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Insurance and Stem Cell Therapy: Why Isn’t It Covered?

13 Apr 2016
| Under COPD, FAQs | Posted by | 39 Comments
Insurance and Stem Cell Therapy: Why Isn’t It Covered?

It’s an understandable question, so let’s get right to the point.

From chronic obstructive pulmonary disease (COPD) to cancer, new forms of treatment are being discovered every day for the diseases we endure. However, the distance between discovery and being fully covered by HMOs can be vast. Although the benefits of an emerging treatment may be readily apparent through its use and further research, often, the delay between widespread application and coverage can simply be time.

So How Do Emerging Treatments Get Covered?

For your peace of mind, the Lung Institute is here to breakdown and provide a simple answer to a complex question regarding Insurance and Stem Cell Therapy: Why Isn’t It Covered?

Overview

Insurance and Stem Cell Therapy: Why Isn’t It Covered?

To begin, there are forms of stem cell therapy that are currently covered by traditional insurance companies. These treatments typically include bone marrow transplants for diseases of the blood such as leukemia. Although the practice of using stem cell treatments- such as bone marrow transplants- has been in use since the 1970s, as the understanding of stem cells has continued to develop, so too has its use in addressing other diseases.

As the field of stem cell therapy continues to progress, it has led to advancements in treating multiple sclerosis, heart disease, blindness, rheumatoid arthritis and even baldness.  As each new application of stem cell therapy is discovered, it begins its own unique development process.

General Timeline

Insurance and Stem Cell Therapy: Why Isn’t It Covered?

  • After scientific research has led to a new method of treatment being discovered, the first step within its development is animal testing.
  • Once scientists are confident the effects can be controlled and replicated in humans, clinical trials are begun.
  • After human clinical trials are conducted and approved for use, the treatment can be used in general medical practice.
  • As the emerging treatment begins to see widespread use and appeal, various medical associations and agencies will examine the treatment, deciding whether or not it should be included within the standardized treatment regimen of the disease.
    • For example, in lung disease, the general regimen followed by physicians and pulmonologists is to prescribe an inhaler, medication, oxygen therapy, and ultimately a lung transplant, depending on the stage and severity of the disease.
  • When an emerging treatment is added to a standardized treatment regimen, it is given a Current Procedural Terminology (CPT) code by the American Medical Association (AMA).
  • This code is meant to facilitate communication between medical specialists and insurers, and typically leads national social insurance programs such as Medicare and Medicaid to eventually cover treatment.
  • Once the emerging treatment is accepted for coverage by Medicare and Medicaid, coverage by traditional HMO’s is generally soon to follow.

What This Means for the Future

Insurance and Stem Cell Therapy: Why Isn’t It Covered?

Although the process for an emerging treatment to be covered by traditional insurance companies can take time, the use of stem cell therapy- in the treatment of lung disease- has made tremendous strides in recent years. With every passing year, the benefits of stem cell therapy are felt by a greater number of patients, and as stem cell research continues to develop, a future where stem cell therapy is fully covered may be here sooner than expected.

Time can be a factor in any decision, so if you’re looking to take control of your health, don’t wait. If you or a loved one suffers from COPD or another lung disease, the Lung Institute may be able to help with a variety of stem cell treatment options. Contact us at (800) 729-3065 today to find out if you qualify for stem cell therapy.

Still need more details on Insurance and Stem Cell Therapy: Why Isn’t It Covered? Share your thoughts and comments below.

39 Comments

  1. Cameron Kennerly

    1 month ago

    Hello Robert,

    First and foremost we’d like to thank you for your question, unfortunately, however, it just isn’t possible for us to give you an accurate measure of longevity in life with COPD. There is a litany of factors such as stage, medical history, and environmental and genetic factors that can have a profound effect on disease progression. With that said, we’d like to invite you to give us a call at (855) 313-1149 to speak with one of our patient coordinators for more information on your condition, and what steps may be available to you moving forward.

    Thanks again Robert and we look forward to hearing from you.

