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Medicare Coverage for Stem Cell Therapy


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 it. In your research below, you’ll learn which services have coverage and which don’t. Also, we’ll go over supplemental Medicare options that can help cover the cost of stem cell treatments.

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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.

Medicare Approved Options:

  • Hematopoietic Stem Cell Transportation
  • Autologous Stem Cell Transplantation

How Much Does Stem Cell Therapy Cost with Medicare?

Stem cell therapy prices usually range from around $5,000 – $50,000. If you receive Stem Cell Therapy in outpatient settings, this will fall under Part B.

Part B covers 80% of the cost, you’re responsible for 20% of the cost. If you receive Stem Cell Therapy in inpatient settings, this will fall under Part A. Part A has a deductible as well as other cost-sharing you’re responsible for.

If you have a Medicare Supplement, the above-mentioned coinsurance would be covered as well as the cost-sharing under Part A. Depending on which Medigap letter plan you enrolled in, you may have zero cost-sharing to pay for Stem Cell Therapy.

Does Medicare Cover Stem Cell Injections?

As long as the injections are FDA approved, Medicare covers treatments.

Stem cell therapy treatment is an inpatient hospital stay. Inpatient therapy for stem cells is 3-4 weeks long. Yet, outpatient stem cell therapy will fall under Part B and have a shorter duration.

Does Medicare Cover 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.

Does Medicare Cover Autologous Stem Cell Transplantation?

Yes, Medicare will cover Autologous Stem Cell Transplantation. Autologous therapy can help treat Acute Leukemia that’s in remission and Advanced Hodgkin’s Disease.

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Do Medicare Advantage Plans Cover Stem Cell Therapy?

Medicare Advantage plans must provide the same coverage as Part A and B. However, they decide how much you’ll pay out of pocket in the form of cost-sharing. Advantage plans also require you to use their in-network doctors.

If you go out of network, you will have to pay 100% of the cost. You will pay more out of pocket if you go with a Medicare Advantage plan instead of Medigap.

Do Medigap Plans Cover Stem Cell Therapy?

When Medicare approves the service, Medigap will always pay. You can take the guesswork out when it comes to predicting your out-of-pocket costs.

When you know what to expect, you can focus on treatment instead of finances. If you are on the fence about which plan to choose, compare the differences between Medicare Advantage vs. Medicare Supplement.

Does Medicare Cover 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.

Does Medicare Cover Stem Cell Therapy for Back Pain?

Medicare won’t cover stem cell therapy for back pain 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.

Does Medicare Cover 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.

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FAQs

Does Medicare Cover Stem Cell Therapy for Arthritis?
Medicare won’t cover stem cell therapy to treat arthritis. Stem cells used for arthritis are not approved by the FDA. You’ll be responsible for the costs. While Medicare doesn’t cover stem cell therapy for arthritis, there are other treatments.
Does Medicare Cover 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.
Will Medicare Cover Stem Cell Transplants for Multiple Myeloma?
Medicare doesn’t cover stem cell transplants for multiple myeloma since it doesn’t have FDA approval.

How to Get Coverage for Stem Cell Therapy Under Medicare

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Jagger Esch

Jagger Esch is the Medicare expert for MedicareFAQ and the founder, president, and CEO of Elite Insurance Partners and MedicareFAQ.com. Since the inception of his first company in 2012, he has been dedicated to helping those eligible for Medicare by providing them with resources to educate themselves on all their Medicare options. He is featured in many publications as well as writes regularly for other expert columns regarding Medicare.

30 thoughts on “Medicare Coverage for Stem Cell Therapy

  1. 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?

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