Does Medicare Cover Stem Cell Therapy for Cancer?

Yes, Medicare covers FDA-approved stem cell therapy for certain cancers, including lymphoma and leukemia. The two approved therapies are HSCT and AuSCT. Medicare may also cover stem cell therapy through eligible clinical trials for other cancer types.

Does Medicare Cover Stem Cell Therapy for Knees or Hips?

No. The FDA has not approved stem cell therapy for knee or hip conditions. Because Medicare only covers FDA-approved treatments, stem cell therapy for joints is not covered. Medicare does cover [knee replacements](/faqs/does-medicare-cover-knee-replacement) and hip replacements when medically necessary.

Does Medicare Cover Autologous Stem Cell Transplants?

Yes. Medicare covers Autologous Stem Cell Transplantation (AuSCT) for conditions such as acute leukemia in remission and advanced Hodgkin's Disease, as well as to replenish stem cells destroyed during cancer treatment.

How Much Does Stem Cell Therapy Cost with Medicare?

With Original Medicare, you pay the Part A deductible ($1,632 in 2024) for inpatient transplants and 20% of outpatient costs. A [Medigap Plan G](/faqs/medicare-supplement-plan-g) can reduce your share to just the annual Part B deductible ($240 in 2024).

Does Medicare Cover Stem Cell Therapy for COPD?

No. Stem cell therapy for COPD is not FDA-approved and is not covered by Medicare. Costs can range from $10,000 to $35,000 and the procedures may carry significant health risks.

Can Medicare Cover Stem Cell Therapy through a Clinical Trial?

Yes. If you qualify for an eligible clinical trial that meets CMS criteria, Medicare may cover the routine costs associated with the trial, including stem cell therapy. Ask your oncologist about available clinical trials.

Does Medicare Advantage Cover Stem Cell Therapy?

Yes. Medicare Advantage plans must cover the same services as Original Medicare, including FDA-approved stem cell therapies. Prior authorization is typically required. Contact your plan before treatment.

Does Medicare Cover Stem Cell Therapy for Cancer?

Yes, Medicare covers FDA-approved stem cell therapy for certain cancers, including lymphoma and leukemia. The two approved therapies are HSCT and AuSCT. Medicare may also cover stem cell therapy through eligible clinical trials for other cancer types.

Does Medicare Cover Stem Cell Therapy for Knees or Hips?

No. The FDA has not approved stem cell therapy for knee or hip conditions. Because Medicare only covers FDA-approved treatments, stem cell therapy for joints is not covered. Medicare does cover [knee replacements](/faqs/does-medicare-cover-knee-replacement) and hip replacements when medically necessary.

Does Medicare Cover Autologous Stem Cell Transplants?

Yes. Medicare covers Autologous Stem Cell Transplantation (AuSCT) for conditions such as acute leukemia in remission and advanced Hodgkin's Disease, as well as to replenish stem cells destroyed during cancer treatment.

How Much Does Stem Cell Therapy Cost with Medicare?

With Original Medicare, you pay the Part A deductible ($1,632 in 2024) for inpatient transplants and 20% of outpatient costs. A [Medigap Plan G](/faqs/medicare-supplement-plan-g) can reduce your share to just the annual Part B deductible ($240 in 2024).

Does Medicare Cover Stem Cell Therapy for COPD?

No. Stem cell therapy for COPD is not FDA-approved and is not covered by Medicare. Costs can range from $10,000 to $35,000 and the procedures may carry significant health risks.

Can Medicare Cover Stem Cell Therapy through a Clinical Trial?

Yes. If you qualify for an eligible clinical trial that meets CMS criteria, Medicare may cover the routine costs associated with the trial, including stem cell therapy. Ask your oncologist about available clinical trials.

Does Medicare Advantage Cover Stem Cell Therapy?

Yes. Medicare Advantage plans must cover the same services as Original Medicare, including FDA-approved stem cell therapies. Prior authorization is typically required. Contact your plan before treatment.

Does Medicare Cover Stem Cell Therapy?

Quick Answer

Part A: CoveredPart B: Some PlansMedicare Advantage: CoveredMedigap: Covered

Medicare covers stem cell therapy only when it is FDA-approved and deemed medically necessary. The two approved therapies are Hematopoietic Stem Cell Transplantation (HSCT) and Autologous Stem Cell Transplantation (AuSCT), primarily for certain cancers and blood disorders. Stem cell therapy for knees, hips, back pain, arthritis, COPD, or cosmetic purposes is **not covered** because the FDA has not approved these applications.

Coverage Comparison by Plan Type

Plan Type	Coverage	Notes
Original Medicare (Part A)	Covered - inpatient transplant	Covers inpatient stem cell transplant hospital stay after Part A deductible
Original Medicare (Part B)	Partial - outpatient only	Covers outpatient stem cell therapy sessions at 80% after Part B deductible
Medicare Advantage	Covered - same as A+B	Must cover same FDA-approved therapies as Original Medicare; prior auth required
Medigap (Plan G)	Covered - cost-sharing	Covers Part A/B deductibles and coinsurance; reduces your cost to near $0

Understanding Your Coverage Options

Original Medicare (Parts a & B)

Covered - HSCT and AuSCT for qualifying conditions

Covered - FDA-approved therapies only

Medicare Part A covers inpatient stem cell transplants during a hospital stay. The transplant process - which can last 3 to 4 weeks as an inpatient - is covered after you meet the Part A deductible ($1,632 in 2024). Part A also covers any skilled nursing facility care needed after discharge.