    Best,

    The Lung Institute

  2. robert amaral

    1 month ago

    but how long does it take for copd to cause death

  3. Pingback: Interstitial Lung Disease: What is ICD-10? | Lung Institute

  4. PB

    4 months ago

    Dear Richard,

    Unfortunately, at this time, insurance companies and Medicare don’t cover treatment. However, we’re hopeful that treatment will be covered by insurance companies and Medicare in the near future. Keep in mind that it will take some time before the insurance companies see a financial benefit in their favor and then decide to cover it. In the meantime, you can learn more about stem cell treatment options and have your questions answered by one of our patient coordinators. Feel free to contact us at (855) 313-1149 for more information. We look forward to hearing from you soon.

    Best Regards,

    The Lung Institute

  5. Richard Charron

    4 months ago

    I have Medicare in addition to supplemental insurance (not an HMO). Is there a possibility this will be covered. I have an appointment in two weeks for follow-up with my pulmonologist after an MRI this week. I have had extended tests for heart disease and it appears that the problem is in the lungs. I’m hoping to have some type of diagnosis in the coming weeks but maybe I’m being to optimistic.

  6. PB

    6 months ago

    Dear Pauline,

    Thanks for your comment. The Lung Institute does not have a clinic location in Spring Hill, FL. However, we do have a clinic in Tampa, FL. If you have questions regarding stem cell treatment at the Lung Institute, we would be happy to answer them. So, feel free to contact us at (855) 313-1149. We wish you and your husband the best.

    Kind Regards,

    The Lung Institute

  7. Pauline Shaver

    6 months ago

    My husband just signed up for the procedure in Spring Hill, Florida. He has COPD and 76 years old, not able to do anythingexcept sit. We expect him to improve enough that he will be able to breathe better and begin to enjoy our retirement — no fun to be retired and not able to breathe — we are both tied down!
    Don’t worry about the cost. Check it out first — you might be pleasantly surprised!

  8. PB

    6 months ago

    Dear JayJay,

    Thanks for your questions. Having an autoimmune disease, such as HIV, is not a disqualifying factor. However, it’s important for the patient to stay up-to-date on his or her routine blood work and checkups with his or her doctor. We only use the patient’s own stem cells (autologous stem cells) in our treatments. To speak one-on-one with one of our patient coordinators and to have your questions answered regarding stem cells, treatment options, cost and candidacy, call us today at (855) 313-1149. We look forward to hearing from you soon.

    Kind Regards,

    The Lung Institute

  9. JayJay Kenny

    6 months ago

    As stem cells are extracted from the patient his or herself, would an autoimmune disease such as HIV disqualify the person from this tx?
    Are there ever any instances of a family member being a marrow donor if found to be a match ?

  10. Cameron Kennerly

    6 months ago

    Hello Peggy,

    First and foremost we’d like to say “thank you” for your questions, and we’ll try to be as direct as possible with our answers. To start, stem cell therapy cannot cure COPD. COPD has no known cure and currently traditional treatment options can only address the disease symptoms rather than the disease itself. Stem cell therapy, on the other hand works to address the disease’s progression rather than simply the disease symptoms. In response to your second question, COPD is a fatal disease, and if left untreated, symptoms will begin to compound causing various complications and ultimately death. As stem cell therapy works to slow the progression of COPD and its symptoms, quality of life is improved and symptoms are reduced, leading to a mitigated progression of the disease.

    In short, stem cell therapy is the process of collecting specialized cells from the blood or bone marrow–that essentially act as the body’s building blocks–and then reintroducing these cells into the body where they become trapped in the lungs and promote healing and reduce inflammation. Stem cell therapy however, does not repair lung tissue, rather it promotes the natural healing process within the body. In response to your final question, stem cell therapy is a procedure that can be repeated at the patient’s discretion for an increased or elongated effect.

    We hope this has been clear and please feel free to contact us again with more questions.

    Best,

    -The Lung Institute

  11. Peggy

    6 months ago

    Hello, no where in your literature do you answer a basic question (s).

    Does Stem Cell therapy:
    1) Cure COPD?
    2) Prolong a person’s life?

    Please tell me in detail what Exactly stem cell therapy doesumes@rayvenitsolutions.com?

    You mention it can repair lunge tissue, but to what extent?

    Also someone asked, (but I could not find an answer), does stem cell therapy happen once? Are there follow therapy needed?

