Is stem cell therapy covered by insurance? Usually not. Insurers, including Blue Cross Blue Shield and Medicare, generally cover stem cell transplants for blood cancers and some blood disorders. They treat mesenchymal stem cell therapy for joints, the spine and most other conditions as investigational. That means they don’t pay for it. Most patients pay out of pocket, often with financing.
A new treatment can look like the answer when you live with an ongoing injury or illness. That doesn’t mean your insurance will pay for it. This guide covers what Blue Cross Blue Shield, Medicare and other insurers say. It also explains the covered exceptions and how patients pay instead.
What Is Stem Cell Therapy?
Stem cell therapy uses living stem cells to help the body calm inflammation and repair damaged tissue. Whether your health insurance covers it depends on two things: the type of cells used and the condition being treated.
At BioXcellerator, we use mesenchymal stem cells (MSCs) from the Wharton’s jelly of donated umbilical cords. These cells carry low levels of the surface proteins that trigger rejection, so the body is more likely to accept them. You can get these treatments legally. However, they are not FDA approved for orthopedic or most other uses. That is the main reason insurers don’t cover them.
Does Blue Cross Blue Shield Cover Stem Cell Therapy?
For most uses, no. Blue Cross Blue Shield plans cover stem cell transplants for blood and bone marrow diseases such as leukemia. These transplants use the patient’s own cells or cells from a donor.
Mesenchymal stem cell therapy is a different story. The Blue Cross Blue Shield Federal Employee Program’s medical policy 8.01.52 says “mesenchymal stem cell therapy is considered investigational for all orthopedic applications.” The same policy says investigational treatments are not covered. Each Blue Cross Blue Shield company publishes its own medical policies, so check yours. Still, expect a denial for knee, hip, spine or other joint treatment.
Does Medicare Cover Stem Cell Therapy?
Only for certain transplants. Medicare says Part A and Part B “may cover stem cell transplants”, under certain conditions. Mesenchymal stem cell therapy for joints or chronic pain is not a transplant. It also isn’t FDA approved for those uses, so don’t count on Medicare to pay for it. Check with Medicare or your Medicare Advantage plan before you book anything.
Stem Cell Therapy Insurance Coverage From Other Insurers
Most private insurers publish medical policies like the one above. Most classify mesenchymal stem cell therapy for musculoskeletal problems as investigational or experimental. To see where your plan stands, search your insurer’s medical policy library for “stem cell.” You can also call the number on your insurance card and ask which policy applies to your condition.
What Insurance Does Cover
Two kinds of stem cell treatment are the most likely to be covered. The first is a stem cell (bone marrow) transplant for blood cancers and some blood disorders. The second is a cell therapy the FDA has approved for a specific use.
That second group is still small. In December 2024, the FDA approved Ryoncil, which it called “the first FDA-approved MSC therapy.” It treats children with steroid-refractory acute graft-versus-host disease, a complication of transplants. It shows the usual path to coverage: an approval for one condition, backed by clinical trials.
When Will Stem Cell Therapy Be Covered by Insurance?
There’s no date. Insurers follow FDA approvals and large clinical trials, and each condition needs its own evidence. Those trials take years. For some conditions, results take up to a year to show, and patients have to be followed long after treatment.
Until then, stem cell treatment for conditions like arthritis, chronic pain or spine problems will be paid out of pocket.
How Patients Pay for Stem Cell Therapy Instead
Most patients combine more than one of these:
- Self-pay. At BioXcellerator, treatment starts from $18,500 and most patients pay $20,000 to $30,000. Our guide on how much stem cell therapy costs explains what changes the price.
- Financing. Payment plans let you spread the cost instead of paying it all at once.
- HSA or FSA funds. The rules depend on your plan and on IRS guidance, so ask your plan administrator before you book.
- Clinical trials. Some trials provide treatment at no cost to participants. You can search for one on ClinicalTrials.gov.
To see what you get for the price, read is stem cell therapy expensive?
Questions to Ask Your Insurer
Before you count on coverage, call your insurer and ask:
- Is mesenchymal stem cell therapy covered for my condition?
- Which medical policy applies, and what is its number?
- Does my plan cover treatment received outside the United States?
- Can I use my HSA or FSA for treatment that insurance doesn’t cover?
Frequently Asked Questions
Does Insurance Cover Stem Cell Injections for Knees?
Rarely. Insurers generally classify stem cell injections for knee arthritis and other joint problems as investigational. Most patients pay for them themselves.
Does BioXcellerator Accept Insurance?
No. Treatment is self-pay and generally not covered by insurance, and financing is available. After a free candidacy review, your Patient Advocate walks you through the cost and payment options. You can also call 1-888-567-2469.
