Is Stem Cell Therapy Covered by Insurance

One of the most common questions we’re asked regarding stem cell therapy and platelet rich plasma (PRP) is whether or not these procedures are covered by insurance. As new medical techniques develop over time, all aspects of modern medicine need to be adaptable to changing methods, and insurance providers are no exception. The healing potential of stem cells are among the most exciting areas currently developing within medicine, both in the orthopedic field and beyond, with orthopedic stem cell treatments having shown impressive healing results time and time again! However there are also plenty of other areas of medicine where the capabilities of stem cells are very much in their earlier stages of development, and in turn, that much farther away from the regulatory approval that is often required for a service to be covered by medical insurance. Much of the challenge moving forward lies in determining what new medical technologies, and particularly what types of stem cell treatments, can and will become prominent treatment options for the foreseeable future.

Unfortunately the stem cell therapy treatments that we offer here at South Valley OrthoMed are not currently billable to any known insurance providers. However at an out-of-pocket price of $1,950, South Valley OrthoMed offers orthopedic stem cell therapy treatment at one of the best overall values found anywhere!

But why isn’t it covered?

Orthopedic stem cell therapy is currently categorized as FDA Cleared, however as was mentioned earlier, stem cells are being used in many different areas of medicine. Plenty of these treatments are still very experimental, with results not replicated often enough to truly be considered as viable treatment options. As a result, it appears to be the case that insurance providers are waiting until there’s a much better understanding of all of it, before they’ll be covering any of it. In other words, with so many new medical technologies developing over time, differentiating between what has true long-term viability and what might just be a passing fad is an important distinction that insurance providers will want to make.

I spoke to my insurance and they said it is covered!

Several times here at our clinic, we’ve encountered a misunderstanding where certain insurance provider representatives have told prospective patients that stem cell therapy would be covered under their plan. This unfortunately is not the case. This miscommunication refers to a type of bone marrow/stem cell transplant for treatments related to conditions such as leukemia, Hodgkin’s Disease, and others. These treatments do not go into areas such as orthopedic use, and despite the miscommunication that has appeared to happen on several occasions, orthopedic treatments with stem cells are still indeed not yet covered under insurance.

Moving forward:

It’s impossible to say when orthopedic stem cell injections might be covered under insurance. With ongoing clinical testing and almost countless success stories, it seems like an inevitability down the road, we just don’t know how long that road will be. Considering the drastically reduced cost of stem cell therapy in relation to an alternative and more traditional treatment like knee replacement surgery, one would think stem cell therapy is something the insurance providers SHOULD be in a rush to cover. With lower cost procedures the can yield significantly better results than traditional treatments, one has to think it will happen sooner rather than later.

Stem Cells for “Bone-on-Bone” Knee Joints

For many people, knee pain becomes an unfortunate reality of day-to-day life. With continued aging comes the continued wear and tear of the joints absorbing the majority of the impact from literally every step we take. For some, the deterioration of a knee joint can start at a young age, often jump-started by traumatic injury of some kind or another. For others, knee issues may develop later on in life, due simply to the amount of mileage put onto the joints. Regardless of timetable, there tends to be one particular diagnosis of a person’s knee that is often both overused and misinterpreted…

“My knee is bone-on-bone.”

It’s a frustrating outlook to have to face when the structure that’s held the knee together for a person’s whole life, has worn down to have very little of that structure remaining. But the outlook usually is never as grim as people may think, or are led to believe. In offering free consultations for stem cell therapy here in our clinic, we’ve seen countless people come through our doors under the impression that their knees were bone-on-bone, and that all hope was gone for avoiding something like total knee replacement surgery. And in years past, that absence of hope may have been perfectly valid. However, with the development and progression of orthopedic stem cell therapy in recent years, patients suffering from osteoarthritis have more hope for non-surgical recovery than ever before!

If there’s one common trend that we’ve come to notice here in our clinic, it’s that the “bone-on-bone” diagnosis of a knee, tends to be drastically overused. Oftentimes, it seems that this diagnosis is given to any knee suffering from a noticeable deterioration of cartilage. While the cartilage may no longer be in tip-top shape, A true bone-on-bone status of a joint is representative of the severity of stage 4 osteoarthritis. Among patients we see who fear their knee joint is bone-on-bone, only a small percentage are truly into this most severe stage of arthritis when examined under X-ray. The vast majority of patients would properly be classified as either stage 3, or even stage 2 arthritis, which brings with it a very promising outlook with regards to stem cell therapy.

Even at the point of stage 3 osteoarthritis, the vast majority of patients stand a very high chance of significant improvement from stem cell therapy. When compared to total knee replacement surgery, stem cell therapy can often provide the additional perks of avoiding a major operation, drastically shorter recovery time, and better overall results. And when it comes to out-of-pocket costs, stem cell therapy can also often provide a much more cost-effective option compared to knee replacement surgery.

