Regenexx insurance

Regenexx insurance refers to coverage or reimbursement for Regenexx procedures, which are proprietary orthobiologic treatments using stem cells and platelet-rich plasma for orthopedic conditions. Most major US insurers, including UnitedHealthcare and Aetna, classify Regenexx as experimental and do not cover it as of 2024.

Some self-funded employer health plans–such as those at Des Moines Public Schools and Lee County Government–specifically include Regenexx benefits for employees. Medicare does not reimburse any Regenexx procedure according to the Centers for Medicare & Medicaid Services (CMS) guidelines published in 2023.

Out-of-pocket costs for Regenexx treatments average $5,000–$8,000 per joint based on clinic-reported pricing data from 2022. Patients can use Health Savings Accounts (HSAs) or Flexible Spending Accounts (FSAs) to pay for Regenexx if their plan administrator approves the expense under IRS Code Section 213(d).

Preauthorization requirements vary; some employer-sponsored plans require medical necessity documentation before approving Regenexx claims. Denials by commercial insurers often cite lack of FDA approval or insufficient clinical evidence supporting efficacy compared with standard care such as corticosteroid injections or surgery.

Appeals processes exist but rarely succeed unless supported by strong physician letters and peer-reviewed studies demonstrating individual patient benefit, as described by YourInsurance.info.