What Insurance Companies Cover PRP Therapy?

Platelet-Rich Plasma Therapy, or PRP, is the newest medical technique. The use of this method in the treatment of chronic pain and other illnesses has demonstrated to have considerable potential. However, the price is high and frequently prohibitive for consumers to pay out of pocket. So, will insurance assist in paying for PRP therapy?

Platelet-rich plasma (PRP) has grown in popularity as a therapeutic option for injuries during the past several years. Tiger Woods, Rafael Nadal, and other well-known athletes have all benefited from PRP treatment for a variety of conditions, including damaged knees and persistent tendon ailments.

PRP procedures had previously been covered by the patient. When you have been diagnosed with lateral epicondylitis, often known as “tennis elbow,” or mild to moderate chronic osteoarthritis of the knee, TRICARE now covers PRP treatments.

What is Platelet-Rich-Plasma (PRP)?

Even though the majority of blood is a liquid (called plasma), some minor solid components are still present (red cells, white cells, and platelets.)

PRP is plasma that has a significantly higher platelet count than regular plasma. There may be a 5–10 times larger (or richer) number of platelets than usual, which in turn increases the concentration of growth factors.

PRP at Perimeter Orthopaedics is covered by TRICARE

One of the most researched areas of musculoskeletal care is orthobiologics. Orthobiologics offers therapeutic options that are frequently less intrusive and more effective than more conventional therapy modalities, albeit not all of their potential applications have yet been identified.

In Most Cases, No, It Won’t

What is covered and what isn’t is handled differently by each insurance company and policy. Therefore, we are unable to generalize whether or not your insurance provider will cover platelet-rich plasma therapy. The majority of the time, the response is no.

Why wouldn’t insurance providers cover such an effective method of therapy? PRP therapy is typically not covered by insurance companies because it is still regarded as experimental. This indicates that the procedure has not yet undergone sufficient research and clinical testing to establish its efficacy for classification as conventional medicine.

Does This Indicate That PRP Therapy Isn’t Successful?

Without a doubt! With PRP Therapy, you can treat a variety of pain disorders. It has also been shown to be beneficial in treating osteoarthritis, muscle strains and injuries, and several ailments of the mouth. Because there are insufficient data on its efficacy for other chronic illnesses, the medical community still views it as “investigational.”

How Can I Reduce the Cost of PRP?

There are several ways to make PRP affordable without going over your spending limit or insurance coverage! All you need to do is know where to go for financial assistance. Personal loans are one option. The use of an HSA account, which enables tax-free savings for any medical expense—including platelet-rich plasma therapy—is an additional choice.

Can I Actually Use HSA Money for PRP Therapy?

You can, indeed! There are a few limitations on the kinds of medical expenses that can be paid for with money from your HSA account. Make sure not to mix up FSA funds with this because that is not the situation.

Therefore, keep in mind that there are options available and that not all of them need emptying your pocket in order to receive the care you need if you’re looking for ways to pay for platelet-rich plasma therapy.

Are you trying to find a PRP therapy provider in Chicago who can assist you find financing options? the Regenerative Stem Cell Institute, then. We provide PRP therapy for a wide range of diseases, and we can work with you to make our treatments affordable.

How Does PRP Work?

Because human plasma contains many chemical components that aid wounded tissue in rebuilding and repairing itself, platelet-rich plasma (PRP) can hasten the body’s natural healing process. PRP therapy is already widely used by medical professionals to treat a variety of soft-tissue injuries, including rotator cuff tears and injured Achilles tendons.

Additionally, active folks who enjoy playing tennis and golf are turning to PRP for relief from common conditions like tendinosis, chronic tendinitis, and golf/tennis elbow. The therapy’s capacity to lessen or perhaps do away with the need for potent pharmaceuticals like opioids and anti-inflammatory drugs is one of its main benefits.

The absence of negative effects with PRP therapy is another benefit. There is no chance of infection or rejection because the patient’s own blood is used in the procedure.

The Cost of PRP Therapy

Of course, costs differ significantly depending on the clinic a person uses and the doctor they see. For the initial PRP injection, consumers should typically budget between $800 and $1,000. The costs are then much more difficult to predict because some people just require a few injections while others require many more. A typical PRP treatment, however, might cost between $5,000 and $8,000 and involve up to 8 injections. Typically, the patient’s treatment regimen is continued until complete recovery.

Insurance and Reimbursement In PRP

It is reasonable to assume that PRP therapy and treatment plans are on the pricey side of things. Most insurance companies offer no coverage at all for it. PRP is viewed as a “pay for service” sort of treatment by clinics that provide it. Insurance companies reluctance to pay for the treatment, at least for the time being, is primarily due to insufficient testing. Experts in medical insurance reimbursement believe that PRP is still in the experimental stages of proving its effectiveness.

Currently, anyone choosing PRP therapy will be responsible for covering the entire cost out of their own money.

The therapy will probably continue to be a fee-for-service procedure until more studies can be done and PRP can have the scientific backing required for full insurance reimbursement.

How to Obtain Insurance Coverage for PRP Injection

Many PRP researchers think there is strong opposition to the therapy among the medical and surgical communities. PRP therapies have the potential to replace a variety of surgical procedures.

Medical practitioners who support PRP and have personally experienced its efficacy are working hard to have PRP covered by insurance companies.

To put it mildly, this work is challenging. To promote PRP more widely, researchers and proponents are employing a four-pronged strategy.

Advocates for PRP are actively striving to

  • Compile scientific findings that show PRP’s effectiveness
  • Compile enormous amounts of information from medical professionals that utilize PRP treatments on a daily basis and comprehend how beneficial they may be for those who use them.
  • Motivate institutions to conduct additional PRP research
  • Produce cost comparison charts that are in-depth and clearly demonstrate how much less expensive PRP is than the surgical procedures it can replace.


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