Medicare Part B covers outpatient stem cell therapy sessions. You pay 20% of the Medicare-approved amount after meeting the Part B deductible ($240 in 2024). Given the high cost of stem cell treatments ($5,000–$50,000+), this 20% can be substantial.

The critical requirement is FDA approval. Medicare only covers stem cell therapies approved by the FDA - specifically HSCT and AuSCT for certain cancers, blood disorders, and immune system conditions. Any non-FDA-approved therapy will be denied.

What It Covers

Hematopoietic Stem Cell Transplantation (HSCT) for certain cancers and blood disorders
Autologous Stem Cell Transplantation (AuSCT) for qualifying cancer conditions
Inpatient hospital stay during the transplant process
Outpatient follow-up sessions covered under Part B
FDA-approved stem cell therapy through eligible clinical trials

What It Doesn't Cover

Stem cell therapy for knees, hips, or joint pain (not FDA-approved)
Stem cell therapy for COPD, back pain, or arthritis (not FDA-approved)
Cosmetic or regenerative stem cell therapies
Non-FDA-approved experimental applications

Stem cell therapy costs range from $5,000 to $50,000+. With Original Medicare only, you pay 20% of outpatient costs and the Part A deductible for inpatient stays.

Clinical Trials May Expand Coverage

Medicare may also cover FDA-approved stem cell therapy through eligible clinical trials. Ask your oncologist if you qualify for a covered clinical trial.

Medicare Advantage

Covered - prior authorization required

Covered - same as Original Medicare

Medicare Advantage plans must provide the same coverage as Original Medicare Parts A and B. Therefore, FDA-approved stem cell therapies covered by Original Medicare are also covered by Medicare Advantage plans.

Some Advantage plans may offer additional benefits, but non-FDA-approved stem cell therapies remain excluded regardless of plan type. Prior authorization is commonly required for stem cell transplants under Advantage plans.

Network restrictions may require you to use specific oncology centers or hospitals. Verify that your preferred cancer treatment center is in-network before proceeding.

Cost-sharing varies by plan. Review your Evidence of Coverage for specific stem cell transplant cost details.

Prior Authorization is Almost Always Required

Prior authorization is almost always required for stem cell transplants under Medicare Advantage. Contact your plan immediately after your oncologist recommends treatment.

Medigap (Medicare Supplement)

Covers Part A deductible and Part B coinsurance

Covers your cost-sharing

A Medigap Plan G covers the Part A deductible and the 20% Part B coinsurance for Medicare-approved stem cell therapy. Given the high cost of these treatments, Medigap can save you thousands of dollars.

Medigap covers any service that Original Medicare approves - so if Medicare approves a stem cell therapy, your Medigap plan will cover your share of the cost. This provides significant financial protection for expensive cancer treatments.

If you have a Medicare Advantage plan, you cannot use Medigap. Medigap only supplements Original Medicare (Parts A and B).

With Plan G: pay only the Part B deductible ($240 in 2024). Without Medigap: 20% of all outpatient costs plus the Part A deductible for inpatient stays.

Stem Cell Therapy Coverage by Condition

Condition/Application	FDA Approved?	Medicare Covers?	Estimated Cost Without Coverage
Certain cancers (lymphoma, leukemia)	Yes (HSCT/AuSCT)	Yes	$50,000–$200,000+
Blood/immune disorders	Yes (HSCT)	Yes	$50,000–$150,000+
Knee/hip/joint pain	No	No	$3,000–$10,000 per joint
Back pain	No	No	$5,000–$7,000
COPD	No	No	$10,000–$35,000
Arthritis, neuropathy, shoulders	No	No	$1,500–$10,000

Only FDA-approved stem cell therapies are covered by Medicare. Non-approved therapies are entirely out-of-pocket and may carry legal and safety risks.

✦ Stem Cell Therapies Medicare Does not Cover

Non-FDA-Approved Applications

The vast majority of stem cell therapy applications - including for knees, hips, back pain, arthritis, COPD, neuropathy, and cosmetic purposes - are not FDA-approved and therefore not covered by Medicare. Clinics advertising these treatments may be operating illegally.

Multiple Myeloma

Despite being a blood cancer, stem cell transplants for multiple myeloma do not currently have Medicare coverage because they lack FDA approval for this specific indication.

Regenerative Medicine

Regenerative stem cell therapies (including exosome products) are not FDA-approved and are not covered by Medicare. The FDA has issued consumer alerts warning about unapproved regenerative medicine products.

Experimental Applications

Experimental applications of stem cell therapy, including for COVID-19, epilepsy, and many other conditions, are not FDA-approved and are not covered by Medicare.

✦ Frequently Asked Questions

David Haass

Author

David Haass is the Chief Technology Officer and Co-Founder of Elite Insurance Partners and MedicareFAQ.com. He is a member and regular contributor to Forbes Finance Council.

Ashlee Zareczny

Reviewer

Ashlee Zareczny is a licensed Medicare agent in all 50 states dedicated to educating those eligible for Medicare. She trains agents on CMS compliance guidelines.