Is Stem Cell Therapy covered in Health Insurance?

Will Your Health Insurance Coverage Include Stem Cell Therapy Cost? 

Stem cells are unprocessed materials from which all the other cells with specific functions are generated. Stem cells are also called master cells of the body that generates into bone cells, blood cells, brain cells, etc. With the help of these cells, many diseases and medical conditions are treated.

What are Stem Cells?

Stem cells are primarily found in the bone marrow. Blood cells from the soft bone marrow are generated, matured, and released into the bloodstream.

Stem cells are found mainly in two sources like embryos and adult body tissues. in other body organs like the brain, blood, bone marrow, muscle, skin, heart, and liver tissues. These cells are quiescent until required to regenerate the damaged tissue.

Types of stem cell therapy.

• Some of the various types of stem cell therapy are mentioned below:
• Autologous Stem Cell Therapy: This is where stem cells are taken from a patient himself.
• Allogenic Stem Cell Therapy: Using the patient's stem cells from a donor.
• Cord Blood Stem Cell Therapy Using stem cells extracted from the cord blood.
• Each might also have different connotations as far as the treatment efficacy and insurance coverage are concerned.

Do I get coverage for Stem Cell Therapy?

 Whenever a person is unexpectedly admitted to the hospital for Stem Cell Therapy, finds it difficult to pay the medical charges. To pull them up from that situation purchasing a policy from a right Health Insurance Company is recommended.

Almost all Star Health Insurance Policies provide coverage for Stem Cell Therapy provided it is indicated based on evidence based medicine and is recommended by the treating doctor.

Among them, Star Health Premier Insurance Policy and Star Family Health Optima Insurance Policy are discussed here as they pay keen attention to modern treatments, including Stem Cell Therapy.
 

Factors Influencing Insurance Benefits

Policy Differences: Health insurance benefits for treatment through stem cell therapy can differ for each policy. 

State-Level Legislation: Some states have required insurance companies to cover experimental treatments such as stem cell therapy.

Pre-existing Conditions: In many cases, people with pre-existing conditions may be subjected to an even more intense screening to qualify for benefits.

Documentation and Approval

In most cases, obtaining health insurance for stem cell therapy involves extensive paperwork. The patient may have to present:

• Medical history
• Records of other forms of treatments
• A letter of medical necessity from a medical doctor

Pre-treatment might also depend on the approval of a provider for insurance coverage prior to commencing with the therapy.

Out-of-Pocket Costs

Average Costs of Stem Cell Therapy

On average, treatments involving stem cells in India can cost between ₹15 lakhs ₹25 lakhs, depending on the type of transplant. For example, the cost of an allogeneic stem cell transplant in India can be higher than that of an autologous stem cell transplant. Hidden Costs

In addition to the direct costs, there are also potential hidden costs, including those for:

Follow-up appointments: Regular monitoring and follow-ups may not be covered.

Rehabilitation: There could be a lot of expenses on post-therapy rehabilitation.

Travel expenses: Patients must travel to specialized centres offering such therapy.

Navigating  Health Insurance Coverage

Step To Take

1. Understand Your Policy: Patients should take the time to understand their policy concerning stem cell therapy, including coverage details.
2. Talk to Your Insurer: Direct communication with an insurance representative can answer what is covered and what needs to be done to get approved.
3. Contact Health Providers: Sometimes, a physician trained in stem cell therapy can help you navigate the health insurance process and obtain the necessary paperwork.

Star Health Premier Insurance policy

• People suffering from ailments like red blood cells, white blood cells, platelets, bone marrow, lymph nodes, spleen, anaemia, leukaemia, sickle cell anaemia etc., can get treated with Stem Cell Therapy.
• This coverage includes the pre-hospitalisation and post-hospitalisation expenses.

Family Health Optima Insurance Plan

Stem cell treatment is indicated for haematological malignancies and hence covered under Insurance. Through this policy, the insured person can avail the coverage for Stem Cell Therapy under modern treatment.
 

Sublimit.

The sub-limits of this cover are included for pre- and post-hospitalisation along with the in-patient hospitalisation expenses.

People with cancer, Diabetes, and cardiac disease can utilise some special policies like Star Cancer Care Platinum Insurance Policy, Diabetes Safe Insurance Policy, Star Cardiac Care Insurance Policy, etc. These policies provide cover for Stem Cell Therapy under modern treatment coverage apart from the coverage for these diseases.

As the specified diseases will burn a hole in your pocket with the medical bills, you have to pay the medical expenses out of your savings. By availing such policies your burden of medical expenses for your treatment will be reduced. You can avail cover for Stem Cell Therapy under these policies.

In a Nutshell

Opting for the right policy from the right Health Insurance Company will make you free from medical debts. Visit Star Health website for more details regarding the policy.

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