, you’ll want to compare plans to see if a policy in your area covers stem cell therapy.
But, it’s possible that none of the plans cover stem cell therapy. So, if there are no plans in your area, don’t be surprised.
Since Medigap covers all claims that Medicare approves, we suggest those policies the most.
Will My Medicare Supplement Plan Cover Stem Cell Therapy
When Medicare approves the service, Medigap pays it’s portion too. You can take the guesswork out by enrolling in Medigap.
When you know what to expect, you can focus on treatment instead of finances. If you’re on the fence about which plan to choose, compare the differences between Advantage and Medigap.
Medicare Coverage for Stem Cell Treatments
Stem Cell Therapy for Knees
It makes sense that people look for alternatives to knee replacements. Many suffer from osteoarthritis in their knees and look for solutions to help with the pain.
Medicare won’t cover stem cell therapy for knees because it doesn’t have FDA approval. You’d have to pay for this treatment.
The average cost for stem cell therapy of your knees is about $3,000 – $5,000 per knee.
Stem Cell Therapy for Back Pain
Medicare won’t cover stem cell therapy for back pain. So, Medicare won’t cover since there’s no FDA approval.
Costs for stem cell treatments for back pain are around $5,000 to $7,000. But, Medicare does cover other back pain treatments.
Stem Cell Injections for Shoulders
Like other forms of stem cell therapy, the use within your shoulders doesn’t have FDA approval. Medicare won’t cover stem cell injections for shoulders.
Further, shoulder injections can range in price from $1,500 – $10,000.
Stem Cell Therapy for Arthritis
Medicare won’t cover stem cell therapy to treat arthritis. Stem cells used for arthritis are not approved with the FDA.
You’ll be responsible for the costs. While Medicare doesn’t cover stem cell therapy for arthritis, there are other treatments.
Stem Cell Therapy for Chronic Obstructive Pulmonary Disease
Stem cell therapy for COPD can range from $10,000 – $35,000. Medicare won’t cover this type of therapy because there is no FDA approval.
Sure, Medicare doesn’t cover stem cell therapy for COPD, but there are other options for coverage.
Medicare and Stem Cell Therapy FAQ’S
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How do I sign the petition my doctor has recommended a knee replacement within the next year
Hi Frank! You can sign the petition here!
Hi, my name is Faith. I’m diagnosed with OA of the left hip. I have Medicare and Medicaid. I’m also diagnosed with multiple sclerosis, over 20 years. Will this stem research be beneficial to my left hip if approved?
Hi Faith! That’s something you would have to speak to your primary physician about. I hope it’s beneficial for you!
Medicare should absolutely pay for stem cell therapy. Aferall, stem cell therapy is less invasive to our bodies and the recovery time is faster. Any ideas on what we can do to get SCT covered by Medicare?
Hi Wanda! Yes, you can sign this petition to get CMS to cover all Stem Cell therapy treatments!
So Medicare will Pay the bills for having both of my knee icompletely replaced at tens of thousands of dollars expense but they won’t cover eight hundred dollars For PRP injection into my knee that could heal them.
Yes they should cover stem cells because there are so many people out there that would benefit greatly from this, & many lives saved.
Yes, the FDA needs to approve these types therapies. There are so many alternatives to help people, PEMF therapy, cold laser treatments, stem cell therapy. These therapies would greatly enhance quality of life for many patients, not to mention greatly reduce opioid use. We need to start somewhere and offer help and education for those suffering with pain and/or illness. I hope for you, Donna, that it happens soon.
Why does Medicare not pay for stem cell therapy for the lungs? It would improve my life so much.