    And PLEASE, don’t give vague answers, or recommend I call.

    Peggy

  12. Pingback: Insurance and Stem Cell Therapy: Why Isn’t It Covered? |

  13. Cameron Kennerly

    7 months ago

    Hello Brenda,

    First, we’d like to extend our deepest condolences to you for the loss of your friend. Although we are unaware of the practice which performed the treatment on your friend, we can assure you that the Lung Institute is separate and distinct in its efficacy and safety. Though we cannot speak on our exact cost of treatment over this channel, we can assure you that our cost of treatment is fractions of the cost your friend experienced. However for more detailed information please feel free to reach out to us at (855) 313-1149 to speak with one of our qualified patient coordinators.

    Thanks for your feedback and we look forward to hearing from you,

    -The Lung Institute

  14. Brenda Shaw

    7 months ago

    I had a close friend have stem cell rejenerations treatment and it cost him $85,000.00 out of his pocket. He died two weeks later and they still don’t know what happened.

  15. Cameron Kennerly

    7 months ago

    Hello Traci,

    First and foremost we’d like to thank you for your feedback. Due to the complex and personal nature of treatment qualification, unfortunately we cannot give the cost of treatment over the internet as costs vary by disease, current stage, and medical history. However, we can assure you that when you call, any and all questions regarding treatment and what it could mean for your father will be answered in a quick and efficient manner. Please give us a call today at (855) 313-1149 and we’d love to go through any questions and concerns that come to mind.

    We look forward to speaking with you,

    -The Lung Institute

  16. Traci Wicker

    7 months ago

    The only way to get a price is to call I am just asking for info before I ask my dad to consider this

  17. PB

    7 months ago

    Dear Sherrie,

    Thanks for your questions. We recommend speaking with your patient coordinator to discuss your questions. Feel free to contact us at (855) 313-1149, and we would be happy to help you.

    Best Regards,

    The Lung Institute

  18. Sherrie Lynn Plemons

    7 months ago

    do you have to take follow up treatments with the stem cell treatment for COPD or any other injections after you leave Dallas?

  19. PB

    7 months ago

    Dear Marilyn,

    Thanks for your comment and question. Because treatment cost varies depending on treatment type, it’s best to speak one-on-one with one of our patient coordinators to discuss your questions. They have a wealth of knowledge about stem cell therapy, treatment and cost, and they would be happy to answer your questions today. Feel free to contact us at (855) 313-1149, and we look forward to hearing from you soon.

    Best Regards,

    The Lung Institute

  20. Marilyn Webner

    7 months ago

    Before I delve into this therapy any further, and after going through all the pertinent info on this site, please give me some idea of the range of costs for stem cell treatment. I don’t need a sales pitch at this point, only more info on potential cost. Thank you.

  21. Cameron Kennerly

    8 months ago

    Hello Roger,

    To start, we’d like to let you know that we understand you and your frustrations 100 percent. The lack of insurance coverage can be difficult for anyone to navigate when seeking treatment, and simultaneously, it makes our jobs more difficult in our desire to bring treatment to those who suffer from chronic lung disease. What is comforting to us and what we hope will be to you, is that many pulmonary physicians are excited about stem cell therapy. Although stem cells are new and exciting within the medical field, many doctors remain wary of getting their hopes up too soon, and often, despite the positive results and testimony of their patients, they’re still waiting for more data and research to come out before siding with popular opinion.

    We are doing everything in our power to promote our research, our patient’s success, and to reach out to physicians directly about the effectiveness of stem cell therapy as an option for treating lung disease. Unfortunately, the process takes time. The discovery of autologous stem cells has been nothing short of revolutionary, and traditional practices are still catching up. We understand that time is a critical factor in the lives of our potential patients, and that drives us to work harder.

    Roger–we’d like to thank you so much for your feedback and honesty in addressing your concerns and frustrations, and without question we want to reaffirm that you are an integral member of our society, and we thank you for your service.

    If you have any more questions, please feel free to contact us at (855) 313-1149 and we’d be happy to speak with you.

    Keep in touch, Roger.

    -The Lung Institute

  22. Roger

    8 months ago

    I have to share a couple thoughts after reading the comments.

