Is unproven stem cell therapy covered by insurance?

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.

Stem cell therapy covered by insurance?
Does insurance cover stem cell therapy at clinics? Generally, the answer is “no”. What about coverage from employers? That is rare.

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.

2 thoughts on “Is unproven stem cell therapy covered by insurance?”

  1. Hello Dr Paul,
    I’d also add the “It’s a clinical trial” fall-out that happened due to many of the rogue pay-to-treat stem cell clinics and their human experimentation and what happened regarding that. As a re-cap (I know you know this) : Several of these pay-to-treat clinics were offering on the NIH “clinical trials .gov” site their big bucks “treatments”. That further led consumers (desperately ill in most cases) to further believe “Wow, these must be legit treatments, I mean they’re on the NIH site, right ?” – and thus many went into said clinics believing they were part of a “paid and covered clinical trial” only to be receiving big, big bucks cash-n-carry (as you describe above) “treatments” which caused them to borrow, spend their life savings, go into debt, etc. And for what? Nothing essentially, as nearly all will testify said “treatment of cell IV drip or injection” etc did nothing for them (except drain their wallet) and in some cases, they were even gravely harmed. The legal case that brought all this “Use of the NIH clinical trials site as essentially being used as an advertisement site by rogue clinics” was one of the blinded ladies cases as filed (and won in the end) by trial lawyer Andrew Yaffa out of south Florida. He even has a short video blurb posted on his law firm site “Things to be aware of if going to a stem cell clinic” (something like that – but close enough) and in that video clip, he says (paraphrasing) “And as a direct result of some of my legal cases, the NIH site now has a warning stating, That Just Because You Are Here, Does Not Mean This Trial Is Necessarily Vetted and Safe” etc. THAT WARNING added to the NIH site – was a direct result of rogue pay-to-treat stem clinics in FL. The clinic and legal case resulting in said new “NIH site Warning” being the clinic most famous for blinding several innocent victims and Yaffa was attorney on every one of those cases. It ties directly into, IMO, your explanations of why medical insurance companies and/or Medicare etc generally won’t touch this stuff “yet” , and probably not for years to come yet.

    1. There are some good points here.
      A minor thing. I don’t know, however, that Yaffa was directly responsible for the relatively new warning on stem cell-related searches on Others have pushed for changes there too. For instance, I pushed to warn patients.

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