Stem cell injections at unproven clinics are expensive and unproven so a lot of patients have asked me if insurance covers stem cell therapy at clinics?
Mostly the answer is “no”, but in rare cases there is some kind of coverage, mainly from employers that have inked some kind of deal with a stem cell clinic firm.
However, overall we just aren’t seeing insurance companies cover stem cell injections by clinics.
Does insurance cover stem cell therapy?
It’s an important question because the average total stem cell injection price tag for an individual customer can easily end up being $10K-$20K or more. The expense adds up in part because the cost per injection (see poll data here) has to be multiplied by the number of injections (see data here) the customer gets over time. Some patients have received one or two dozen injections. Some clinic practitioners also self-treat as well with unproven stem cells.
If insurance won’t cover the expensive, unproven stem cell “treatments” at for-profit clinics, and I don’t blame them since in my view they are generally a big waste of money and are risky, then can the average person afford to pay so much themselves? Often they can’t.
Sadly many clinics are frequently now pushing patients to take out loans or go fundraise online to scrape together money.
Weirdly some clinics falsely claim that their offerings are covered by insurance when really they aren’t, a fact patients will quickly realize if they do a little research.
Do employers cover stem cell therapy?
From what I’ve seen, Regenexx seems to be the main provider of stem cell injections that has gotten some limited coverage okayed, mainly through certain employers. While Regenexx seems compliant with FDA regulations here in the U.S., in my opinion there aren’t rigorous data to prove it works. This new paper for knee arthritis with Regenexx is worth a closer look as it seems at least relatively stronger in design than past studies in this arena even if it wasn’t blinded/lacked placebo control and wasn’t a large study.
Overall, I haven’t seen other stem cell clinics get any kind of real insurance or corporate coverage, although perhaps there are a few buried amongst the ~1000 clinics out there these days. Medicare also does not cover stem cell injections.
Why doesn’t insurance cover stem cell injections? Why doesn’t Medicare? The reason is that the stem cell “therapies” from stem cell clinics are unproven and most often a waste of money.
Proven therapies like bone marrow transplant are covered
To be clear, proven bone marrow transplants/hematopoietic stem cell therapies such as for leukemia, which are established therapies covered by insurance, are a different story.
Note that still experimental uses of bone marrow combined with partial immune ablation for autoimmune disorders including MS have promise, but aren’t yet proven and mostly lack insurance coverage.
Hopefully in the future more FDA compliant stem cell therapies that are rigorously proven safe and effective from strong clinical trials will come onto the market and these are likely to be covered by insurers, reducing burdens on patients and their families.