As is the case with treating any joint with stem cells, the first step will be to visit South Valley OrthoMed for a free consultation. We want to evaluate each potential patient on a one-on-one basis, to make the most responsible recommendation possible regarding their candidacy for stem cell therapy. Even though the aches and pains of persistent joint pain can make a situation seem hopeless, the outlook almost always tends to be better than most patients anticipate before coming in to see us!

Am I Too Old For Stem Cell Therapy?

“Am I too old for stem cells to work on me?”

This is definitely one of the most common questions we hear regarding stem cell therapy, and really, it’s not hard to see where people are coming from with this inquiry. The effects of aging have a funny way of changing our perspectives on the concepts of pain and healing. We all remember our younger years when aches and pains just simply got better, and often in a short amount of time. Unfortunately, we have much more fresh memories of aches and pains that linger for much longer stretches of time, sometimes even long enough to force changes in the way we live our lives.

Alleviating those aches and pains, and oftentimes overcoming more traumatic injuries, is the very goal of stem cell therapy. And believe it or not, age has little to do with whether or not it will be effective in achieving those goals.

During our younger years, a major factor in why injuries more rapidly heal is due to the body naturally producing stem cells at a higher rate than our older selves. But that doesn’t mean stem cells aren’t still present in the body and continually producing as we age. More importantly though, when a concentrated amount of stem cells are introduced into a damaged area, as they are during stem cell therapy treatments, they begin working to heal and rebuild damaged tissue, regardless of age. Stem cells adapt to their surroundings, essentially following the original programming of the human body’s composition. Age-discrimination is essentially a non-factor in the effectiveness of stem cell therapy, as even in older patients, that construction crew of cells is able to go to work on repairing the structure of damaged or arthritic joints.

Looking toward the future, stem cell therapy appears to be at the forefront of a regenerative medicine revolution. Whether patients are battling the physical limitations of a traumatic injury, or simply the aches and pains of worn-down joints that comes with old age, stem cells are offering patients a new beacon of hope for recovery. Many patients experience significantly better results and pain relief from stem cell therapy than they otherwise might have with the traditional treatments and/or surgeries of yesteryear. Along with that, stem cell therapy is often much less costly, has shorter recovery times, and a procedure that only takes roughly one hour to perform.

If you’d like to learn more about how stem cell therapy can help you break free from things such as joint pain and arthritis, don’t hesitate to call and schedule your free consultation at South Valley OrthoMed.

Baseball’s First Great Hope in Stem Cell Therapy

Angels starting pitcher Garrett Richards. (Otto Greule Jr. / Getty Images )

One of the most intriguing storylines going into the 2017 Major League Baseball season was that of Los Angeles Angels pitcher Garrett Richards and stem cell therapy. Richards, who suffered a torn ulnar collateral ligament of his pitching elbow in 2016, shocked the baseball world by opting out of Tommy John surgery, which has long been the traditional treatment for such an injury. Richards instead chose to try stem cell therapy as his avenue toward healing, and eventually back to the pitcher’s mound. With a potentially much shorter recovery time, as well as less potential for side-effects that can come with Tommy John surgery, the baseball world has been eagerly awaiting the long-term results of Richards’ return to action.

On April 5, just days into the 2017 season, Richards made his first start for the Angels. And early on, things were looking awfully promising for each one of Richards, his team, and the healing power of stem cell therapy. Unfortunately, the waiting game reared its head once again, as Richards was forced to exit the game early with an irritated nerve in the bicep muscle of his pitching arm. While the previously damaged ligament was still intact, this new injury put the Angels pitcher back on the disabled list.

Though the sample size from his return is still small, Richards finished the game pitching 4 and 2/3rd innings, allowing just three hits, one walk, no runs, and striking out four batters. His fastball velocity was also on par with his performance prior to the torn UCL that sidelined him in the first place. Now, the waiting game still lingers onward. Much of the medical community remains eager to see how well a joint that undergoes as much stress as the elbow of a major league starting pitcher can ultimately recover as a result of stem cell therapy.

Here in Utah, there’s also a sense of hometown pride for someone that grew into the major-league player that he is today with multiple stops here in the Beehive State. Drafted by the Angels in 2009, Richards made his professional baseball debut with the Orem Owlz that same year. Fast forward several years to 2012, and Richards had elevated himself among the top 100 prospects in all of baseball. That same season, Richards took his final step toward the big leagues just a handful of miles North from his first steps, making 14 starts for the Salt Lake Bees before getting the call to Los Angeles for good. Having made multiple stops with multiple local minor league teams, it’s no wonder why baseball fans in Utah are also hoping that stem cell therapy can deliver the regenerative results that Richards and his doctors have hoped. With the continually developing technology of stem cell therapy, a success story like the one that appears to be in the works with one of Utah’s former minor-leaguers could serve as a valuable benchmark to the staggering potential of this treatment.

Richards currently is on the verge of returning to the pitcher’s mound following the setback from his bicep injury in April. The team hopes he can add a valuable boost to its pitching rotation for the final stretch of the regular season in September. But maybe more importantly, a true, long-term recovery from Richards will offer added faith in the healing potential of stem cell therapy from here in Utah, all the way to the rest of the baseball world.