Is PRP Therapy Covered By Insurance

Dec 10, 2020Blog Post, PRP, PRP Therapy

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Financing Platelet-Rich Plasma Injections: Is PRP Therapy Covered by Insurance?

You may be ready to try out platelet-rich plasma (PRP) therapy if you’ve done your research! For many people, this pioneering therapy offers a natural way to promote healing, eliminate pain, reduce inflammation and restore mobility. One of the big questions that may be on your mind now is financing your PRP treatments. Here’s a quick look at the process for financing PRP treatments:

  • Discuss PRP with your care provider to see if this treatment option is appropriate for you.
  • Figure out if your insurance coves PRP treatments.
  • If it looks like your insurance won’t cover PRP injections, investigate whether there are any special provisions for certain diseases or conditions that will move this procedure into the “covered” category.
  • Explore the benefits of paying out of pocket for PRP injections.

It’s important to know that PRP treatments are much less expensive than options like surgery. The fact that this is an in-office procedure also helps to keep costs lower than many alternatives. What’s more, people who only require one PRP treatment to see results can ultimately spend much less than people who choose long-term therapies that require continual treatments. Let’s take a deeper look at what to know as a patient going into the PRP experience for the first time!

PRP Therapy: An Overview for New Patients

As you may know, PRP has grown in popularity to become a mainstream treatment option following years of use in the world of professional sports. PRP is highly praised among professional competitors due to the fact that it’s a natural, effective treatment option for people pursuing restorative medicine. During a PRP treatment, platelet-rich plasma taken from a patient’s own blood is placed in a centrifuge to create a concentration of platelets. Next, that ultra-potent plasma is then injected at the site of an injury. The concentration that is injected is full of natural growth factors that can speed up the body’s own ability to heal and regenerate tissue. PRP therapy is used to treat a wide variety of conditions and injuries. Here’s a look:

  • Joint pain.
  • Patellar injuries.
  • Shoulder injuries.
  • Knee injuries.
  • Hamstring injuries.
  • Tendon injuries.
  • Elbow injuries.
  • Osteoarthritis.
  • Back pain.
  • Hair loss.

The obvious benefit of PRP therapy is its effectiveness. Both medical experts and patients appreciate the fact that this is such a low-risk therapy. PRP therapy owes its safety to the fact that the patient’s own blood is used during the procedure. As a result, the likelihood of rejection is essentially nonexistent.

Ultimately, every person interested in using PRP therapy must consult with a qualified physician to determine if this is the best treatment route available. It should be said that PRP is commonly used for both “fresh” and lingering injuries. That means that it could be a good topic to bring up with a care provider regardless of how long you’ve been struggling with pain stemming from “slow” healing. Next, let’s explore what cost and coverage may look like when you receive PRP injections.

Is PRP Covered by Insurance?

PRP is increasingly being offered by care providers. In fact, it’s much easier to find a PRP provider today than it was just two to three years ago. The growing availability of PRP treatments is great news for anyone interested in natural, noninvasive treatment options. Coverage for PRP therapy still varies by insurance plan.

You’ll need to speak with your specific insurance provider to determine if this type of treatment is fully or partially covered under your policy. When you visit your healthcare provider, the front-desk staff should be able to review your benefits to let you know if this is a covered procedure under your policy. As of today, most insurance plans don’t cover PRP injections. However, a number of private plans and workers’ compensation plans do cover PRP. PRP is generally not covered by Medicare. However, some patients who meet specific criteria are approved for PRP would-healing treatments.

Why PRP Will Soon Be a Widely Covered Treatment

We are only a short time away from PRP becoming a widely covered treatment option. Insurance companies stand to benefit from covering PRP for many of the same reasons patients stand to benefit from using this treatment. First, PRP is very safe. It is also a much less expensive option than invasive treatments like surgery. PRP has also been shown to speed up healing times. That means that insurance companies will pay less over the lifespan of a treatment path if they encourage the use of PRP. When combined with chiropractic care, PRP can significantly boost healing in a shorter amount of time. Advocacy work is being done every day to help patients enjoy better access to PRP therapy.

Is PRP Worth Paying for When Insurance Won’t Cover It?

First, it’s important to actually confirm what your insurance policy does or doesn’t cover. Don’t assume that PRP isn’t covered for you just because PRP coverage is relatively rare. There may be caveats within your insurance policy that can fast track approval for PRP based on the fact that you meet certain criteria. If you can confirm that PRP will not be covered, it’s then time to analyze the value of this procedure. While it may not feel pleasant to pay out of pocket for PRP, you could actually see bigger savings over time by treating an injury or condition effectively now instead of prolonging your pain and discomfort. An issue that requires multiple treatments over many years will cost you a lot in deductibles even if other treatments are technically covered by your insurance.

There is also the “quality of life” factor to consider when weighing the decision to pay for PRP treatments out of pocket. If you’re living with pain or loss of mobility, paying a few hundred dollars for an injection that will allow you to enjoy regenerative healing will ultimately seem like nothing compared to the benefits! The path to PRP begins by asking your care provide about this therapy.

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