    First: I consider myself to be an average middle aged male. I have served my country for many years in the military and then served my community and surrounding communities as both a paramedic and a volunteer fireman also for several years. No doubt I was exposed to materials that lead to my lung problems. I don’t expect any special acknowledgement nor treatment but when I see other people who also suffer from lung problems that have worked hard their entire lives and because they aren’t wealthy have to settle for treatments that are essentially the fast track to death….I get really upset! If it isn’t the cheapest option for the insurance companies one has to accept that fast track to death. I have been reading about a couple other treatments that are being use for reversing lung damage and like Stem Cell they aren’t covered by insurance.

    Second: Can it be that the average person doesn’t stand a chance due to the pharmaceutical companies controlling everything to include the FDA? There are so many cures for a number of ailments but yet you and I won’t see them unless we really dig deep and then we are faced with the very same issue……since the FDA is controlled by big pharma you won’t see any of these generally inexpensive effective treatments approved. Politicians aren’t allowed to take kickbacks so why in the world can doctors get golf clubs, vacations and other forms of kickbacks to prescribe medications that have a laundry list of potential side effects…….REALLY!

    I don’t begrudge any business for making a profit. My goodness, it’s the American Way! Lung Institute why wouldn’t you be doing everything in your power to get this approved. Those that develop new medications have to get everything pushed through and approved by the FDA. If you have something that really works get it approved and don’t dangle a carrot in front of people who have no chance in being able to afford to get healthy.

  23. PB

    8 months ago

    Dear Christine,

    Thanks for your comment. The Lung Institute’s aim is to help people with chronic lung diseases feel better. We have done research and continue to do research to make sure the patient receives the best quality of care. We have published a White Paper with our latest findings. For more information about stem cell treatment options and about our study, please feel free to contact us at (855) 313-1149. We look forward to hearing from you soon.

    Best Regards,

    The Lung Institute

  24. Christine Voght

    8 months ago

    its funny you say it works but my Doctor say its not legitimate

  25. PB

    8 months ago

    Dear Dev,

    Thanks for your comment and question. The Lung Institute is not conducting clinical trials, which would involve a control group who receives a placebo. The Lung Institute does not and will not ever give a placebo to their patients receiving stem cell therapy. However, we are providing stem cell therapy under the regulation of the IRB for the protection of our patients while we’re collecting research data for further knowledge and to better help our patients. If you have any other questions regarding stem cell therapy, we would be happy to answer them one-on-one over the phone. Feel free to contact us at (855) 313-1149.

    Best Regards,

    The Lung Institute

  26. PB

    8 months ago

    Hello Eleanor,

    Thanks for your comment. Even though, unfortunately, stem cell therapy for people with COPD and other chronic lung diseases is not yet covered by insurance, we’re hopeful that it will be in the future. However, the process can take some time before insurance companies see a financial benefit in their favor. In the meantime, you can learn more about stem cell treatment options and have your questions answered by calling us at (855) 313-1149. We would be happy to answer your questions and look forward to hearing from you soon.

    Best Regards,

    The Lung Institute

  27. Louise

    8 months ago

    Hello-
    I see a lot of reference to damage to lungs caused by smoking, but I don’t see any reference to damage done by diacetyl or other toxins-even leaf particulate matter is known to be just as hazardous to the lungs as asbestos.
    Sincerely,
    Louise

  28. dev

    8 months ago

    If you are in your clinical trials stage, why do patient have to pay to participate in your studies? Don’t researchers usually pay patients to participate in studies and not charge them to get insurance companies to recognize your progress.

  29. Eleanor

    8 months ago

    I find it very hard and insulting that medicare will not cover stem cell for people with COPD but will cover it for someone with a vanity problem because they are losing their hair. What is more important, baldness or breathing?

  30. Cameron Kennerly

    8 months ago

    Hello Gary,

    Thanks for your question! After our recent Dallas opening earlier this month, we haven’t yet set our next expansion schedule for the rest of 2016. However, if you live in the Southern California area, we do offer clinics in Scottsdale, Arizona, as well as Dallas, Texas. We really appreciate your feedback though, and will take your comment under consideration when planning our next expansion! Feel free to call us at (855) 313-1149 if you have any more questions!

