Stem Cell Therapy Costs and Insurance
Written by Stem Cell The Magazine July 31, 2017
One of the most common concerns about stem cell therapy is cost. More patients are becoming interested in testing stem cell therapy but questions about pricing, affordability, and insurance coverage are preventing them from reaching out. We’re seeing incredible advancements in conditions like diabetes, Parkinson’s and joint pain from osteoarthritis but with all the benefits that this non-surgical, non-invasive solution offers, many people still avoid talking seriously with their doctor about stem cell therapy because of myths they’ve heard about the expense of the treatment. It’s a natural concern. Annual premiums, deductibles, and out-of-pocket expenses are steadily rising in this country with no end in sight. Americans spend more per capita for prescription drugs than any other country with a high-income economy, and if you have been battling a chronic condition that has you considering stem cell therapy, you have no doubt felt the sting of these expenses at the pharmacy. No patient should have to choose between expensive medical procedures and chronic pain, and far more can be at risk if you rule out stem cell therapy as an option for your treatment. In many cases, stem cell therapy is the choice that will cost you the least in the long run. When comparing stem cell therapy to surgical procedures like joint replacement, hidden costs and unsatisfactory results drive the real cost of traditional treatment way up. Luckily, most assumptions about the costs of stem cell therapy are untrue and here’s why:
Many medical providers accept insurance for stem cell therapy procedures in conjunction with surgeries. Insurance providers are still behind the mark on contemporary medical treatments, and they still consider standalone stem cell treatments as “experimental.” The exception to this, at this time, comes in the form of clinical trials. Insurance companies will cover patients participating in clinical trials which are experimental by definition with a few conditions. The trial study must be independently reviewed for safety and intent, and the trial must be approved by the Food and Drug Administration. Whether a patient is looking into stem cell therapy trials to treat their COPD or is suffering from chronic joint pain and wants regenerative therapy injections, it’s possible that their provider accepts their major insurance plan.
While most standalone stem cell procedures aren’t covered by major insurance plans, the likelihood of them being accepted in the future is only increasing alongside the growth of the stem cell therapy industry. Clinical trials for stem cell therapy effectiveness on conditions like cerebral palsy, Parkinson’s and spinal paralysis are the light at the end of this long tunnel of stem cell therapy vs. insurance. More often we see grossly positive results in stem cell therapy clinical trials, and the ideas about stem cell therapy being the revolutionary solution the human race has been searching for are becoming less abstract and more concrete. This general rule does not include standardized stem cell therapy procedures such as bone marrow transplants for leukemia patients, which are often covered by insurance providers and Medicaid/Medicare.
Out of pocket costs are cheaper than nearly any surgery. While the cost of stem cell therapy is typically determined on a case-by-case basis – factoring in the severity of a patient’s condition, amount of treatments needed, type of stem cell therapy required, etc. – there are few stem cell therapy procedures that exceed the out of pocket costs of a surgery, even after insurance has cut costs. Hidden costs of traditional treatments continue to widen the gap between the bottom line pricing of stem cell therapy vs. insurance accepted treatments. Many patients don’t factor in things like lost wages due to their condition, modifications to their lives and employment to accommodate living with a chronic disease, changes to quality of life and fluctuating prescription medication costs.
While some patients will require multiple stem cell therapy treatments, those same patients would likely end up requiring multiple surgeries. For example, hip and knee replacement patients are typically satisfied with their results. At least for a while, that is. Unfortunately many hip and knee replacement patients experience continued pain and numerous patients will need continued surgeries to replace faulty implants or damaged parts. Patients regularly choose surgery because of the lower upfront out of pocket cost and insurance coverage compared to the out of pocket expense of stem cell therapy but usually spend twice the amount of the stem cell therapy after surgery as they continue to search for solutions. The reality is that surgeries like joint replacement procedures aren’t the best answer for your joint pain, they are simply the best widely accepted solution. Insurance companies drive this idea by making the ineffective treatment more affordable. Stem cell therapy aims to create a real fix to your issues by healing and repairing the damage. In most cases, because prosthetic joints are not intended to heal, after the agony of surgery and recovery patients experience a marginal decrease in pain and usually turn to stem cell therapy in the end. It’s important to consider the likelihood of revision surgery after a joint prosthetic has been surgically installed as well. Prosthetics can breakdown after five or ten years of use requiring a revision or replacement surgery. When you factor in the increased age of the patient since the first surgery, and the decrease of our healing capability that comes along with age, stem cell therapy is the most cost-effective choice to consider before undergoing the traditional surgery.
Financing options are almost always available. These break out the costs of stem cell therapy into manageable installments that make it easier for a patient to say yes to getting the treatment they need and deserve. More patients are turning to this option to pay for medical costs when insurance coverage is limited. Financing options like CareCredit, Wells Fargo Health Advantage, Capital One Healthcare Financing and Lending Club are bridging the gap between what insurance will pay for and what we need to reach our health goals. These financing options make stem cell therapy a real option for any patient hoping to experience the healing capability of the treatment and they work with almost all credit ratings and income levels.