    We look forward to hearing from you Gary,

    -The Lung Institute

  31. Gary Ingraham

    8 months ago

    When are you coming to So. Cal.

  32. Richard Furie Soles

    8 months ago

    The information is good for those who wish to understand the process for the payment towards a treatment… by using a CPT code number which includes blood transfusions, it could be addressed to people who have COPD…cause the sequence and tools, instruments, and the teams who perform this are all numbers that the insurance companies know…hopefully very soon it will be ready for so many…

  33. Cameron Kennerly

    8 months ago

    Hello Joe,

    Although we completely understand your frustration (believe us, this question comes up often), for issues of medical privacy we unfortunately cannot give the cost of treatment out over the internet. When it comes to factoring the cost of treatment, many factors are taken into consideration; factors that are specific to the health and current stage of the patient. In response to your request for a range for the cost of treatment, although this is an understandable request, the cost of treatment varies so widely that it would simply be disingenuous to the unique, person-specific health factors that determine treatment. However we urge you to give us a call at (855) 313-1149 to speak with one of our qualified patient coordinators. We can assure you that if you choose to call, you will receive the answers you are looking for without taking too much of your time.

    We look forward to hearing from you,

    -The Lung Institute

  34. joe jack

    8 months ago

    Why do you avoid the cost question, there has to be a range of prices.Give us a ballpark price from day one admittance to hospital or clinic to release, I we understand there are follow up cost as well.
    Joe Jack

  35. Lee kicklighter

    8 months ago

    The final answer from you is, it’s not covered by insurance. So, for me,On SSDI, I can’t afford this cutting edge treatment. Even though the collection of stem cells and the redistribution of stem cells to the patient remains the same as done in the 70’s. Because of the “discovery ” of it’s many uses, the cost is prohibitive for people without large bank accounts. The science is not new. It’s time that, we the sick poor people, stand up to those who want profit only.

  36. PB

    8 months ago

    Dear Francis,

    Thank you for your comment. The Lung Institute treats patients with chronic lung diseases using stem cells from the patient’s own body. Because treatment cost varies depending on treatment type, it’s best to speak one-on-one with one of our patient coordinators. They have a wealth of knowledge about stem cells, treatment and cost, and they are happy to answer any questions you have. Feel free to contact us today by calling (855) 313-1149. We look forward to hearing from you soon.

    Best Regards,

    The Lung Institute

  37. francis griffin

    8 months ago

    is there any studies going on that need patients now? because im on ss and cant afford any medical, and ive had copd for 8yrs and am in stage 3. how much is stem cell treatments?

  38. Cameron Kennerly

    8 months ago

    Hello Jane,

    Thank you for your comment Jane! Unfortunately at this point in the emerging treatment process, stem cell therapy (for the treatment of lung disease) is not yet covered by traditional HMOs. However, please feel free to contact us at (855) 313-1149 to speak with one of our qualified patient coordinators today. They should be able to answer any and all questions regarding the cost of treatment and what stem cell therapy could mean for your quality of life moving forward.

    We look forward to hearing from you Jane,

    -The Lung Institute

  39. Jane

    8 months ago

    How much do the treatments cost? Do insurance companies cover any part of this?

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* All treatments performed at Lung Institute utilize autologous stem cells, meaning those derived from a patient's own body. No fetal or embryonic stem cells are utilized in Lung Institute's procedures. Lung Institute aims to improve patients' quality of life and help them breathe easier through the use of autologous stem cell therapy. To learn more about how stem cells work for lung disease, click here.

All claims made regarding the efficacy of Lung Institute's treatments as they pertain to pulmonary conditions are based solely on anecdotal support collected by Lung Institute. Individual conditions, treatment and outcomes may vary and are not necessarily indicative of future results. Testimonial participation is voluntary. Lung Institute does not pay for or script patient testimonials.

Under current FDA guidelines and regulations 1271.10 and 1271.15, the Lung Institute complies with all necessary requirements for operation. Any individual who accesses Lung Institute's website for information is encouraged to speak with his or her primary physician for treatment suggestions and conclusive evidence. All information on this site should be used for educational and informational use only.